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<br />COND 1 'J uns UF F'EHI'II T (~FF I D(W IT
<br />(). NlJIt~_E;:__QE._._pg~!LB~~'rE~.JJ':JJJJ.I\I!::; ,
<br />Ihe undersigned understands that this per.it lay be ~ubject to "deed restrictions" Hhich lay be lore restrictive than City
<br />fegulations. Ihe undersigned as~u.es responsibility fDr (o~pliance Hith any applicable deed restrictions.
<br />
<br />Fl. U!-JL I G.p.JSE,!>.. CQN.IHm:~'U:m.!:;.,J)IJl)H t;PI:-JTBDGJ[)ll.I3E::E:;e(JH~.!JUbITtE;,S;.
<br />If the o"ner has hired a contractor or contractors to underta~p Mork, they may be required to be licensed in accordance Mith
<br />state and local regulations. If the contractor is not licensed as required by la", both the o"ner and contractor lay be
<br />cited for a lisdeleanor violation under state laM. If the owner or intended contractor are uncertain as to "hat licensing
<br />reQuire.ents lay apply for the intended "ork, they are ad~ised to contact the City of Zephyrhills Building Depart.ent, 18131
<br />788-6611.
<br />
<br />FUfther~ore, if the o"ner has hired a contractor or contractors, he is advised to have the contractorls) sign portions of the
<br />.Contractor Sections" of this application for "hich they Hill be responsible. If you, as the o"ner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the "ork. If the contractor "ishes 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 tephyrhills.
<br />
<br />\; . rDAN!?PORTAT I DILl nPA~L.f_E;J~.~_l:ltjQ,JJ.I..tl.-I.ILn..I.::91~.t'-~~IJQtL...fEE,!2,
<br />
<br />n. ~ON!?rRUGTION_1",..u::IL1--'.tH (CllflF'n::,n 7j~=J~ FLIJF<UH'. ST(nUTES~ ()S (WIENDEUI
<br />I certify that I, the applicant, have been provided "ith a copy of "Florida's Construction Lien La" - HOleo"ner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and [onsu.er Affairs. If the applicant is sOleone other than the
<br />"oHuef". I cprtify that I have obtained a copy of the ahove described docu~ent aud promise in good faith to deliver it to thp
<br />"oMner" prior to cOllencelent.
<br />
<br />F . ~(JtH:.R()CTQR I s/m'J!jf:;B_~J:;L.EEE!..PH'v'J.I.
<br />J certify that all the inforlation in this application is accurate and that. all "ork will be done in cOlpliance with all
<br />applicable la"s regulating construction, loning, and land develop.ent.
<br />
<br />Application is hereby lade to obtain a perlit to do Murk and installation a~ indicated. I certify that no "ork or
<br />installation has cOI.enced prior to issuance of a per~it and that all work "ill be perforled to leet standards of all la"s
<br />regulating construction, City codes, loning regulations, and land development regulations in the jurisdiction. I also
<br />cprtify that I understand that the regulations of other govern,ental agencies lay apply to the intended "ork, and that it is
<br />"Y responsibility to identify Hhat actions I .ust take to be in co.pliance. Such agencies include but are not Ii.ited to:
<br />· Departlent of Environlental Requlation - Cypress Bayheads, Wetland Areas and Environ,entally Sensitive Lands,
<br />Water/Wastewater Treat~ent
<br />, South"est Florida Nater nanaqe,ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />, flr.y Corps of Enqineers - Sea"alls, Docks, Navigable Water"ays
<br />· ~~p'~~ent of Health & Rehabilitative Servi~~~vir~~ental lIe~~.~t - Wells, Wastewater Treatlent, Septic lanks
<br />· US Environ.ental Protection Aqency - Asbestos abatelent
<br />I also certify that, if fill lIlaterial is to be used in Flood lone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "co"pensating volule. "ill be sublitted "hich is prepared by a professional engineer registered in the State of
<br />FIDrida prior to per.it issuance.
<br />
<br />A per.it issued shall be construed to be a license to proceed "ith the "ork and not as authority to violate, cancel alter, Dr
<br />set aside any provisions of the technical codes, nor shall issuance of a per.it prevent the Building Official fro. thereafter
<br />requiring a correction of errors in plans, construction, Dr violations of any code. Every perlit issued shall becollle invalid
<br />unless the "ork authorized by such per-it is co",enced "ithin si~ lIlonths of issuance, Dr if work authorized by the perlit is
<br />suspended or abandoned for a period of six lonths after the tile the "ork is co..enced. One 90 day extension of ti.e, lay be
<br />allowed for the perlit "ith fee charge of tI5.00. The extension shall be requested in "riting to the Building Official. An
<br />approved inspection lust be logged during each six lonth period, or the project "ill be considered abandoned.
<br />WARNINS TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT nAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PRUPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATIORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VAlUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEnENT".
<br />
<br />~l3~~~~
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />-_._._--
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />WUN JY OF
<br />Tile foregoing instrument
<br />hefof'e me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />befDre me this
<br />
<br />\o'las acknc'\o'lledged
<br />, 19_ by
<br />
<br />"IIID is per SDna 11 y l:no,,"1ll to me Ctl- whD has
<br />pl-oduced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />who is persDnally known to me or whD has
<br />pt-odLlced
<br />as identification and I-'Iho did/did not
<br />take an oath.
<br />
<br />(SignatLn-e)
<br />
<br />(SignatLll-p)
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />NUl ARY PUBLIC
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />mH AR.:LE..ll!3L I C
<br />
<br />.'
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