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<br />CUNP' I J (JI.lH fir F'FFI-" r r,rr IIHW 1 T
<br />;) . NP IJ.~_~__P.f..._lJg~!Lm:}?'LP~tr; I.IJJ.LI H
<br />lh~ "ndprsignpd undprst~nds th~t this p~r.it I~y bp ~ubj~et to "d~~d r~strictions" Hhieh May b~ .ore rpstrictivp than City
<br />rl'guhtions. Ihe undersigned aSSUMes responsibility f{lf eOI!l"liam:~ Hith any applicablp deed restridions.
<br />
<br />Fl . LII~!:::.L~gtt~E-!LJ,::_Qt~.IB!~GLQB!:).. (.)IW.. __ (;(jIJJrIOL,:TlJI3_ RE E:iF:QN !?I!U!"" IIJ.E;;$
<br />If thp o"ner has hirpd a eontr~ctor or contractors to undprt~~p Hork, thl" l!Iay b~ requirpd to bp licpnspd in ~ccordancp Hith
<br />statp and local regulations. If the contractor is not lic~nspd ~s rpquirpd by I~", both tne ownpr and contractor lay bp
<br />citpd for a .isde,panor viol~tion undpr statp IaN. If thp ONnpr or intpndpd contractor are uncprtain as to "hat licpnsing
<br />rpquire.ents lay apply for the intendpd work, thpy ~rp advised to contact thp City of Zephyrhills Building Depart,ent, 18131
<br />7IlB-bbll.
<br />
<br />Further~orp, if thp owner has hirpd a contractor or contractors, he is advispd to have the contractor Is) sign portions of th~
<br />"Contractor Spctions" of this application for Hhich thpy Hill bp responsibl~. If you, as the ownpr sign as the contractor,
<br />you arp indicating that you, rathpr than the contractor, arp responsible for the work. If the contr~ctor Mishes you to sign
<br />as contractor that lay be an indication that hp is n~t properly licpnspd and is not entitled to perlitting privilpges in thp
<br />City of Zpphyrhills.
<br />
<br />t: . .LB(}N!:?.f' 08 -r A - r ..U}LLUJF ()t:;.LEJ;.l;.ILD1.::H>-,JJ...U.kl.LY_ LQNN.I;J,-;THJ.!:J....E~J~;.$.,
<br />
<br />D.. l:;.m"'STRUt;;TL!JN_kLQL1JlH (CII(\F'TER '1.t:=~ ~ FLI.lF< IIH) SnHUTES, ns (WIEHDED)
<br />I cprtify that I, the ~pplicant, h~vp bepn provided with a copy of "Florida's Construction Lien LaH - HOMpoHner's Protection
<br />Suidp' prepared by thp Florida Dppart.pnt of Agriculturp and [on;".~r Affairs. If thp applicant is so.pone other than thp
<br />"OH"P'", I [~rtify that I havp obtained a cop, of the abovp dp~[,ibed do[n~pnl and pro~i~p in good f~ith to dplivpr it to thp
<br />.o"npr" prior to co..pncplpnt.
<br />
<br />F . L;Qr.-!TRflCTQR ' SLP~'Jb!.~B.~_!?_._(}fEI."P.O\lJ.I.
<br />I cprtif, that all the inforMation in this application is accuratp and that all work Hill be done in co'pliance with all
<br />applicablp laws regulating construction, loning, and land dpvelopMpnt.
<br />
<br />Application is hereby lade to obtain a per.it to do Hork and installation as indic~ted. I certify that no work or
<br />installation has cO'lenced prior to issuancp of ~ per.it ~n~ that all Hork Hill be perforlpd to Ipet standards of all laHs
<br />regulating construction, City codps, zoning rpgulations, and land develop.pnt regulations in thp jurisdiction. I alsD
<br />[prtify that I undprstand that the regulations of oth~r govprn.ental agpncies lay apply to thp intpndpd Hork, and th~t it is
<br />MY responsibility to identify Nhat actions I lust takp to be in cOlpliancp. Stich agpncips include but are not lilitpd to:
<br />· Depart.pnt of Environ.ental ReQulation - Cypress Bayhpads, Ketland Areas and EnvironMpntally Spnsitive Lands,
<br />Water/Wastewater Ireat.ent
<br />, SouthHest Florida Water nanaQelent District - Wells, Cypress Bayheads, Ketland Arpas, Altering Katercourses
<br />, ~r.y Corps of EnQinpers - Sea"alls, Docks, Navigable Natprways
<br />· Departlent of Health L Rehabilitative Services, Environlenlal IIealth U~lt - Wells, WasteHater Trpatlpnt, Septic Tanks
<br />, ~S Environ.ental Protection Aqpncy - Asbpstos abatp.pnt
<br />I also cprtify that, if fill laterial is to be used in Flo~d Zone "n" or "A,etc.", it is understood that a drainage plan
<br />addressing a "coMppnsating volulp. Mill bp sub,ittpd Hhich is rrepared by a profpssional engineer registpred in thp Statp of
<br />Florida prior to perlit issuancp.
<br />
<br />A perlit issupd shall be construpd to be a license to procped with thp Hork and not as authority to violatp, cancel altpr, or
<br />set aside any provisions of the tpchnical codes, nor shall issuancp of a perlit prevpnt the Building Official frol therpaftpr
<br />rpquiring a correctien of errors in plans, construction, or violations of any code. Every perlit issued shall bpcoIp invalid
<br />nnless the Hork authorized by such ppr.it is co"pncpd Hithin six lonths of issuancp, or if Mork authorized by the pprlit is
<br />susppndpd or abandoned for a period of six .onlhs aftpr thp tile the Hork is cOI,pnced. Onp 90 day extension of tile, lay be
<br />allo"pd for the perlit with fee charge of $15.00. The extension shall be requested in writing to thp Building Official. An
<br />approvpd insppction .ust bp loggpd during each six .onth ppriod, or the project "ill be considered abandoned.
<br />WARN INS 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 OBIAIN FINANCING, CONSULT WITII YOUR LENDER OR AN ATTORNEY eEFORE RECORDING YOUR NOTICE OF
<br />conMENCEnENT. Joes UNDER .2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT",
<br />
<br />
<br />
<br />'JG"'"", ....R OR 'G'N' ,~~~
<br />
<br />STATE or FLORIDA
<br />CO,," TV OF
<br />'lie for ego i I1g ills t1-ument
<br />befof-e me this
<br />
<br />1'185 acknDI'lledqed
<br />, 19_ by'
<br />
<br />I'1~1[o is person.:llly ~:nD~m to me or ,.,ho h.:ls
<br />Ploduced
<br />as identific.:Itioll .:IlId who did/did not
<br />take i'ln o.:lth.
<br />
<br />(Signa!;uf-e)
<br />
<br />(Name Typed, Printed Dr .St.:lmped)
<br />t:lQJ ArtY PUBL) C
<br />
<br />STATE OF FLORIDA -) I
<br />COUNTY OF /-; /)..e / let 5
<br />The frwf?QDim.j instrument I'I,:\S acknol'lledged
<br />befol-e m~ this /- 7 ' 19~ by'
<br />~
<br />..a/ltV -I-~ rfa.rO
<br />Io'/ho is pel-son.::!ll y !
<br />pl-oduced ~,'/"--.---'
<br />as identifi ation
<br />Ge .:In o.:lth. (! ...-----~ . !
<br />(~ -6L-< -l::L-~ U "-..../' / / "<1..:.:..../.A .r ~'---' /
<br />(Signature) ........ . /r-,
<br />I'Yl 4 /'f -5 /---/ /) a.. /[: }-L- / r'::;~<': cr-
<br />(Name Typed, Printed Dr Stamped)
<br />
<br />llg]fif M~~~K~~H
<br />
<br />: My Comml..lon Explr..
<br />\ ; April 28. 1996
<br />'SClF~.. Comm. No. CC 197176
<br />..........
<br />
<br />
<br />:- ,'" -<;':,..;- ,',
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