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' PlCDTICIE O� �+EED V2E��'�IC�IClId�: The undersigned understands that this permit may be subject to"deed"restrictians"
<br /> which may be more restrictive than Caunty reguiations. The undersigned assumes responsibElif�r for compliance vuifh any
<br /> applicable deed restrictions.
<br /> , t3�4LIC�NSED CtDN�GIR�►C��R� ,�►�If� CO�IY�ki�'��� i�fE�f��Pl�l1�1L!'T1��: !f the awner has hired a contractor or
<br /> , contractors to undertake work, they may be requir�d to be licensed in accardaRCe virifh s#ate and locai reguiations. !f the
<br /> contractor is not licensed as required by lauu, both the o�nrner and contractor may be cited for a misdemeanor violation
<br /> under state law. if the ov�rner ar intended contractor are uncertain as to v�rhat licensir�g requirements may apply for the
<br /> intended work, they are advised to contact the Pasco County Building Inspection Clivisian—Licensing Sec#ion a#727-847-
<br /> 8009. Furthermare, if the ornrner has hired a contrac#or ar cantractors, he is advised to have the contractar{s) sign
<br /> portions of the "contractar 61ock" of this applicatian for which they mvill be`responsible. tf you, as #he ovvner sign as the
<br /> contractar, that may be an indication that he fs not properly licensed and is not entitled to permitting privileges in Pasco
<br /> County.
<br /> Y�N��O�i'YI��'lU�R Ii1�P�G�IIJ�'ILI�"I�� I�1PA�'T�Fl� �t��OU�C� �EC�V�RIf F��S: T'he undersigned understands
<br /> that Transpor#ation lmpact Fees and Recourse Recovety Fees may apply ta the constcuctian of nevtt buitdings, change of
<br /> use in existing buildings, or expansion of existing buildings, as specified in Pasco Caunty Ordinance number 89-07 and
<br /> 9(}-O7, as amended. The unders4gned alsa understae�ds, that such fees, as may be due, will be identified at #he time of
<br /> permitting. It is further understood that Transportafion Impact Fees and rtesource Recovery �ees must be paid prior fo
<br /> receiving a "certificate of occupancy" ar fina! po�nrer release. If the�roject does not involve a cer#ificate of occupancy or
<br /> final power reiease, the fees must be paid prior ta permit issuance. Furth�rmore, if Pasco County V!later/Setnrer Impact
<br /> fees are due, they must be paid prior ta permit issuance in accordance with applicable F'asco County ordinances.
<br /> CON�'F�t1CTlO�i �.i1E�i t..�i�f{CF�ap4�r 7�3, �I�rid��ta�ut��, �s �rn�ncl��d): lf valuation of uvork is$2,5Q0.00 or more, 1
<br /> certify that I, the applicant, have been provided with a capy of the °Florida Constructian Lien Lawr—Homeowner's
<br /> F'rotectian Guide" prepared by the Flo�ida Department of Agricultvre and Consumer Affairs. lf the applicant is someone
<br /> other than fhe "owner", I certify that I have obtained a copy of fhe abave described document and promise in good faith to
<br /> deliver it to the"owner" prior to commencement.
<br /> �t�NYi�d�CYOIR°S/OWNI�(�'� d�i��la�l/Il�: 1 certify that a{I the infarmation in this application is accurate and that ali work
<br /> vvill be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
<br /> hereby rstade to abtain a permit to do �nrork and ins#allatian as indicated. 1 cert9fy that na vuor4c or instatlation has
<br /> commenced prior to issuance of a permif and that all vvork vvill be performed to meet standards of all laws regula#ing
<br /> canstructian, Caunty and City codes, zaning ragulations, and land develop►nent regulations in the jurisdictian. I also
<br /> certify that I undersfand fhaf the regu(ations of oth�r gavernment agencies may spply ta the intended +n�ork, and that it is
<br /> my responsibility to identify�nrhat actions I must 4ake to be in campliance. Such agencies include bu#are not limited ta:
<br /> - Depa�tment of Enviranrnental Protection-Gypress Bayheads, Vlletfand Areas and EnvironmentalEy Sensitive
<br /> Lands, VVat�rNVas#ewater Treatment.
<br /> - Southwest Florida Vtilater �anagement District-VUeIls, Cypress Bayheads, 1�leiland ,Areas, Altering
<br /> Watercaurses.
<br /> - Army Corps of�ngine�rs-SeawaUs, Docks, Navigable UVaterv�rays.
<br /> - t�epartment of Heaifi� � Ftehabilitative ServicestEnvironmental Nealth Unit-t�/elts, 11Vastewater Treatment,
<br /> �eptic`Tanks.
<br /> - US Environmental Protectian Agency-Asbestas abat�ment.
<br /> - Federal Aviation Authority-Runways.
<br /> I understand that the follovving�estrictions apply to the use of fill:
<br /> - Use of filf is nat allawed in Fload Zone"V"unless expressly permitted.
<br /> - If the fill mat�rial is to be used in Flood zone "A", it is understood that a drainage plan addressing a
<br /> "campensating voiume° wiil be submitted at time of permifting vuhich is prepared by a professionai engineer
<br /> licensed by the State of Florida.
<br /> - If the fll material is to be used in Fload Zone "A" in cannection vuith a permitted building using stern v+ra11
<br /> construction, I certify tha#fill will be used only to fill the area within the stem wall.
<br /> - !f fill material is ta be used in any ar�a, I certify that use of such fil! wrill not adversely affect adjacent
<br /> prope�ties. if use of fill is found to advers�ly affec# adjacent properties, the auvner may be cited for vialating
<br /> the conditions of the building permit issued under the attached permit applicatian, for lots less than one (1)
<br /> acre which are elevated by fi11, an engineered drainage plan is required.
<br /> If I am the AG�tV7' �OR�"O�IE C�11'VW�Y�, I promise in good faith to inform the ouvner of the permitting conditions set forth in
<br /> #his afiidavit prior to comm�racing construc#ion. I uncierstand that a separate petmit may be required for electrical uvork,
<br /> plumbing, signs, wells, paols, air conditioning, gas, or other installafions not specifically inciuded in the appiication. A
<br /> permit issued shall be canstrued ta be a license to proceed �rith kh� vvork and not as authority to.violate, cancel, alter, or
<br /> sef aside any provisions of the#echnical codes, nor shall issuance of a permit prevent the Building Officiai from thereaffer
<br /> requiring a carrection of errors in plans, constructian or violations of any cades. �very permit issusd shall became invalid
<br /> �nless the v�rork authorizecf by such permit is commenced �nrithin six manths of permit issuance, ar if vvork authorizec! by
<br /> ihe permit is suspended or abandoned for a period of six(6) months after the time the work is commenced. An extension
<br /> may b� requested, in v�rriting, from the Building Official for a period not to exceed ninety (90) days and rnrill demanstrate
<br /> justifiable cause for fhe extension. If work ceases for ninety (90)consecutiv�days, the job is considered abandoned.
<br /> {fil�RAIIRi� Yi3 OIN�t�R: YOl1� ��IL�lRI� T� (�(�C�R� � l��YiC(E t�(� �0�6�iEN���fi�NY �V9hiY �2��t7LT 1�1 YOtlR
<br /> �QlYIN1;� 'Tlii!lICE IFdJtl� Itill�'�tOVE�iiEN7� TG11(OlJla I�Ih�OfPEi�7Y. YF 1fOU IR17fEii1D TO OBYAIW �INAW�IPlt9, �ONSIJ�.T
<br /> ttN1T@i V�UiZ iL�(+It3��CD��i�i1�i�7'C?�'t�t9�lt����J►�� ���{�$��I�dC YL���2 61�01I'$���F CQlif��llEi�CiE�1t1El3tY.
<br /> FLORIDA JURAT(F.S. 117. 3)
<br /> 01�1�lEF2 OF2 AG�N7 � �Q�I7'E�AAC7'Ogt�...���`�✓i<-c���i�-/�_
<br /> Subscri sd d sworn to(or affirmed)before me this SubscFi d swom to(or affirmed)before me this
<br /> [ o°��� 0�2
<br /> Who islare erson known to me or haslhave produced Who 1 re person 11y knowm to me ac haslhave produced
<br /> as Identification. as identification.
<br /> � G� �
<br /> Notary Public �-�-. Notary Public
<br /> Commis io ' Y���., �ACQUELINE GES Com sion . ;:�::°"
<br /> ` m ' �'�= Gommissian#EE Q4452Q
<br /> '�' •�R� �k�•
<br /> :�;, �o; Expires December 12,2014 � -
<br /> IVame oC No ��id r Name af Nota ''; °�frin � ���Q�9
<br />
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