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<br />COND 1 'I tiNS UF PEnN I T (\FF I D/W I T
<br />() . I"QII.~t;:-_QE.,._Q~~P__.B~t?IRAt:;.J..!..lJ.N.E3
<br />The undersigned understands that this perlit lay be ~"bject to "deed restrictions" Khich lay be .ore restrictive thanCily
<br />regulations. The undersigned assu.es responsibility for co~pliance Kith any applicable deed restrictions.
<br />
<br />Fe. lJNL lJ';;J;.Nt?E-.ILJ~;mflf'lfl.t:;TJJB9u.ol.mu f;9NIHf)C_'QfL.Por:::f:lF:PHJ?I!Ul""ITtr;.9..
<br />If the OHner has hired a contractor or contractors to uuderta~e work, they may be required to be licensed in accordance Kith
<br />state and local regulations. If the contractor is not licensed as required by laM, both the owner and contractor .ay be
<br />cited for a .isde,eanor violation under state laK. If the OKner Dr intended contractor are uncertain as to Khat licensing
<br />require.ents lay apply for the intended "or~, they are ad~ised to contact the City of lephyrhills Building Depart.ent, lB13'
<br />7BB-bblJ.
<br />
<br />Further~ore, if the OHner 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 Hhich 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 Kor~. If the contractor wishes you to sign
<br />as contractor that .ay be an indication that he is not properly licensed and is not entitled to per.itting privileges in the
<br />City of lephyrhilIs.
<br />
<br />l:. JJ3ANSPO~TAT I OIJ J t.IPt4~LEI;.t;:JJ_l:!IJl!.,_IJIJ'=-tD'~j':;lJHtlJ~_~LtQtt"..FEE,9.,
<br />
<br />D. (:~,UI\ISTRUGnQN_l.::JEtL1--'}H (C"nPIEn '7 j ~=l. FLUn I IH) STATUTES. ()S I)NHWED)
<br />I certify that I, the applicant, have been provided Kith a copy of "Florida's Construction Lien La" - 1I0leo"ner's Protection
<br />Guide" prepared by the Florida Depart~ent of Agriculture and [onsuler Affairs. If the applicant is sOleone other than the
<br />"oKner"~ I certify that I have obtained a copy of the above described docu~ent and pro~ise in good faith to deliver it to the
<br />"oKnpr" prior to cO'lence.ent.
<br />
<br />F . t;lli_iTnr~.rQR_'-B.LPt'Jt!~B.-'-_~_.,DE_F_!..R()\l).I.
<br />I certify that all the infor.ation in this applicatiun is accurate and that all Murk Kill be done in cOlpliance with all
<br />applicable laKs regulating cunstruction, zoning, and land develop.ent.
<br />
<br />Application is hereby lade to obtain a per.it to do "or. and installatiun as indicated. I certify that no "ork ur
<br />installatiun has co.,enced prior to issuance of a per.it and that all "ork "ill be perfor.ed to leet standards of all la"s
<br />regulating construction, City cudes, loning re~lIlatiuns, and land develop.ent regulations in the jurisdiction, I also
<br />cprtify that I understand that the regulations of other goyprn~ental agencies .ay apply to the intended work, and that it is
<br />.y responsibility to identify "hat actions I IlIst take to be in cOlpliance. Such agencies include but are not li.ited to:
<br />· Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Hetland Areas and Environlentally Sensitive Lands,
<br />Uater/WasteKater TreatMent
<br />, Southwest Florida Water nanaqelent District - Hells, Cypress Bayheads, Hetland Areas, Altering Watercourses
<br />, ~r.v Corps of Enqineers - Sea"alls, Docks~ Navigable Waterways
<br />, ~epart.ent of Health & Rehabilitative Services, Environlental "ealth Unit - Wells, HasteKater Treat,ent, Septic Tanks
<br />, US Environ.ental Protection Aqency - Asbestos abate.ent
<br />I also certify that, if fill .aterial is to be used in Flood lone "A" Dr "A,etc.", it is understood that a drainage plan
<br />addressing a "co.pensating volule' "ill be sub.itted "hich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A per.it issued shall be construed to be a license to proceed Kith the Hork and not as authority to violate, cancel alter, Dr
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, Dr violations of any code. Every per.it issued shall beco.e invalid
<br />unless the "or. authorized by such per.it is co..enced within six lonths of issuance, Dr if "or. authorized by the perlit is
<br />suspended Dr abandoned for a period of six .onths after the tile the "ork is co..enced. One 90 day extension of tile, lay be
<br />alloNed for the per.it "ith fee charge of '15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection .ust be logged during each sin lonth period, or the project "ill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT nAY RESULT IN YOUR PAYING THICE FOR IMPROVEMENTS TO YOUR
<br />PRUPERTY. IF YOU INTEND TO OBlAI" FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT'.
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />- --~-
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COIJNTY OF
<br />The foregoing instnlment
<br />before me this
<br />
<br />If/as ackmmledged
<br />, 19_ by
<br />
<br />STATE OF FLORIDA
<br />[DUPlTY OF
<br />The foregoing instrument
<br />befcore me this
<br />
<br />was acknowledged
<br />~ 19_ by
<br />
<br />IIlho is persoTl.:llly kno...m to me or Nho h.:ls
<br />pl'oduced
<br />as identification .:lnd who did/did ,mt
<br />t.:lke .:In o.:lth.
<br />
<br />who is personally known to me or who has
<br />pl-oduced
<br />as identification .:lnd who did/did not
<br />telke .:In o.:lth.
<br />
<br />(Signahwe)
<br />
<br />(SignatUl-p)
<br />
<br />(Name Typed~ Printed Dr Stamped)
<br />tl.QLllliY PUBLJ C
<br />
<br />(Name Typed~ Printed or Stamped)
<br />NQ.IAR'LfJJJlL I C
<br />
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