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• ' I <br /> ' NOTICE OF DEED RESTRICTIONS: The und rsigned understands that this permit may be subject to"deed"restrictions" <br /> ° which may be more restrictive than County re ulations. The undersigned assumes responsibility for compliance with any �i <br /> , • applicable deed restrictions. <br /> UPJLICENSED CO�TRACTORS AFlD CON RACTOR RESPONSIBILITIES: If the owner has hired a contractor or <br /> contractors to undertake work,they may be re uired to be licensed in accordance with state and local regulations. If the <br /> contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation <br /> under state law If the owner or intended co tractor are uncertain as tb what licensing requirements may apply for the I <br /> intended work,they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847- ', <br /> 8009. Furthermore, if the owner has hired contractor or contractors, he is advised to have the contractor(s) sign <br /> portions of the"contractor Block"of this appli ation for which they will be responsible. If you, as the owner sign as the <br /> contractor,that may be an indication that he i not properly licensed and is not entitled to permitting privileges in Pasco <br /> County <br /> TRAPISPORTATIOPf IMPACT/UTILITIES IMP CT AND RESOURCE RECOVERY FEES: The undersigned understands <br /> that Transportation Impact Fees and Recours Recovery Fees may apply to the construction of new buildings,change of <br /> use in existing buildings, or expansion of exis ing buildings, as specified in Pasco County Ordinance number 89-07 and <br /> 90-07, as amended. The undersigned also u derstands, that such fees, as may be due,will be identified at the time of <br /> permitting. It is further understood that Trans ortation Impact Fees and Resource Recovery Fees must be paid prior to <br /> receiving a"certificate of occupancy"or final o�ver release. If the project does not involve a certificate of occupancy or <br /> final power release,the fees must be paid pri r to permit issuance. Furthermore, if Pasco County Water/Sewer Impact � <br />� fees are due,they must be paid prior to permit issuance in accordance vvith applicable Pasco County ordinances. <br /> I CONSTRUCTION LIEN LAW(Chapter 713, lorida Statutes,as amended)� If valuation of work is$2,500.00 or more,I <br /> certify that I, the applicant, have been pro ided with a copy of the "Florida Construction Lien Law—Homeowner's <br /> Protection Guide"prepared by the Florida De artment of Agriculture and Consumer Affairs. If the applicant is someone <br /> other than the"owner", I certify that I have obt ined a copy of the above described document and promise in good faith to <br /> deliver it to the"owner"prior to commenceme . <br /> CONTRACTOR'SIOWPJER'S AFFIDAVIT I rtify that all the information in this application is accurate and that all work <br /> will be done in compliance with all applicable aws regulating construction,zoning and land development. Application is <br /> hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has <br /> commenced prior to issuance of a permit an that all work will be performed to meet standards of all laws regulating <br /> construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also <br /> certify that I understand that the regulations o other government agencies may apply to the intended work, and that it is <br />� my responsibility to identify�vhat actions I mus take to be in compliance. Such agencies include but are not limited to: <br />'� - Department of Environmental Pr ection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive <br /> Lands,WaterlWastewater Treatm nt. <br /> - Southwest Florida Water Man gement District-Wells, Cypress Bayheads, Wetland Areas, Aitering <br /> Watercourses. <br /> - Army Corps of Engineers-Seawall ,Docks,Navigable Waterways. <br /> - Department of Health & Rehabil tative Services/Environmental Health Unit-Wells, INastewater Treatment, <br /> Septic Tanks. , <br /> - US Environmental Protection Age cy-Asbestos abatement. <br /> - Federal Aviation Authoriiy-Runwa s. <br /> I understand that the following restrictions app to the use of fill: <br /> - Use of fill is not allowed in Flood ne"V"unless expressly 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 volume"will be su mitted at time of permitting which is prepared by a professional engineer <br /> licensed by the State of Florida. <br /> - If the fill material is to be used i Flood Zone "A" in connection with a permitted building using stem wall <br /> construction,I certify that fill will b used only to fill the area N�ithin the stem wall. <br /> - If fill material is to be used in ny area, I certify that use of such fill will not adversely aifect adjacent <br /> properties. If use of fill is found t adversely affect adjacent properties, the owner may be cited for violating <br /> the conditions of the building per iit issued under the attached permit application,for lots less than one (1) <br /> acre which are elevated by fill,an ngineered drainage plan is required. <br /> If I am the AGEPJT FOR THE OWNER, I pro ise in good faith to inform the owner of the permitting conditions set forth in <br /> this affidavit prior to commencing constructio . I understand that a separate permit may be required for electrical work, <br /> plumbing, signs, wells, pools, air conditionin , gas, or other installations not specifically included in the application. A <br /> permit issued shall be construed to be a licen e to proceed with the work and not as authority to violate,cancel,alter,or <br /> set aside any provisions of the technical code ,nor shall issuance of a permit prevent the Building Official from thereafter <br /> requiring a correction of errors in plans,const uction or violations of any codes. Every permit issued shall become invalid <br /> unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by <br /> the permit is suspended or abandoned for a p riod of six(6)months after the time the work is commenced. An extension <br /> may be requested, in writing,from the Buildi g Official for a period not to exceed ninety(90)days and will demonstrate <br /> justifiable cause for the extension. If work cea es for ninety(90)consecutive days,the job is considered abandoned. <br /> WARNING TO OWNER: YOUR FAILURE O RECORD A NOTICE OF COMNiENCEMENT MAY RESULT IN YOUR <br /> PAYING TWICE FOR I OVEMENTS TO OU , OP RTY. IF YOU INTEND TO OBTAIN FIIVANCING,CONSULT <br /> WITH YOUR LERID R AN ATTOR RE CORDIPJG YOUR NOTICE OF COMMENCEMENT. <br /> FLORIDA JURAT(F.S. .03 y �� /� > <br /> OWNER OR AGEN ^- � CONTRACTOR ��� LR_• I�y�(�it�(/vu <br /> Subs e ,a�d sw r affi d)before this ub ri�?ed a sworn to(or affirmed) efore me[his <br /> J'rby • ���V�� bY �LYS <br /> Wh s/ar perso ly known to me or ha ave p ed Who is/are personally known to me or as!a e p odu �d <br /> as identification. as identifi tion. <br /> 1 V � <br /> Notary blic � Notary Public <br /> Commission No. Com issio No. <br /> ,.��n.p�. <br /> Name of No��y eQ�sprin d - ame of �.,•t d.:n����E��3053 <br /> Q� o�NOTARY PUBLIC <br /> a o STATE OF FLORIDi4 ��;�F��;�� ����IFS���u��g�,���y <br /> �'' ?Comm#EE137010 <br /> `��n'CE 19�� Expires 10/10/2015 <br />