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<br />CONDITIONS OF PERMIT AF~ 0 ~'
<br />A. I'IOT I CE OF QsEJj_[~ST..f: I!=T I ON~",_
<br />The undersigned understands that this permit may be subjed to "deed rcstrict.\c'ns" ~;',ir.h ,C,,/ br, 00rE' restrictivE' [i ty
<br />reguJitions. The undersigned assumes responsinility for compliancE' with ~ny ~rplicable ~[Prl rostrictions.
<br />
<br />B . hL!:ll- ICE N f> E D _(;'gl'\l T BD CT O.G S e!-N Q~9N T R tl.~_JJJr-:~J=:r::~;::)E:.q 1\1 ~.u~E{_l~).I"E~X!.
<br />If the owner has hired a contractor or contrilCtors to l\nderta~:Q 110rL, they milY Iii: required te, tl[ licensed in ,;i.CC,rnilncr .lith
<br />state and local regulations. If the contractor is not licensed as required by I~M, both the owner and contractor ~ay be
<br />cited for a oisdeaeanor violation under state law. If the owner or intended contractor are uncertain as tD "hat licensing
<br />requireeents Day apply for the intended "ork, they are advised to contact the Cily of 2or~yrhills Building Depart~ent, 18131
<br />788-6611.
<br />
<br />Furth~rmore, if th~ o"n~r has hired a contractor Dr contractors, he is advised to have, the contractor!s) sign portions of the
<br />'Contractor Sections' of this application for Hhich they Hill be responsible. If you, as the D"ner sign as the contractor,
<br />you are indicating that you, rather than the contractor, ar~ responsible for the ~ork. If the cDntractor Kishcs you to sign
<br />as contractor that may be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TF:Af'.JSF'ORT ('4 T I ON II'1F'ACT FEES Ai'JD LIT I Ie' IJ~~LLQNi':lE.CI.LQtLnEESc?
<br />
<br />D. Cm'lSTRUCT I ON L I ~N LA.H (CHAF'TER 713, FL 0 1:-::: I DI, ST(',TUTE~3, P,S nr'1Er,lDED)
<br />I certify that I, the applicant, haY~ b~~n provided with a copy. of 'Florida's Con5tfuc~iDn Lien La" - Ho~eo"ner's Protection
<br />Guide" prepared by the Florida D~partment of Agricultur~ and Consumer Affairs. If the, applicant is someone other than the
<br />'owner', I certify that I haY~ obtained a copy of the above described document and promise in good faith to deliver it to the
<br />'own~r' prior to commence~ent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />--- ..-
<br />I certify that all the information in this application is accurate and that all work "ill be done in compliance Kith all
<br />applicable laws regulating construction, zoning, and land development.
<br />
<br />Application is hereby made to obtain a perait to do work and installation as indicated, I certify that no ~ork or
<br />installation has commenced prior to issuance of a permit and that all work will be perfor~ed to meet standards of all la~s
<br />regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br />c~rtify that I understand that the regulations of other governnental agencies may apply to the intended work, and that it is
<br />IY rJrsponsibility to identify tihat adions I I'mst take to be in cor:;pliance. Such agencies include but are not lir.ited te,:
<br />I Depart~ent of Environ~ental Requlation - Cypress Bayheads, Hetland Areas and Environmentally Sensitive Lands,
<br />Hater/Wastewater Treatment
<br />I Southwest Florida Water Manaqement District - Wells, Cypress Bayheads, Hetland Areas, Alterinq Watercourses
<br />I Ar~y Corps of Enqineers - Sea"alls, Docks, Navigable Waterways
<br />f Department of I(ealth 1. Rehabilitative Services, Environmenbl Health Unit - iL1Js, flastel1ater Treatment, Septic TanKS
<br />I US Environ~ental Protection ADenCY - Asbestos abatement
<br />alsD certify that, if fill material is to be used in Flood Zone "A" or "n,elc,', it is understood that a drainage plan
<br />addressing a 'compensating volume" Hill be subaitted which is prepared by a professional enOineer registered in the State of
<br />Florida prior to permit issuance.
<br />
<br />A per~it issued shall be construed to be a license to proceed with the \1orl: and not as autrwrity te< violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official fro~ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code, Every perlil issued shall becole invalid
<br />unless the "ork authorized by such permit is com~enced within six ~onths of issuance, or if work authorized by the per~it is
<br />suspended Dr abandoned for a period of six months after the time the "ork is conaenced, One 90 day extension of ti~e, nay be
<br />allowed for the permit with fee charge of SI5.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection ~ust be logged during each six month period, Dr the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD n NOTICE OF COMMENCEMENT MAY RESULT IN YOUR rnYING THICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO DBTI\IH Fllii'llICHIG, CONSULT ~IITH YOUR LENDER OR r:N i\TrOR1iEY DEFDRE RECOG:DING YOUR !lOTlCE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT HEED TO RECORD nND POST A "NOTICE o~ COMMENCEMENT',
<br />
<br />~ YV\1<:b~
<br />
<br />SIGNATURE: OWNER OR AGEHT
<br />
<br />_"'~. lY\,<"~
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />
<br />PAS (!..{)
<br />
<br />;:::';,0:/"'" no, ~ (}S ('..(:>
<br />
<br />Th E' fe, r Eeg e, i (ICJ i n,=. t i" umcn t Vi'::' S elC k nD\'ll ed ged
<br />befr-) this rUDv /3, 1'7' c,~ by
<br />
<br />__J:llli2~~~Q~-~-
<br />~~~:d~t~E.~;el"~t\ ~()\klt~o!1' ?;~5 t3;~flD
<br />
<br />as identification and WhD did/did nDt
<br />
<br />The foregDing instrument was acknowledqed
<br />befc'J-e me this lJ~vr 13, 19~.J- by. -
<br />
<br />'~LLS~oe... \ \ (Y) 2r 0 y::ltJ
<br />who is persDnally known to me o~ who has
<br />produced ~ \ \.....C)\ <-SO '1 'D?> 5) 2>'11 (J
<br />as identification and who did/did not
<br />
<br />take an oat(1 ~ k Q 8"1Ua:> Qr\.().y. O~
<br />
<br />(Signatun.') /y\-o[,.,._ t. {.--,
<br />L' Ii A/U.. D rr t::.- LLl!...LJ.!&,.~
<br />(Name Typed, Printed or Stamped)
<br />NOT AF:\~..F.'UBL I C
<br />/~ ~... OFFICIAL SEAL
<br />: !rl '\ Charlotte Mlhalakis
<br />: : My Commission Expires
<br />."~ II"".AI Noy. 16. 1996
<br />.....~~.... Comm. No. CC 235863
<br />
<br />take ,,,n~I-~. _~~(~
<br />(Si g"" ",," i ~~::;. iJTT';' ~ be \<Ll\ 'J
<br />
<br />(Name Typed, Printed or Stamped)
<br />r-j 0 T()f\'{.?lJrilJ~
<br />
<br />...*......
<br />"..~ ~... OFFICIAL SEAL
<br />! ~ \ Char lotte Mihalakis
<br />i : My commission Expires
<br />\ ! Noy. 16. 1996
<br />'~OF~. Comm. No. CC 235863
<br />.......
<br />
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