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<br /> �!�}�'�CfE pF �D�(E� RE��'�IC�'BI�PI�: The undersigned unders@ands that this permit rnay be subject to"deed" restrictions"
<br /> which may be more restric#ive than Caunfy regulatians. The undersigned assurrtes respansibility for compEiance v�rifh any
<br /> applicable deed restrictions.
<br /> �iNL.1C��SED Ct�NT���TO�� �N� C�����3'�� ��SF'QR1�i�tL�Y'lf��: !f the owner has hired a contrackar or
<br /> contractors to undertake�vork, they may be required to be (icensed in accordance vuith state and locafi regulations. If the
<br /> contractor is r�ot licensed as required by lawr, balh the owner and contractor may be cited for a misdemeanor violation
<br /> under stafe law. If fhe ou�ner or intended cvntractor are uncertain as to whaf licensing requirements may appEy for the
<br /> intended work, they are advised to cantact the Pasco County Building Inspection I�ivision—Licensing Section at 727-847-
<br /> 8009. Furthermore, if the arnrrter has hired a contractor or contractors, he is advised to have the cantractor�s} sign
<br /> partions of the "con#ractor Block" of this applicatian for vuhich they vvili b� responsibie. tf you, as the ovuner sign as the
<br /> � eonfractor, that may be an ind4cation that he is not properly licensed and is nof �ntitled to permitting privileges in Pasco
<br /> County.
<br /> T���pp��'�,Y�C��d ��fp,�CY�IITILi�'�E� ��1P�+C�'�+�6� f���C1U�C� R��COV'�RY��f��: The undersigned understands
<br /> that Transpor#ation impact �ees and Ftecou�se F2ecovery Fees cnay apply to�fi�e construct3oe� af newr buildic�gs, change of
<br /> use in existing buildings, or expansion of existing buildings, as specified in �'asco Caunty Ordinance number 89-07 and
<br /> 90-Q7, as amended. The uridersigned also unders#ands, that such fees, as rnay be due, wi#I be identified at the time of
<br /> permitting. It is further understood that Transpor#ation Impact Fees and Resource Recovery Fees must be paid pr'tar fo
<br /> receiving a certificate of occupancy or final pov+rer release. (fi the project does not involve a certificate of occupanay or
<br /> �� „
<br /> finai pauver reiease, the fees rnust be paid prior to permit issuance. Furfhermore, if Pasco Caunty 1�later/Seuver Impact
<br /> fees are due, they rnust b� paid prior Qo permit issuance in accordance with applicable �'asco County ordinances.
<br /> C��l�T62�C71��V l.I�N �.�1fi�{Ci�a���r�'�3, �Ic��ic���tr�t�e���, a� a�etr�er�d�e!): If valuation af work is $2,500A0 or more, 9
<br /> cerfify #hat I, the applicant, have been provided vvith a copy oi the "Florida Construction Lien Lav�r—Hameowner's
<br /> Protection Guide" prepared by the Ftorida Department of Agriculture and Gonsumer pffairs. lf the appiicant is someone
<br /> afher than ihe"owner", 1 certify#hat t hav�obtained a copy of the above describeci document and promise in gaod faith to
<br /> deliver it to the"owner" prior to commencement.
<br /> CQ�VT��CT�}F2'SIt9���R'��1��1�it�V1�': � certify that a1l the information in this application is accurate and that all uvork
<br /> will be done in compliance with all applicable lavus regulating constructian, zoning and land development. Applicatian is
<br /> hereby made fa obtain a permit ta do uvark ancf 9nstallatian as ind9cated. ! certEfy that no work ar installatian has
<br /> commenced prior to issuance of a permit and that all work wiil be performed to rneet standards of ali lawvs reguia�ing
<br /> construckion, County and Ciky codes, zoning regulations, and land development regulations in the jurisdiction. ! also
<br /> certify #hat 1 understand that fhe regulations af ather gov�rnmer�t agencies may apply to the intended vvark, and that it is
<br /> my responsibility to identify what actians I must take to be in campliance. Such agencies include but are not limited to�
<br /> - Depa�tment af Enviranmenfal Pratection-Cypress �ayheads, V�1�tiand Areas and Environrnen#ally Sensitive
<br /> Lands, VVat�rMlas#ewater Trea#menf.
<br /> - Southvtres4 �forida Wat�r �anag�m�e�t Distric4-V1(el{s, Cypress Bayheads, Wetland Areas, Altering
<br /> Watercaurses.
<br /> - Army Corps of Engineers-Seawralls, C7ocks, Navigable Vilateruvays.
<br /> - Deparfinent of Health & F2ehabilitative Services/�nvieonrrtental Health Unit-Vttells, Was�evtrater Treatment,
<br /> Septic Tanks.
<br /> - US EnvEronmenfal Protectian Agency-Asbestos abatem�nt.
<br /> - �'ederal Avi�tion Authori#y-Runways.
<br /> ! understand that the follavuing restrictivns apply to the use af fill:
<br /> - Use of fill is no#allaweci i� Fload Zone"V"unless expressiy permitted.
<br /> - If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
<br /> "compensating vatume" vuill be submitted at fime of permiEtin� which is prepared by a professional engineer
<br /> licensed by�he State of Florida.
<br /> - If the �II material is to be used in Flood Zone "A" in connection uvith a permiEted building using stem vvall
<br /> construction, I certify tF�at fill will be used only to fill the area wi#hin �h�sfem wall.
<br /> - !f fill material is to be used in any area, ! certify that use of such fi!! will not adversely affect adjacent
<br /> properties. If use of fill is founci to advers�ly affect adjacent properties, the avvner may be cited for viala#ing
<br /> fhe conditions of the building permit issued under the attached permit applicatian, for lots less than one (1)
<br /> acre which are elavated by fi(I, an engir��ered drai�tage pian is requir�cf.
<br /> If I am the Af�ENT �OR 1fH� �DV`!!�➢f��, I promise in good faith to infarm the owmer of the permitting conditions set forth in
<br /> this affidavit prior to comrnenc'sng construction. O undersfand that a separate permit may be required for electricaE work,
<br /> plumbing, signs, wells, pools, air canditioning, gas, or other insta(la#ions not specificatly inciuded in the application. A
<br /> permit issued shall be construed to b� a license to proceed with the work and not as authority to.violate, cancel, alter, or
<br /> set aside any provisions of the fechnical codes, nor shal! issuance af a perm'tf prevenf the Building Ufficia!from thereafter
<br /> requiring a correction of errors in plans, constructian or violations of�ny cades. Every permik issued shall become invalid
<br /> �nless the work authorized by such permit is commenced within six months o�permit issuance, or if work authorized by
<br /> the permit is suspended or abandoned for a periad of six(6) months after the time the tn�ork is commenced. An extension
<br /> may be reques#ed, in v+rriting, from the Building (7fficial for a period not to exceed nine4y (90) days and vuil! demonstrate
<br /> justifiable cause for the extensian. If vvork ceases_for ninefy(90)consecutive days, fhe job is__considered abandoned.
<br /> �if�Ridl�d� T't3 �1�ilil9��: Yf.1tJ� ���L��� Y� {�(c��RD � R90T��#E Qi� ���ii�E�l�����9T ��Y R�SUL7' 1�I �t�i��
<br /> �.��l�IK� T-li111C� IFCbR Y�fIB'9�OV�i�i�GU7��'�1�OlJ� f�I�.�DfP�RYY. ���(OlJ 9RlYI�P1D TIC1 O�li',d�l�l f�IPIl�►�ICOW(y, GOR��IU�.�'
<br /> lf�1�H 'Y'�iU�tt��iV�}�R�1�2�l#Y��C)�23��1(1���438�fE�fE�C?�tYJ�f��'Y�l��I���'�G��F��6ifd6��6�C�6���1T. --
<br /> FI.ORIDA JURAT(F.S. 117.03)
<br /> awe���o������r �o��rtt�c �
<br /> Subscriped and sworn to(or affirmed)before me this Subsc�lbe and swom to( r ed)befot'e me this
<br /> by y_
<br /> Wha islare personally known to me or haslhave produced Wha lslare persanally known fa me or haslhave praduced
<br /> as Identificatian. as identifiaation.
<br /> Notary Publlc Notary Public
<br />� Commission Na. �Comm si o�;��.
<br /> *�� �:= Commission#F�137473
<br /> Name o(Notary typed,printed ar stamped Name of ,�, B,,,i eo�y.lo�a
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