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<br />CUNDI , JUNH flF PEnNI! (\FFIIHW'IT
<br />() . l'IQTI~_I;:__QE..._pg~JL.R~_ElJr~tGLI!J.1\1 E';
<br />lh~ "nrl~rsigned understands that this p~rlit lay bp 5"bj~ct t~ "d~~d r~5tricti~ns" which .ay b~ 'or~ r~strictiv~ than City
<br />r~gulati~ns. The undersigned assu.~s responsibility fpr co~rliance Mith any applicable deed restrictions,
<br />
<br />Fe. lJNL I C~NElE-lLJ,;:,Qt{[[if~~Jl,lI3E1,_0.IJP.I~J)IJJBf)J,;rLJJ3__p.r:::9.rLJH?I~J,!:::LrJ,~f.J.
<br />If th~ OMner has hired a contractor or c~ntractors to undertak~ work, th~y may be required to be licensed in accordance with
<br />state and local regulations, If the contractor is not licensed as required by laM, both the OMner and contractor lay be
<br />cited for a .isde,eanor 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 adyised to contact the City of Zephyrhills Building Depart.ent, IBI3!
<br />7BB-6611.
<br />
<br />Furtherlore, if the o"ner has hired a contractor or contractors, he is advised to have the contractor Is! sign portions of the
<br />"Contractor Sections" of this application for "hich they Mill be responsible. If you, as the OMner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the "ork. If the contrattor Mishes 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 />t: . TBAI'J!:;lPOR TAT IPtLI t-1P 14~LEr.;J;.J;LD.!J!)___lJJILtD::__..C.Qt~Ns.I,;;T!JJ!:.'L.E~E,EI,
<br />
<br />n. ~OI'JElTRUI,;;T .tQN____.L."LI;!L1,.JtH (Cll(\PTER 7 J ~=J ~ FLlm I D() STfHUTES, ns (WIENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien LaM - Ifoleo"ner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
<br />"owner", I certify that I have obtained a copy of th~ above described doc"~ent and prolise in good faith to deliver it to thp
<br />"owner" prior to to.lencelent.
<br />
<br />F . ~Q1iI.f<(~TQI3...~ SLQHN~-'--_El_,BEF:_UH)VJT.
<br />I certify that all the inforlation in this application is accurate and that all work Mill be done in cOlpliance Mith all
<br />applicable laMS regulating construction, loning, and land developMent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no Mork Dr
<br />installation has co..enced prior to issuance of a per~it and that all "ork "ill be perforled to leet standards of all laMS
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction, I also
<br />certify that I understand that the regulations of other governMental agencies lay apply to the intended "ork, and that it is
<br />.Y responsibility to identify "hat actions I lUSt take to be in cOlpliance, Such agencies include but are not liMited to:
<br />· Depart,ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive lands,
<br />Water/HasteMater Treat~ent
<br />· SouthHest Florida Nater nanaQelent District - Hells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />· ~r.y Corps of EnQineers - SeaHalls, Docks, Navigable WaterMays
<br />· ~!p.!!.1lent of Ifealth L Rehabili~~tiv~~eJvi~!_~_LE.!ix!!~!,!el.ll~U!p.!llt1!__UnU - Hells, Haste"ater Treat.ent, Septic Tanks
<br />, ~S EnvironMental Protection AQency - Asbestos abateMent
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or 'A,etc,", it is understood that a drainage plan
<br />addressing a "coMpensating volule' "ill be sublitted Hhich is prepared by a professional engineer registered in the state of
<br />Florida prior to per.it issuance.
<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 p~rlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in pians, construction, or violations of any code, Every perlit issued shall beCOMe invalid
<br />unless the work authorized by such per.it is co.,enced Mithin six lonths of issuance, 'Dr if Mork authorized by the perlit is
<br />suspended or abandoned for a period of six aonths after the tile the "ork is co..enced, One 90 day extension of tile, May be
<br />allo"ed for the perMit Hith fee charge of tI5.00. The extension shall be requested in Mriting to the Building Official. An
<br />approved inspection lust be logged during each six Month period, or the project Mill be considered abandoned.
<br />HARNING TO OWNER: YOUR FAilURE TO RECORD A NOTICE OF COMMENCEnENT nAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PRUPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT HITH YOUR LEHDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMnEN[E"ENT. JOBS UNDER $2,500 IN VALUE DO HOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT",
<br />
<br />{J~/ /J~
<br />SIGNATURE: OHNER OR AGENT
<br />
<br />,~~.JI
<br />SIGNATURE: CONTRACTOR
<br />
<br />SlATE OF FLORIDA
<br />COUNTY OF '? As r-<>
<br />The fOf'egoing instnlment I'Ia5 afnNlledged
<br />befDre me this 4----:JArI, 199 by
<br />
<br />Itlhlc~i~1~r~l~~e 01- NhD has
<br />
<br />produced
<br />as identification and who did/did not
<br />
<br />:~~~f&~
<br />
<br />(S i gnCl tLu-e)
<br />
<br />(NClme Typed, Printed or StClmped)
<br />tlO l ARY,
<br />
<br />SlAlE OF FLOR~
<br />COUNTY OF ~&5 Ln
<br />The foregCting ins!,pJment I'las aCkrfl'lledged
<br />before me this r~N , Irq by
<br />
<br />W~~ J.~+:' ~Jj)
<br />
<br />Io',ho is pe;'=-~'na 11 y knDIo'I[L. to me or l.oJho has
<br />pt-odllced
<br />as identification and who did/did not
<br />t ap 0 th
<br />
<br />
<br />
<br />. CINDY BOOKER
<br />.~:~ MY COMMI86ION , CC 112026
<br />~', /;) EXPIRES: MIy 11. _
<br />"Jl ..::;~, landed ThIu NutIIy I'IlIIllc .........
<br />I, . tx''''
<br />
<br />(Name Typed~ Printed or Stamped)
<br />t.~.Q.IAR\LP 101 Jr-
<br />"....';.....,. CINDY BOOKER
<br />l'R,.~;E;.~;:'~ MY COMMISSION' CC 192026
<br />~~.~.~j EXPIRES: May 19. 1996
<br />~.J.i:.Cff.:r..?:'.' Bonded TI1Iu IMary PuIIIIc t.JnderM\teIS
<br />
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