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NOTIC� O� DE�D Rf��"T�iCTIOPJ�: The undersigned und�rstands that this permit may be subject to"deed" restrictior�s"
<br /> which may be rr►ore resteictiv�thar� County regulatians. The und�rsigned assumes responsibility for compliance vtrith any
<br /> applicable deed restrictions.
<br /> PJ�lL�CiENS�� CC1ft9TR��7��� A�I� CC1P1Y���'Q� l���i�Ol��1��L1�'flL��: If the owner has hired a contractor or
<br /> contractors to undertake work, they may be required fo be fieensed in accordance rnrith state and local reguEations. !f the
<br /> contrackor is not licensed as required by law, bo#h the ovuner and contractor may be cited for a misdemeanor violation
<br /> under state 1aw. tf the awner ar ir�tended contractor are uncertain as to �nrFtat Ficensing requirements may appty far the
<br /> intended work, they are advised fo contact the Pasco County �uilding Inspection Division—Licensing Sec#ion at 727-847-
<br /> 800�. Furtherrnore, if the ov�rner has hired a contractar or cantractors, he is advised to have the contractor(s) sign
<br /> portions of the "contractar Block" of this appficatian for vvhich they wili be responsit�le. tf you, as #he owner sign as the
<br /> contraetor, that may be an +ndication that he is not properly licensed and is ►�of entitled to permitting privileges in Pasco
<br /> County.
<br /> T�NS�O�,�'�Y9�R9 ��F"AC�'l�➢TOLVy'YCE� I�fl�l�►C'Y�,�� �f����9��� I��IC�i/��Y��f�S: 1"he undersigned understands
<br /> thaf Transporta#ion Impact �e�s and Recou�se Recovery F�es may appiy to Ehe constructian of new bu'sidings, change of
<br /> use in existing buildings, or expansion of existing buildings, as specified in I'asco County C7rdinance number 89-07 and
<br /> 90-07, as amended. The undersigned aisa understands, that such fees, as may be dus, vuill be identified at the time of
<br /> permitting. I# is further understaod tha# TransporEation Impact Fees and Resource Recovery Fees must be paid prior to
<br /> receiving a "certificate of occupancy" or final power release. If the project d�es not involv� a certificate of occupancy or
<br /> finai power re{ease, the fees must be paid priar to permit issuance. Furthermore, if F'asco County VI/aterlSewer 4mpact
<br /> fees ar� du�, they must be paid prior to permit issuance in accordance with applicable F'asca Coun#y ordinances.
<br /> G�P1�T�ttJCT101� 1.1��5 !.�►1fi!{Ch��nt+�rr Y'�3, �I�Pida��a���t��, �� �rn�n+��e�}: lf valuation of work is$2,50QA0 or more, 1
<br /> certify that I, the applicant, have been provid�d vvith a copy of the "Florida Construction Lien Law—Homeowner`s
<br /> Pratection Guide" prepar�d by the Florida Department af Agriculture and Consumer Affairs. If the applicant is someone
<br /> other than the"owner", 1 certify#hat 1 have obtained a copy of#he above described document and promise irt good faifh ta
<br /> deliver it to the"owner" prior to commencement.
<br /> ��3�T�l�iCTt��'SJt��lf���'� t�(��1�►k�►l���: I certify that all the informafion in fhis application is accurate and fhat a#I v�rork
<br /> will be done in compliance with all applicable la�rs regulating construction, zoning and land develapment. Applicakian is
<br /> hereby made to obtain a permit to do vuork and installation as indicated. 1 certi€y that na vuork or installatian has
<br /> commenced prior #o issuance of a permit and that all work will be performed to meet sfandards of afi larrvs regu(ating
<br /> const�uc�ion, Counky and City codes, zoning regulations, and land development regulations in the jurisdictian. I also
<br /> certify thaf 1 unders#and tF�at the regulations of other gavernm�nt agencies may apply ta fhe infended v+rark, and that it is
<br /> rrty responsibility ta identify what actions I must 4ake fo be in compliance. Such agencies include but are not limited to:
<br /> - Department of Enviranmental Protection-Gypress Bayheads, 11Vet1artd Areas and Environmentally Sensitive
<br /> Lends�`'UVaterNVas#ewater Treafinenf.
<br /> - �outhwest� ��,lorida Vlfater fVlanagement District-We!!s, Cypcess Bayheads, Wetland fireas, Altering
<br /> Watercourses.
<br /> - Army Corps af Engineers-Seawalls, Docks, iVavigable Waten+vays.
<br /> - C7epartment of Health � Rehabilitative ServiceslEnvironmer��al Heafth Unit-V1lelEs, 1�lasfewater Trea#tnent,
<br /> Septic Tanks.
<br /> - US Environmental Pra��c�ion Agency-Asbestos abatement.
<br /> - Federal Aviation Authority-Runuvays.
<br /> 1 understand that the follov�ring res4rictions apply ta the use of fill:
<br /> - Use of fill is not a8or�reci in Flood Zone"V"unless expressly permitted.
<br /> - If fhe �II material is to be used in Flood �one "A", it is understood that a drainage plan addressing a
<br /> "compensating vaiume" wfiil be submitted at time of permiffing uvhich is prepared by a professional engineer
<br /> licensed by the Sta�e of Florida.
<br /> - If ihe fill ma#erial is to be used in Flood Zone °A" in cannecEian wtith a permitted bui4ding using stem wrall
<br /> construction, I certify 4ha#fill will be used only to fitl ti�e area�vifhin the stem wa11,
<br /> - !f frl! material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
<br /> properties. ff use of frll is found to adversely affect adjacer�f properties, the awner rnay be cited for vio4atinc�
<br /> the conditions of the building permit issued under the attached permit application, for Iots less than one (1)
<br /> acre w�hich are elevated by fill, an engineered drainage plan is required.
<br /> If I am khe d�GE�IY FO��'Fi� OliilN�f�, I promise in good faith to infarm #he owner of the permitting condi#ions set farth in
<br /> this affidavit prior to commencing construction. I understand that a separate permit may be required far electrical work,
<br /> plumbing, signs, wrells, pools, air conditioning, gas, or other installations not specificafly inciudec3 in the apptication. A
<br /> permit issued shall be construed to be a license ta proceed vuith khe work and nat as authority to violafie, cancel, alter, or
<br /> set aside any provisions of the technicai �ocfes, nor shall issuance of a permit prevent fhe Building Official from thereafter
<br /> requiring a cr�rrectian of errors in plans, canstruction or violations of any codes. �very permit issued shall became invalid
<br /> unless #he work autharized by such permit is commenced u�ithin six manths of permit issuance, or if wark authorized by
<br /> the permit is suspended or abandoned for a periad of six(6) monfhs after the time the work is commenced. An ext�nsion
<br /> may be requested, in writing, from the 8ui}ding Gfficia! for a period not to exceed nineky (90) days and will demonstrate
<br /> justifiable cause for the exfension. If work ceases for ninefy(90)consecutive days, �he job is cansidered abandoned.
<br /> tfU.��NIP9ty 'fC} �iiitR4��t: YOt.1R �A��UR� 7� ��GC9�C9 � ��`�'1�� �� �O�i�i�A1C(Efi�I�i�tIT il��lf �tS�Sl9�.Y l�l '�'�}lJ�
<br /> �'AYINCC� '�VUICfE �'C2F� II►��f��VfEi�liEf�Y� YO VOtl�F� I�ff�q3p�RYl(. I�YOII �PIY��ID�'O O��'AIW FIPII�iP1CIP1(3, (COi��IU�.T
<br /> !lVt�F4�d Y�i�Ft�Et�C����iR fiIIV�i 1f�t��Y�I��i��� ���Q�'3�1�IK�Y�t1f�ft90"CIC�fJIF C �ii6l�lEY�C��d�1�1�.
<br /> FLORIDA JURAT(F.S. 1 7.03) � ;
<br /> 47UV�tER OR�GEi�T� �� G4ft1'F�tACTClP� �"`"
<br /> Subsc�ibed and sworn to( afflrmed)before me this Subscribed and sworn o(or affirmed)before me this
<br /> bY - ..�Y--
<br /> Who islar�rers°onally know�me or hasltiave produced Who lstar ersonally kn�+o u�rr�e or haslhave produced
<br /> as Identificatlon. `'°"'°` as identification.
<br /> �I,4e/�G �����"" _� Notary Public r Notary Public
<br /> ���� �-'-���'
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<br /> Commissfon No. Commission IVo.
<br /> 11��tt�� I � ��5 n� ...T 4��'c�6�' S
<br /> ame of Not ry ,.,. Name of Notary typ ,`printed or stamped
<br /> ,.:`'"Y""8.., tdQNCY J BROCDKS ......,,pYe4'•
<br /> �_� {"�� _�`' e='= i�PANCY J BRClQKS
<br /> =' '- MY COMM(SSION#FF093�i99 `; °e
<br /> ';"�..� oP; ;N MY COMMIS510N#FF093699
<br /> ••.°,'�of'�;;o�;.�, EXPIRES February 18,2018 ';;�o`:�
<br /> �.,'�aFfl;g?•' EXPlRES Pebruary 18.2Q18
<br /> {ao7}39a-at53 FloridaNataryService.com rdo� 3ge-0163
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