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�!O'TIC�O� �1f�ED f�fE�'Y'�IC�"IORI�: The undersigned understands that this permit may be subject to"deed" restric#ians"
<br /> which may be more restrictive than Caunfy regulations. The undersigned assumes responsibility far complEance v�rith any
<br /> applicable deed restrictions.
<br /> �9�l�.IC�tdS��! CaNYR�+C1fO�S �RlI� GQb�11Y����� 1��5�0�lS1�IL1�`I��: if the owner has hirsd a contracfor or
<br /> eontractors to undertake work, they may b� required to be licensed in accordance �rith sfate and local regulations. If#he
<br /> contractor is not licensed es required by law, bokh the owner and contractor may be cit�d for a rnisdemeanor violation
<br /> under state la�. if fhe ouuner or intend�d contrac#or are uncertain as to what licensing requirements may apply for the
<br /> intended work, they are advised #o contact the Pasco Caunty Building Inspection Division—Licensing Section at 727-847-
<br /> 800�. Furtherrnore, if th� ov+rner has hired a cantractor or contractars, he is advised to have fhe car�fractor(s} sign
<br /> partions of the "contractor Block" of this application for vuhich th�y=will be responsible. If yau, as the ovvner sign as fhe
<br /> contractflr, that may be an indication #hat he is not properly licensed and is no# �e�titled to permikting privileges in Pasco
<br /> � Caunty.
<br /> � YB�FV�POk�"�T90iV'i�ifi��,C�1lJ�'ILIY'll�� 9i�1��C1f l��f� �t���U�CI� ����ll�f�Y����: �"he undersigned understands
<br /> that Transporfafion tmpact Fe�s and Recourse Recavery �ees may apply.to the construction aF ne.wr buiidinc�s, change:�f: �
<br /> use in existing_6uildings, or ex�ansiar� og-existing uuildirigs; as specified it� Pasco County Ordinance number 89-07 and
<br /> 9Q-07, as ams�ded. The undersign�d aiso undersfands, thaE such f�ees, as rnay be due, uvil! be identified af the time of
<br /> permitting. It is further understood that Transpo�tation fmpact Fees and Resource Recovery Fees must be paid prior fo
<br /> receiving a "^ertificate of occupancy" or fina! pov�rer release. (f the project does no# involve a certificate of occupancy or
<br /> ftna{ power rei�ase, the fe�s must be paid prior to perrrtif issuance. Furthermare, if F'asco County WaterlSewer Impact
<br /> fees are due, they must b� paid prior ta permif issuance in aecqrdance with applicable Pasco Counky ordinances.
<br /> C0�1S7@�t1CTIQ�3 �1��9 1.�1fil�{C�apd�r 7��, �l�et�9�����t����, �� �e�ra��d�z9}: !f vaSuation of work is $2,500.00 ar more, �
<br /> certify �ha9 I, the applicant, have been provided with a capy of the "Florida Consfructian Lien Law—Homeov�rner's
<br /> h�rotection Guide" prepared by the Florida Depactment of Agriculture and Consumer Affairs. Ef the appiicant is someone
<br /> ather than the"owner", i c�rtify that i have abtained a copy of the above described document and promise in goad faith to
<br /> deliver it to fhe"owner" prior to commencement.
<br /> C€��T���Tt3(R'SIClit�3���2`� ��F1�6�V1�': I certify that aii the informafion in this application is accurate and �hat ali work
<br /> will be done in compliance with all applicable la�rs regulating construction, zoning and land development. Application is
<br /> hereby made to ob#ain a permit to do vuork and installation as indicated. 9 certify that no work af installation has
<br /> commenced prior to issuance af a permif and tha# all work will be perfarmed to meet standards of alI laws regulaking
<br /> construckion, Counky and City codes, zoning regulatians, and land development regula#ions in the jurisdictian_ I alsa
<br /> certify thaf i understand that fhe regulations of ofher government agencies may apply to the intended vvark, and that it is
<br /> my responsibility to identify what actions I must take 4o be in compliance. auch agencies include but are not limited to:
<br /> - C?epartrrtent af �nvironmental F'ro#ection-Gypress �ayh�ads, Wetland Areas and Enviranmentally Sens9five
<br /> l..ands, VVaterNVastewrater Trea#ment.
<br /> - Southuvest Fforida 1tVater �/lanagemer�t Districf-Wells, Cypress Bayheads, �Ve#land Areas, Altering
<br /> Watercaurses.
<br /> - Army Corps of Engineers-S�awalls, [7ocks, Navigable 1f�afierwrays.
<br /> - Deparfinent of Heaifh � Rehabilitafive Services/�nvironmental Flealth Uni#-V1/e11s, Wastewater Treatment,
<br /> Septic Tanks.
<br /> - US Enviranmen#al Protection Agency-Asbestos abatem�nt.
<br /> - �'ederal Aviation Authority-Runways.
<br /> i understand thaf the follovtring restrictsons apply to the use of fill:�
<br /> - Use of fill is not ailawed in Ftood Zone"V"unless expressiy permitted.
<br /> - If the fill material is to be used in Flood Zone "N", i# is understood that a drainage plan addressing a
<br /> "campensating volume" �vill be submitted at time of petmitting vuhieh is prepared by a prof�ssianal engineer
<br /> licensed by the State of Florida.
<br /> - If fhe fill matsrial is to be used in Flood Zone �A" in conr�ec#ion with a permiffed building using stem vtirall
<br /> canstruction, I certify that fill wrill be us�d only to fill the area wi#hin the stem wall.
<br /> - If fill mater'sal is to be used in any area, ! certify that use of such fil! will not adversely affect adjacent
<br /> properties. 1f use af fill is �ound to advers�ly affect adjacent properties, the awner may be cited far vioiating
<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�11, an�ngineered drainage plan is required.
<br /> If I am-the�►G;�R9Y �OR�'�iE C�F�il�t��t, I promise in good faith #o infarm the owner of the permitting conditions set forth in
<br /> this affidavit prior to camrnencing construc4ion. O understand thaf a separat� permit may be requirec! for �tectricat uvark,
<br /> plumbing, signs, vuells, pools, air conditioning, gas, or other installations not specifical(y inciuded in the application. A
<br /> permit issu�d sha!! be construed to be a licer�se ta proceed with the vvork and not as authority fo.violate, cancel, aHer, or
<br /> set aside any provisions of the technical codes, nor shal( issuance of a permit prev�nt the �uilding O�cial from thereafter
<br /> requiring a correction of errors in plans, construction or violations of any codes. IEvery permit issued shall become invalid
<br /> unless the woric authorized by such �srmit is commenced virithin six manths af permit issuance, or if wark aufhorized by
<br /> the perrrtit is suspended or abandoned for a period of six(6) monfhs after the time the uvork is commenced. An extension
<br /> may be requssEed,�in writing, from the �uilding Offiiciai gor a period nat to �xceed ninety-�90) days and vuill demonstrate
<br /> juskifiable cause for the extension. (f wark ceases for ninety(90)consecutiv�days, #he job is considered abandaned.
<br /> t�ARR91Rl� YC) O�litliE�: Y{}LI�2 ��IL��� "T� �t��Q�2D � �Z�T�G� �� ���Hii�i��9C��H�iV'� �fi�,Y E���UL�' ��i Y�IU�
<br /> �AYIN1,� fi1�lI�E FO�d OIIidP�ROi/�NVd�f�`C'� Y��O191R.�f�C11��F�"II'�. I{F YOII 9f�Yl€W13 7�I O�Y�IN� �VWk�PY�'rR��, �13R��fl�ILlf
<br /> �fid'11FH V�E���.�(�6C?�F��?Y�2�N!�a'��'�}{f�(��1(l�����i� �'(�CO�lDi(�9�Y{}t1IR R101'1���}�C��ff�lfiE[�lC�Ei�I(��11T.
<br /> FLORIDA JURAT(F.S. 117 03)
<br /> t)1N�fEi2 t}F2�G��t7 �-"'-`.�__� C�611T�C'i��
<br /> Subscribed and swom to(or affirmed)before me ihis 5ubscribed and swom fo(or afflfined)before me this
<br /> by by
<br /> Who istare personally kr�awn to me or haslhave produced Wha tslare personally known ta me or haslhave produced
<br /> � yas dentification. as identification.
<br /> „�„�,,,
<br /> •µ�Y PY J E.
<br /> :� '..= ommis ' ry public Notary Public
<br /> '�r P� �S Ut18 , ��
<br /> Cammissi �P��°''� 8ondedTlwTroyFainlnauranceBIX}3g$.7018 Commfssion No.
<br /> Name Notary typed,printed or stamped IVame af Notary typed,printed or stamped
<br />'� ,
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