|
<br />COND 1 , J UNS UF PEPr-1 I T (\F r:- I LHW I T
<br />(\ , NQI!..~~_PE..._PEg!L_.Rs_~JBJJ:;IJ.QI"t;.
<br />The"nder~igned under~tand~ that thi~ per.it '~y be ~"bject to "deed re~trictions" Hhich .ay be .ore restrictive than City
<br />regulations. The undersigned assuaes responsibility for co~pliance Hith any applicable deed restrictions.
<br />
<br />Fl. LJNLJCgt"JSEI.t CQHIfY~J,:;J.QBq..()IJRnLj.JlnF<DCrur< . REBF'ONS I BILl TIES
<br />If the owner hilS hired iI contrartpr pr cl:lntradl:lrs tp undert~lp'~prk~-they~~yb~-';'~q~"i~;'d-.t~--b'~'-i'i[l!nsed in accl:lrdance Hith
<br />state and local regulations, If the contractor is not licensed as required by law, both the owner and contractor lay be
<br />cited for a .isdeleanor violation under state laH. If the owner or intended contractor are uncertain as to what licensing
<br />require.ents aay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, 1813)
<br />78B-66I1.
<br />
<br />Further~ore, if the owner has hired a contractor Dr cpntrilctors, he is advised to have the contractorls) sign portions of the
<br />"Contractor Sections" of this application for which they "ill be responsible, If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work, If the contractor wishes you to sign
<br />as contractor that lay be an indication that he is not properly licensed and is not entitled to per.itting privileges in the
<br />City of Zephyrhills.
<br />
<br />I ~ . IDf)I\l!;?F' urn A T I P!L!t!F' 14~_LE_E;.s.~_111jPn_lJ..I.!"=J_LL...l;!Jl~Il~~~LlQ!:LF EE~.
<br />
<br />{). l~J=,N~JRUGT '!'QN_.~_LE;H_J,-J~H (C'InPIFn '7 j :=1. FLUn J D() STATUTES ~ ns (WIEI<!DED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien LaH - IIoMeoHner's Protection
<br />Guide" prepared by the Florida Depart.ent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
<br />"o"ner", I certify that I have obtained a copy pf the abpve described doc"~ent and promise in good faith to deliver it tp thp
<br />ROHner" prior to co..ence.ent.
<br />
<br />F. kDt-n:Rf)CTQR' SLP~'Jb!.~.J3.":'fLJ.)EE!..Rl\\lJI.
<br />I certify that all the infor.ation in this application is accurate and that all "ork Hill be done in cOlpliance Hith all
<br />applicable Iaw~ regulating construction, zoning, and land developMent,
<br />
<br />Application is h~r~by tade to obtain a p~r.it to do work and installation as indicated. (c~rtify that no work or
<br />installation has co.tenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developMent regulations in the jurisdiction, I also
<br />certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is
<br />'y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li.ited to:
<br />. Departlent of Environ.ental Requlation - Cypress Bayheads, Hetland Areas and EnvironMentally Sensitive Lands,
<br />Water/Wastewater Treatment
<br />. Southwest Florida Nater nanaQe.ent District - Wells, Cypress Bayheads, Hetland Areas, Altering Watercourses
<br />. Ar.v Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />. ~epart.ent of Health & Rehabilitative Services, Environ.enlal Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
<br />. US Environ.ental Protection Aqencv - Asbestos abateMent
<br />I also certify that, if fill .alerial is to be used in Flood lone "A" Dr "A,elc,', it is understood that a drainage plan
<br />addressing a "coMpensating volute" Mill be ~ub.itted Hhich is prepared by a professional engineer registered in the state of
<br />Flprida prior to perait is~uance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with the "ork and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, Dr violations of any code, Every perlit issued shall becole invalid
<br />unless the work authorized by such per-it is cOI,enced Hithin six lonths of issuance, Dr if work authorized by the perMit is
<br />suspended Dr abandoned for a period of six .onths after the li.e the work is co.,enced. One 90 day extension of tile, aay be
<br />allowed for the perlit with fee charge of $15,00. The extension shall be requested in writing to the Building Official. An
<br />apprpved inspection lust be logged during each six Month period, or the project Hill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCEnE"T nAY RESULT IN YOUR PAYING TWICE FOR InPROVEnENTS TO YOUR
<br />PRUPERTY, IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />CO""EN[E"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF connENCEnENT".
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />-- - --.--
<br />SIGNATURE: CONTRACTOR
<br />
<br />Nas acknD~lledged
<br />, 19_ by
<br />
<br />STAlE OF FLORIDA
<br />COUPnv OF
<br />The fDregoing instrument
<br />befc.rE' mE' th i 5
<br />
<br />STATE OF FLORIDA
<br />CDlmlY OF
<br />ThE' foregoing instrument
<br />bE'fore me this
<br />
<br />was acknoNledged
<br />, 19_ by
<br />
<br />-
<br />~lho is persc.n.;d 1 y kno...m to me C'\- who has
<br />PI-Dduced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />...,hD is personally knDwn to me Dr Nho has
<br />pl-oduced
<br />as idE'nt\fication and who did/did not
<br />take an oath.
<br />
<br />(Signahu-e)
<br />
<br />(Siqnaturp)
<br />
<br />(Name Typed~ Printed or Stamped)
<br />NOIARY PUBLIC
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />mn AR'LP_UBL I C
<br />
|