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<br />COND 1 I JUNe..; UF PEHH I T nFF I. DIW I T
<br />(). /'lQII.~~_P.E.___pgJ;~.!L,m:},Ig..U;JLQLI~3
<br />Th~ "nd~rsigned understands th~t this p~r.it '~y bp. subj~ct to "d~~d r~strictions" Hhich lay b~ .or~ restrictive than City
<br />regulations. The undersigned aSSUle5 responsibility for co'pliance Hith any applicable deed r~5trictions.
<br />
<br />Fl . UNL I q;;NSE!L...hQN_If'~~.GJJJ-'3.9.0.1JI.t.. L__lJtn F3D_~ ILJft.. RE::E3F~QH);iI!UJ,::IIJ_~9..
<br />If the OMner has hired a contractor or contractors to und~rta~p. Hork, they ~ay b~ r~Quired to b~ licensed in accordance Mith
<br />state and local regulations. If the contractor is not licensed as required by laM, both the ONner and contractor lay be
<br />cited for a lisde.eanor violation under state laM. If the OHner Dr intended contractor are uncertain as to Mhat licensing
<br />requirelents lay apply for the intended "ork, they are advised to contact the City of Zephyrhills Building Departlent, (8131
<br />799-6611.
<br />
<br />Further~ore, if the o"ner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for "hich they Hill be responsible. If you, as the ONner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the "ork. If the contractor 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 lephyrhills.
<br />
<br />t: " InON!:;)F'ORT A T I l,l1:LJ t"lf t41,:;_L,L~t;:_~_ 1')HP.__lJ._L!'=JJ.:_Y:_,.~!Jl~t!s..~I_LQ!:~LF EE,!;?,
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<br />n. 1.:~JJN~IRUGT JjJN_l.::L~!L1-J)H (Cl'f\PTEn"7:1:3 ~ FLUn J DO STlHLJTES ~ ()S IWIENDED)
<br />I c~rtify that I, the applicant, have been provided Mith a copy of "Florida's Construction Lien laM - IIoleoMner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and [onsuler Affairs. If the applicant is sOleone other than the
<br />"oHoer", I certify that I have obtained a copy of the above d~scribed docu~~nt and pro~i5e in good faith to deliver it to thp
<br />"oHner" prior to cOllencelent.
<br />
<br />F. G(jt'lIR"I;TQR I SLQl'JN~B-'-_!3___f}E_EJ.PO\lJ.I
<br />I rertify that all the inforlation in this application is accurate and that all "ork Mill b~ dOn~ in cOlplianr~ "ith all
<br />applicable la"s regulating construction, loning, and land dev~lop.~nt.
<br />
<br />Appliration is hereby lade to obtain a perlit to do "ork and installation as indicated. I certify that no "ork Dr
<br />installation has co..enced prior to issuance of a p~r.it an~ that all Nork "ill be perforled to leet standards of all la"s
<br />rfgulating construction, City codes, loning r~qulations, and land develop~ent regulations in the jurisdiction. I also
<br />certify that I und~rstand that the regulations of other gOYfrn.~ntal agenries lay apply to the intended "ork, and that it is
<br />.y responsibility to identify "hat actions I lust take to be in ro.pliance. Such agencies include but are not li.ited to:
<br />. Depart.ent of Environ.ental Requlation - Cypress Bayheads, Wetland Ar~as and Environlentally Sensitive Lands,
<br />Hater/HasteNater Tr~at.ent
<br />· South"est Florida Nater "anaqe.ent District - H~lls, Cypress Bayh~ads, Wetland Areas, Altering Watercourses
<br />. ~r.y Corps of Enqineers - Sea"alls, Docks, Navigable Hater"ays
<br />, Q~~artlent of IIealth L Rehabilitative Servi~~vir~~ental "~~~lt - Hells, HasteMater Tr~atlent, Septic Tanks
<br />, US EnvironMental Protection Aqency - Asbestos abat~lent
<br />I also [~rtify that, if fill .aterial is to be used in Flood Zone "n" Dr "A,etc.", it is understood that a drainage plan
<br />addressing a "co.pensating volule" Mill b~ sublitted Mhich is prepared by a professional engineer registered in the State of
<br />rlorida prior to p~r.it iSSllanc~.
<br />
<br />A per.it issued shall be construed to be a lic~nse to proce~d "ith the Mork and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuanre 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 beco.e invalid
<br />unless the Mork authorized by such per-it is co.,ented "ithin si~ lonths of issuance, or if Mork authorized by the perlit is
<br />suspended Dr abandoned for a period of si~ lonths after the tile the Mork is cO'lenced. One 90 day e~tension of tile, lay b~
<br />allo"ed for the perlit "ith fee charge of fI5.00. The e~tension shall be requested in "riting to the Building Official. An
<br />approved inspection lust be logged during each six lonth period, or the project Mill be considered abandoned.
<br />HARNING TO OHNER: YOUR FAilURE TO RECORD A NOTICE OF COMnENCEMEHT nAY RESULT IN YOUR PAYING THICE FOR IMPROVEMENTS TO YOUR
<br />PRUPERTY. IF YOU INTEND TO OBfAIN FINANCING, CONSULT HITH YOUR LENDER OR AN AfTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOf NEED TO RECORD AND POST A "NOTIC OF COMMENCEMENT".
<br />
<br />~ I A~ f/S~iJ. 15,.
<br />
<br />f~ER OR AGENT
<br />
<br />
<br />
<br />Sf ATE OF FLORID~~
<br />COI.INfY OF L tJ..4 Co
<br />The foregoing i trument was acknowledged
<br />bef~l'e e this 'jN.~ L.,)/!l!L by
<br />
<br />~
<br />
<br />STAfE OF FLORIDA /"J .'
<br />COUNTY OF . v a~..o C-<./
<br />The foregoi ng i I tnlment
<br />befDre me th i 5 /7t-'
<br />
<br />
<br />
<br />e c.r NhD has
<br />
<br />
<br />(Signahl1~1 /.1 V') '/? ~ L
<br />~----- - ~{; ~ ~
<br />(N~me Typed. Print d or Stamped) (Name Typed, Pri ted or Stamped)
<br />N01 ARY P~ C (1; ,-'1. ", ~.~ / '? '" I.. NOT ARY~U () !. ~ ~/ t/ s; A.. ' 13(.( s II
<br />..... .~ 17 L-'{O;:-;~~:; t..( """'OFFICIAL SEAL .... -..-----.- ~~ QPFICtAt. ~I;At;
<br />l ii\ G''''/t~\ GLADYS L. BUSH ~J GLAOVli ~, ~Y3"
<br />: : M, C"nf!;':. : My Commission Expires t My (:gmmia!llifl ~~~'r~
<br />: I : uc\. ! Oct. 7, 1996 ~ OGt. 1, I@ijg
<br />\~~ (ff'....... Cor-.re.. :..*~~ ~.. Comm. No. CC 234022 "*~~oFF'u1!.. Comm, Ng. gQ ~~4Q2a
<br />*....~:;..... ....fl'~:..... ........."It..... - 'n
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<br />(Signahu-e)
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