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<br /> �i PIOTIC� OF 9��E� RfE�"T�ICY60iV�: The undersigned understands that this permit may be subject to"deed" restrictions"
<br /> vuhich may be more restrictive than County tegulations. The undersigned assumes responsibility for complianae vrittt any
<br /> applicable deed res#ricfians.
<br /> UI�L1���dSEiD C4WYRiA�lfO�� d���! C�3+�IT�►�'Y��t f��S�Qft95�1��l4Y#��: lf the owner has hlred a cantractar or
<br /> contractors #o undertake v�ork, they may be requir�d fo be licensed in accordance rr�ith state and iocai regutations. If the
<br /> ' contractor is not licensed as required by law, bath 4he awner and contractor may be cited for a misdemeanor violation
<br /> under state law. If the ovvner ar intencfed contractor are uncertain as ta vuhat iicensing requfrements may apply far the
<br /> intended work, they are advised to cantact the Pasco County Building Inspection Divisian—Licensing Section at 727-847-
<br /> 8009. Furthermore, if #he ov�rner has hired a contractar ar contracfors, he is advised to have the contractor(s) sign
<br /> portions of the "contractor Block" of this application for which they wiill be responsible. tf you, as the avvner sign as the
<br /> - cont�actor, tt�at may be an indicat+on that he is not properly licensed and is not entitled to permitting privileges in Pasco
<br /> � County. `
<br /> � T�R9�P��1'�'iICB� 9Rf�P�CTIIJTIL9YIfE� �6����►C'�'�R�� ���PJU��� Rf��Ol���Y��fE�: The undersigned understands
<br /> ; fhat Transpo�tation Impact F�es and Recourse Recav�ry Fees may apply ta the cor�stretctian af nevtir buildings, change of
<br /> use in existing buildings, or expansian of existing buildings, as specified in Pasco Caunty Ordinance number 89-07 and
<br /> 9Q-07, as amended. The undersig�ed also unders4ands, that such fees, as may be due, w�ill be identified at the time of
<br /> permit#ing. It is further understaod tha# Transportation Impact �ees and R,esource Recovery Fees must be paid prior to
<br /> receiving a "certificafe of accupancy" or final power release. !f Qhe project does not involve a certificate of occupancy or
<br /> finai power re{ease, the fees musf be paid prior to permit issuance. Furthermore, if i'asco County Water/Sewer Impact
<br /> fees are due, they must be paid prior to permit issuance in accardance with applicable �'asco County ordinances.
<br /> �OPI�Yk2�C'�1�1� �1(ER! ��(+C��p���Y�3, �I�r�¢���Q�gu���, �s �r��nd�cl�: !f valuafion of uvork is $2,500.00 or mare, 4
<br /> certify #hat I, the applicant, have been provided vvith a copy of the °Florida Construction Lien La�nr—Hameowner's
<br /> Protection Guide" prepared by the �'lorida Department of Agriculture and Consumer pffairs. !f the applicant is someone
<br /> other than fhe"owner", 1 certify that 1 have obtained a copy of fh�above described doc�ment and promise in gaod fai#fi to
<br /> deliver it to the"owner" prior to commencement.
<br /> GO�TR�CTC�Hi�'�l�Dlf��9�i�'���IFE��011�': I cerfify that a11 the information in �his application is accurate and that all �nrork
<br /> will be done in compliance vuith all applicabte laws regulating construction, zoning and land developmenk. Application is
<br /> hereby made to abtain a permit 4o do �nrork and ins#allatian as indicated. 1 certify tha# no �nrork or installation has
<br /> commenced prior to issuance of a permit and that all work twill be perfarmed to meet standards of a(f (aws reguiating
<br /> construckion, County and City codes, zoning r�gulations, and land dev�lopment regulations in the jurisdicfion. I also
<br /> Icerfify that 1 understand thaf fhe regulations af ofher government agencies may apply to the infended wark, and that it is
<br /> my responsibility to identify wha#actions I must take to be in compliance. Such agencies include but are not limited to:
<br /> - departmenf of Environmenfal Profection-Cypress Bayh�ads, Vlletland ,�reas and �nvironmentally Sensitive
<br /> Lands, Waf�rNVas#ewat�r Treatment.
<br /> - 5authv�resf �larida V1(ater �anagement District-V!(ells, Cypr�ss Bayheads, 1/Vetland Areas, Alkering
<br /> VVatercourses.
<br /> - Army Gorps of Engineers�Seawalls, C7ocks, YVavigable 1Nafervuays.
<br /> - Depar#ment of Hea#th � Rehabilitativ� Services/�nvirartmental Flealth Unit-Welis, Wasfewater Treafinent,
<br /> Septic`fanks.
<br /> - US Enviranmental P�otection�gency-AsbesEos abafi�m�nt.
<br /> - F'ederal Aviation,4uthorify-F2unways.
<br /> � I unde�stand that the following restrictions apply ta the use of fiU:
<br /> - Use of fill is not allawed in Fiood Zone"V"unless�xpressly permitted.
<br /> - If the fill material is to be used in Flood �one "A", it is unders�ood that a drainage plan addressing a
<br /> "compensating vo€ume" wiEl be submitted at time of permifting �nrhich is prepared by a professianal engineer
<br /> licensed by the State of Florida.
<br /> - If fhe �II material is to be used in Flood Zone "A" in cannection writh a permifted building using stem wra1E
<br /> construction, I cerfify thak fill vvill be used only to fill the area tnrithin the stem wall.
<br /> - !f fill material is to be used in any area, I cerfify that uss of such fill vvi!! not adve�sely affect adjacent
<br /> properties. If use of fili is found to adversely affect adjacent prop��ties, the owner may be cited far�iola#ing
<br /> the conditions of the building permit issued under the attached permit application, for lots less than one (1)
<br /> aere which are elevated by fill, an engineered drainage plan is required.
<br /> If I am the AGIE�II" �0�3�'F9� 011�i11�➢f��, I promise in goad faith to infarm the owner of the permitting conditions set forth in
<br /> this affidavit prior to commencing construction. I understand that a separate permit may be required far electricaf v�rork,
<br /> ptumbing, signs, wells, pools, air conditioning, gas, or other instaliafions not specifically included in fhe app(ication. R
<br /> permit issued shal! be construed to b� a license to procesd writh khe work and na4 as authori#y to_violate, cancel, alfer, or
<br /> set aside any provisions af the technical codes, nar shail issuance af a permit prevent the �uilding {}�cia!frotr� thereafter
<br /> requiring a correction of�rrors in plans, constructian or violations of any cades. Every permit issued shall become invalid
<br /> unless #he wrork authorized b}t sctch permit is commenced vuithin six rs�anths of permit issuance, or if rrvork authorized by
<br /> the permit is suspended or abandon�d for a periad of six(6) months after the time the vvork is commenced. An extension
<br /> may be requested, in v+rriting, from the 8uilding OfFicial for a period not #o excsed ninety {90) days and will demonstraEe
<br /> justifiable cause for the extension. li work c�ases for ninety(90)consecutive days, the job is considered abandoned,
<br /> it�ARNp�(G 1't3 �IiilR1��: Yt?U�t ��f��l�� �� R���R� � RR��IC(E �� �f}ii��iiE�1C��l�P17" ��Y R��11L7' 1�1 Yt3t1�t
<br /> --�'��l9WC� TVRlICE �C1R G6Y0�'�OVIEiW�i�7�Y�Y04.U1� �'IFi!�fPE��. Y��011 VP1YEPiD TC) O�Y,k11iV �IPIk�I��IPI�, GO�1�U�.lf
<br /> l�i�H Y'�Ul�d LIE�l��l��Ft��1�7Y��2�P�1(���Q�� �l���l'��}!(��Y�}k1@� R10 IG�C��C�W�i��A1C��V�I��i�f'.
<br /> FLORIDA JURAT(F.S. 117. �
<br /> Ol��t�ft C}��aGEhl'�� ,..,.�-- GOR!'T�GYO� �"�"`—"�°°°�-°—•-�----_
<br /> Subscribsd and swom to(or af' e before me this Subscribed and swom ko or affirmed)before me this _
<br /> by by
<br /> Wha islare personalty own ta me or haslhave produced Wha Islare personally knavun to me or haslhave produced
<br /> as identlficaUan. as identification.
<br /> � �d"� Notary Public � Notary Public
<br /> Commiss '�Ye''••. JOELE.6ACON
<br /> Cam 5 on N
<br /> _;, i.= Commission s��s+.eY,�, JOEL E.BA�ON
<br /> :a: ?<: Fa� ires June 29,2Q18 ;� «� Commtsslon#FF 137073
<br /> Name ot N a .'' , �i�cT1"tlF�f�' PJame of PJota �e8�ir�,2018
<br /> ''.,p,���°�`� 8adedTlwTruyFeNlnaurance800�385•7019
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