� N�TICG O1=17�GD RC�Tl�1GTIONS: The.und�rsigneci unc(ers�t�ncis ti�at�tl�is permit may I�e subj�et�:o"doecP'resirlc{ians"
<br /> wi�icii may b�mare r�sl:rictive th�n Co��nfiy r�gulnfiIons. TI�e und�rsign�d �ssumos responsilaiiity•For compiianc�witf� �ny
<br /> �ppiic7Uie cieed resfirictions.
<br /> UNLIC�NS�D CONTf�ACTORS ANi� CONTC�ACTOI�. I�,�SI'ONSIBILITICS: l�f �Lh� own�r h�ts hir�d � cflntracfior or
<br /> , eantraetars�la uncl�rC�Ic�worlc, ii��y m�y he requir�d•to bo 11c�ns�ci in ��cord�nc�uvifili st�t� �tncl loe�( reguia�ions. f�f th�
<br /> cantr�cfor is nofi licens�cl �s r�quir�d !�y l�w, ha�li7 �[he awncr and confir�cCor m�y�U� cited �Far � misdem��nar violation
<br /> under st�fi� i�w. 1�"fhe own�r or in�t�nd�d confr�cLor �r� unc�rfi�in �s fio wh�t licensing r�quir�m�nfis m�y app[y�for fil��
<br /> tntencl�c(worlc,fihey arc aclvis�ci to�confinct fii�� P�sco Couniy Building insp�cLion Divisiorz—Lic�nsing SeGiion a!727-8�7-
<br /> 8oq�J. Ft�rlhermore, i�T fhe owner i�tas I�ireci �t con[racfior, �r confractors, h� is �civis�ci to i��ve tl�e confr�ctor(s} sic�n
<br /> par[ians o�F'the "contr�tci:or I�Iacic" o�f fihis �pp(ic�[ion �Tor which Li��y wiil b� res�onsiUte. .t�i`you, �s �[17� owner s�gn as ti�e
<br /> eontracfar, f1��1 m�y I�c �n inc(ic�i:ion {!»L lie is riot properly lieensed ancl is not �nfii�Eieci �ta p�rmi�(ing privit�ges in naseo
<br /> Cocmty. '
<br /> TRANSI�ORTATtON IMPACTIUTILITI�S tMt�.ACTANb PCSOUI�C�R�COV�RY I=�CS: Th� und�rslgned underslands
<br /> fiha[Tr�nspor[�fiion imnact i=ees �nel RecoL�rso Recovery F��s m�y�pply fio�l�e construciion'o�f new bullclings, cJ7ange a�f
<br /> �3se in �xistinc� buildings, or �xp�nslon a�T�xisting i�uiidings, �s sp�ci�Fi�d in Pasca Caunty Orelinanc� numuer 8�-07 �nd
<br /> 90-07, �s �mendccL T(1� unclGrsic�n�d nlso undcrs�(ancls, �[i»t sucl� •F�es, �s m�y 1�� due, wiii 1»�idenfii(ied �[t1��i:ime o3 .
<br /> ��rmit�inc�. it is �Furti»r unders�(oocl �th��l Trans�art�tlon Imp�ct C'�es �nc! R�source Recov�ry t=�e� must Ge paid priar to
<br /> rec�ivinc� � "c�r[ifiic�f� af occupancy" or�Fina) pow�r rele�see i•f.�[!�e praj�efi cloes no�[ involve � c�rti[icaC� o�f oc�upancy or
<br /> �final �ow�r reiease�, �t���Feos musi: tae pnid prior��o permit issunnc�. Furtl��rir�are, 1�F�'�sco Couni.y Waterl5ewer (m�acfi
<br /> 'fe�s�re clue,fl�ey must b�paid prior�[a ��rmit Issu�nce in accorcianc�wifl� n�piicnbi� P�sco Coun�y ordin�nces.
<br /> GC?i�lST[�.UCTION LI�N LI�W(CI����lei•7�I�, 1=loricIa 5���:utes, as �.mend�ci): l�('v�tu�fiion o�(`worlc is m2,500.00 or more, t
<br /> cortiiy fii7��: f, ti�� appfic�tnt, hav� b�en prouid�d wi�Ll� � co�y o�f �C1�e 'Tlorld� Consfirucfiion L.i�n Law—Ffom�owner's
<br /> I'ro(oction Guicle" �rQp�r�ci by�ti�� r(orida De�artm�nt a�r Agric�tlturc anc! Co��sumer AFf�irs, I�f ihe �p�alieant is someone
<br /> ofiher than th�'bwner", i cer[i('y th�tt i h�vc.obfi�tined � copy o�fii`�c abov� ciesct-ib�d docum�t�G 7nci {�ramis� in gaod•Fai�h to
<br /> c{eliver i1 to the"owner"prlor i:o commencemenfi.
<br /> GC�NTRACTOP'�IOVI/N�P'S AT=�IDAVIT: 1 c�rli�Cy th��C�nII�the In�Forma�ion in�his appiic�tian is aecur�te �nd tiiat aii rrvorlc
<br /> wil( i�� dan� in com�fi�nce wifl� �ll ��aplic�bl� I�vus r�gul�ling cons�truci;ion, zoning ancl lancl d�velopmen�t. Ap�iic�tion is
<br /> horeUy m�de fio obt�tin � �ermit ta do wark �ncl insta!lafiion �s indic��L�d. f c�rL•i��y �thai: no vuorlc or insfia!latio« has
<br /> comm�nc�d �rior to issuanco of � p�rmit �nci ti��fi �11 woriz wiii U� perfarmecl ta me�t sfanclards a�f �!! l�uvs regulating
<br /> constru�lion;`�G,_�unty �nc( City coctos, zoning r�guiatians, �nci i�nr1 d�v�ioprnent regui�tions in fii1� jt�r(sdiction. 1 �iso
<br /> c�rtify�I��t ! �srid�rs��nc! Ll��l�il�� r�gul�tions o�f o�lh�r government �g�naios m�y apply fia fiti� infended worl<, �ncl fih�t it is
<br /> my responsibi(Ety fo icl�nti�fy w17�t�c�tlans 1 mus�l t�lte fio be in compli�ncc. Sucl�ag�ncies Inciuci� i�ut ar� not timified to:
<br /> - Dep�rtmenx ofi Environmont�i �prot�cfion-Cypress B�yheads, W��lland l�re�s and �nvirnnmenially Sensltive
<br /> Lands,W�terlWast�wa�tor Tre�tfim�n(.
<br /> - 5o��fil7west Cloricla W�fior M�n�c��m�n�[ Dis�[rict�Vlleils, Cyprass Bayi���tds, UVeti�nci Are�s, Afl�ring
<br /> W�fi�rcot,mses. •
<br /> - Army Corps o�F Cngin�ers-Scawa{}s, Docks, Navigala[�W�terways.
<br /> - pep�r[tn�nt of i-te�itl� & R�1i�l�iii[ative ServicesiGnvir.onmen�lal 1-l��ltl� Unifi-Wells, W�stew�l�r Treal:m�nt,
<br /> �apt(c T�n]<s.
<br /> - US �nvironm�nfia! Protecfiion Agency-Asb�stos aI»�t�men[.
<br /> - 1=�d�r�1 Aviafion Auii�ori�y»Rt�nw�ys. ' �
<br /> 1 unctorst�nd ih�t fihe 1'oiiowing restricfiions apply�ta'i�h�us�a�C•Fill:
<br /> - Use o���fi11 is nafi�Iiow�ci in 1=1ood Zon�"V"uniess expr�ssiy p�rmitt�d.
<br /> - !�C �th� •fil! mzterial is to U� us�cl in 1=looci Zon� "A", it is ctnderstood �ti��fi � cirain�g� �i�n �c(dr�ssinc� �
<br /> � "com��nsafing volum�" will b� submit�:ed �t timc o�f p�rmit(ing whicti is prcp�rod Uy a pro�F�ssional �ngine�r
<br /> iic�nsed by the St�te o�F C"lar3d�. • .
<br /> - 1��fihe �ri11 m�teriai is fio f��-us�d in F'iaacl Zone "A" in eonnee�ion virith � p�rmiL[�cl Uuilcling using stem wall
<br /> � consfiruction, I certi�Fy�[h�t•��i11 wiii U�us�ci�oniy�:a�iii the�r�a witf7in tl�e sfi�m w�l1.
<br /> � (f.'fill malGCia! is fio 1�� used in �ny �r��, i•aerfiifiy �tha� us� o�r sLich �Fiii wifl ��o�; adv�rs�fy aff�ct acljac�nt
<br /> ' �rroperli�s. fF.tss� o�f�Fil! is�fo�►rid �to advarsely ��Ff�c��c[J�cen[pro�erti�s, �t1�a owner m�y bc cifi�d��ar vioi�fiing
<br /> t1�� condii:ians of ti�e (�uilcling p�rmil: issu�c(�und�i••CI7e att•ach�cl �aerimit a�ap[ic�tion, •�or Iots Iess fitian an� ('i)
<br /> �crc wl�ici��r��tev�t�ci i�y�'i(1, �n �ngin�cr�d drainag� plan is r�quired,
<br /> 1•[1 �m ll�te AG�NT I=OP TI-IC OWN�P, ( �aromis� in gooci•F�'rtii to in�Form fii7e owncr cr�i:f-�� permiii:ing condilions se1:•farEh in
<br /> fif�is ��FfidaviC nr(or to comm�ncing �onsfirucfiian. i �mdersE�nci [h��t � s�p�r�t� p�rmit m�y iae rec�uir�ci�Car ei�ctric�l trvarl<,
<br /> pittmfiinc�, signs, we1Js, poals, �ir condiiioning, gas, or ather insfi�Ilafiions not�specFFically inciueied in h1�c applic�fiion. A
<br /> p�rmit issu�d si��ii he eonsirueci i:o b� � lic�ns�to �aroce�d wi�:l� the worlt ancl not�s �utl�ority fio,vlai�fi�, canc�i, �ifior, or
<br /> set�sici� nny provisions o•�the i:�el�nicai coci�s, nor sh�li issuance o�f� p�rmil preven�t�L•l�e Building o•Fflci�!�from t[�ere�fter
<br /> roquiring�corr�cLion o��crrors in �ians, consfiruetian or vioi�i:ions o•��ny cod�s. Cvcry�a�rmil issL��d si7�11 b�cam� invalicl
<br /> uniess fil» worlc�ufihoriz�d by such .p�rmit is comm�nce�l within six mon�tl�s o�F permit issu�nce, or i�worlc aufii�orizeci by
<br /> fii�e nermit is sus�onclecl or�Uanclon�d�•for a p�rlod o��six(6� months a�Ti:er the{im�fihe worlc is camm�nccd, An extonsion
<br /> m�y be roc�u�st�d, in writing, �(rom fl�� t3uildinc�'O�f(ieizl �Cor z p�rioc! na[fio exc��cl nine�[y (90) days �nd wiil ciamonsfir�[e
<br /> jus�[iFinl�lo c�eise•ror�[i�� extansion. I�Fworic ce�ses•Fo�•nin�ty, (�0) consecu•Civ�cl�ys,�L1��jof� is consiclor�c[alaandon�d.
<br /> WARNIN� T� ClWN�P: YOUI�.C1a.I�.UI�.0 TO PCCOP� �l, NCfTtC� OI= GOItt1I1tI�NCCNI�NT itl(,tl`f �.�SllL.T IN.YClUP
<br /> I'AYING TWICC t=oR IMnI�.oV�IUI�NT�To YouI�pl�al'��'�.TY, Il=YoLi I�IT�ND To oJ�T,�iN �tNANCiN�, coNSULT
<br /> Vt!iTt-i YdUR�L.CNI�GI�oP AN l�T3'C7T�NZY 1���0I�� P�GORI�INC YOCJR NOTIGC �T' GOMM�NC�iVf�NT.
<br /> r-�.or�toA�ur�A�r tr-:s.���.a�} -- -- - �-— -- _ , . _ _ _
<br /> OWNZ�i OR AGGN�'�- •��� ` _ CpNTP.ACTO ..�-�'--.�� i
<br /> s or or�firme 6�ore me il� Suuscri d an sworn to(or aflirm befi me ' .
<br /> ubscr U�r1 and w n ( f �)� 1��
<br /> f(�°"1�6Y.._s r-C JY�'s�G�G� D-1Y— by �('�.GK i�l� �
<br /> W110 istaro nerson�ily imown to mo ar i�as/llave pmduc�d Wl7o is/�ro person�Ily Icnown fo m�ar has/i� e produced
<br /> — - as iclontIfc�tiion. �s ici�ntiiic�tion,
<br /> Not�ry PuG11c Notary Public
<br /> Gommissl Commission iVo.
<br /> NOTARY Pti'tS1.,�-S'fATE OFT�LOR.IDA NOTAR'i PtH�iC•S1A1'E OF�I,dRIDA
<br /> ,�"""�- �-��?zanne Bahr �
<br /> Plamo of No(�ry ly�sed,�r '• �F�tatnp.�ic•n�`EE044504 � Nam�of Notary ty�ed,printed or s[arrt� �:�omn iss��,n�EE6445d4
<br /> ''o�,,,,,,.�'"EXjJiTes. �+OV.22�2014 'o, ,=EXpi!':'; VOV.22�2014
<br /> $Qh�ED'PHRC:�TL.1�;i�BO\'DL°IG CO.,INC. '""`•`
<br /> BOh'DED THRi'?:!!.;�'rlt.B'l\'I)LtiG CO.,INC.
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