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<br />COND 1 , J Ut'lr~ UF FEFI'I IT (\FF I LHW I T
<br />() . NQTI.~_~_QE....J)gI:;JLB~J1IJltGJJJJJ,I_rJ
<br />Ih~ "nd~rsigned understands that this p~r.it '~y b~ ~"bject to "d~~d r~strictions" Mhich tay b~ ,ore restrictive than City
<br />regulations. Th~ und~rsigned assutes responsibility for (o~rlian(e "ith any applicable deed restrictions.
<br />
<br />Fe . P!>JL I CENSE D ~Qt!IfiO~Jlt!3p.__0ImuCJJUT BDJ~IQn._p.E::F:ir:(Jr~J2I!UbIT:Ll;_9.,
<br />If th~ o"ner has hired a contractor or contractors to underta~e Mork, the, may b~ required to be licensed in accordance "ith
<br />state and local regulations. If the contractor is not lic~nsed as required by la", both the owner and contractor lay be
<br />cited for a .isdeleanor violation under state IaN. If the owner or intended contractor are uncertain as to "hat licensing
<br />require.ents lay apply for the intended work, they are advis~d to contact th~ City of Zephyrhills 8uilding Departtent, 19131
<br />7BB-bb I I.
<br />
<br />Further.ore, if the ONner has hired a contractor or contractors, he is advi5~d to have the contractorlsl sign portions of the
<br />"Contractor Sections' of this application for "hich 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 Mishes you to sign
<br />as contractor that tay 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. Jf3BNr;lPOGTAT I fJ1LI t-1Pfl~LEJ~_I;:_~_ {.)tJl)__J=''':U_bl_L'L_.J;Qt~t!~t;,:...I1JJN.__ FEE9..
<br />
<br />O. ~ON~JRUc.;T '!"Q!'!_bLr::::!',L1J.\H (CII()PTER '7 J ~=J. FLOR I D() SlAIUTES ~ ns (WIENDED)
<br />I certify that I, the applicant, have been provided "ith a copy of "Florida's Construction Lien La" ... "oleo"n~r's Protection
<br />Suid~" prepared by the Florida Departlent of Agriculture and C"nSUler Affairs. If the applicant is sOleone other than th~
<br />"o"ner", I c~rtify that I hav~ obtained a copy of the above d~5(ribed do(u~~nt and prolis~ in good faith to d~liver it to thp
<br />"owner" prior to cot.encelent.
<br />
<br />F. ~IJNT.RACTQR' Slm'J~E;:B~J:L})fJ=:J..RHYJI.
<br />I certify that all the infor.ation in this applicati~n is accurate and that all "~rk "ill be done in COMpliance with all
<br />applicable la"s regulating construction, loning, and land developMent.
<br />
<br />Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no Mork or
<br />installation has co.tenced prior to issuance of a perlit and that all "ork "ill be perforled to .eet standards of all laMs
<br />regulating construction, City c~des, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governlental agencies lay apply to the intended "ork, and that it is
<br />.y responsibility to identify "hat actions I lust take to be in co'pliance. Such agencies include but are not li.ited to:
<br />I Depart.ent of Environ.ental Requlation - Cypress Bayheads, Wetland Areas and Environtentally Sensitive Lands,
<br />Water/Wast~"at~r TreatMent
<br />, Southwest Florida Water nanaqe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />, ~r.v Corps of Enqineers - SeaHalls, Docks, Navigable Water"ays
<br />I D.~'p'art,.ent of lIealth L Rehabilitative Services,_EnvironlPntal lIe~lliJ!!I11 - Wells, lIaste"ater Treatlent, Septic Tanks
<br />, ~S Environ_ental Protection Aqenty - Asbestos abateMent
<br />I also certify that, if fill Material is to be used in Fl~od Z~ne "n" or "A,etc.", it is understood that a drainage plan
<br />addressing a .colpensating volu.e' "ill be subMitted "hich is rr~pared by a professional engineer registered in the State ~f
<br />Florida prior to per.it issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed "ith 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 8uilding Official frot thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid
<br />unless the work authorized by such per-it is cOI,enced "ithin six .onths of issuance, or if Mork authorized by the p~r.it is
<br />suspended or abandoned for a period of six .onths after the ti,~ the work is cOI,enced. One 90 day extension of tiMe, lay be
<br />allo"ed for the perlit "ith fee charge of fI5.00. The extension shall be requested in writing to the 8uilding Official. An
<br />approved inspection .ust be logged during each six tonth period, or the project Mill be considered abandoned.
<br />WARNING TO ONNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT nAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO 08lAIN FINANCING, CONSULT WIlli YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMMENCEMENT. J08S UNDER f2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMnENCEMENT'.
<br />
<br />~~j~ f?1.d. ~~b"'t f}~L
<br />
<br />SISNAJURE: OMNER OR AGENT SIGNATURE: CONTRACTOR
<br />
<br />STATE OF flORIDA LtJl
<br />COUNTY OF w.2Co
<br />Ihe fc'rego i ng i trument ",as acknNIl edged
<br />befol'e m this . 19!i.J1- by
<br />
<br />~ /~J!
<br />
<br />
<br />"'I~C. i~ personally knD":;ato me c.r who has
<br />pI oduLed ~..eA o-,.,..,~"f;'$J' ~~ -tJ ~
<br />as ident fication a wlm -d:i:d'/dirJ not
<br />
<br />:o',e on 00411-+ ~ ~~
<br />
<br />(Stgnatur-e) /tJJ /7 /
<br /><.i t- 4- 0 if:. 'i L, 1..2iA- 5..&__
<br />(Name Typed, Printed Dr Stamped)
<br />NO! ARY p~
<br />-.---- ..... OFFICIAL SEAL
<br />~~, GLADYS L. BUSH
<br />_ \ My Commission Expires
<br />.. : Oct. 7. 1996
<br />""..~' -.bl Comm. No. CC 234022
<br />...~ OF f\.~v..,.
<br />.............
<br />
<br />STATE OF FLORIDA ~ ~
<br />l:OUNTY OF (/ t:.L.<:tt50
<br />The foregoing i R.'~trumentwo. acl:nowledged
<br />before me th i s .l /1____ /',/ ~ 19 -U- by
<br />
<br />7iu.~LI- /gt~{LL
<br />
<br />"Iho is pel:.;ona 11 y kno,,", to me Dr \..,ho has
<br />produced d.. P
<br />as identification d ,,~h~did not
<br />take an oath~/l /1 ~) ./If
<br />. {' t?kJ-o . , /:.i<.~
<br />(Signature) (/1 -
<br />;, u4 Otl <; A. /3 V-...5- "-
<br />(Name Typed~ Pdnted Dr Stamped)
<br />NOTARY PUBLIC
<br />......-.---------- OFFICIAL SEAL
<br />t~ GLAO'lfS L. BUsH
<br />_illy Co. m.mission ExpIres
<br />~ : Oct. 1. 1996
<br />'\~, "...11 Comm. No. CC 234022
<br />~ClF~"
<br />........
<br />
<br />
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