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<br />CUND 1 I J UN[~ UF PEEI'II T {)FF I J)()'v' I T
<br />() . NQTJ.~~_Q.L._J)gslLg~!:l.JJ:Ltt;II..JJ.I\'-~3.
<br />Ihp Ilndprsignpd undprstands that this ppr.it I~y bp ~ubjpct tD "dppd rpstrictions" whi[h lay be lore restri[tive than City
<br />regulations. Thp undersigned ilSSIlIPS rpspol1sibility f(lr c(llllllliance with any applicablp dl!l!d reslridillns.
<br />
<br />Fl _ Uft'=JJ~sN~!=-!tSm{I.Rl:.!'::TPJ::<!? (JI.JIJ... C(JLIT H{\~rL)lJ. B r=: ElF:.lJHl?!J::-{JJ,,,II.L~$.
<br />If thp owner has hirl!d a contractor or contractors to Ilnderta~p work, they IlI~Y be reQuirpd tll be licensed in ac[ordance with
<br />state and IDcal regulations. If the contra[tor is nllt li[ensed as required by la", both the owner and contra[tor lay be
<br />cited fllr a lisdeleanor violation under state IaN. If the owner or intended [ontra[tor are uncertain as to "hat licensing
<br />require.ents .ay apply for the intended Nor~, they are advispd tD [onta[t the City of Zephyrhills Building Depart.ent, (813)
<br />71111-6611.
<br />
<br />Further~ore, if the owner has hired a contra[tor or cDntractors, he is advised to have the contractor(s) sign portions of the
<br />.Contra[tor Sections" of this application for which they Mill bp responsiblp. If you, as the o"nl!r sign as the contra[tor,
<br />YDIl are indi[ating that you, rather than the [ontra[tor, alP responsible for the work. If the [llntractor wishes you to sign
<br />as contractor that .ay be an indication that he is "(It properly licensed and is not entitled to peraitting privileges in the
<br />City of lephyrhills.
<br />
<br />C _ JTIAN!?F' OR TAT liJ1LJ I-IF' (~~LEs~_~_l}!JlJ.JJU'=J_D::__..t:;!J1tt~U~_~I..UJJ:L..FEE.!?.
<br />
<br />n. ~QH2THUGT!'QH__'-=-LE1~Ll-I)H (CI 'tIP n=n 71:=1" n.un.T))() ST{HUTES ~ AS {WIEhIDEDI
<br />I certify that I, the applicant, hilve bepn providpd with il copy llf "Florida's Construction lien law -- IIo.eowner's Prote[tion
<br />Gllidp" prepared by the Florida Dppart.pnt of Agricllltllrp and [on~ll.pr Affilirs. If thp applicant is SO.l!llnp other than thp
<br />'oM"pr", 1 [ertify that I have obtainpd a copy of thp above desclibed docll~e"t and pro~ise in good faith to dpliver it to the
<br />"llW"er" prior to COllen[elent.
<br />
<br />F. l,;(JI'!TR(~TQR 'SLQ~'J~.~B-'-_:?___BEEJ..Rl\'v'_LI
<br />I cprtify that all the infor.ation in this application is accurilte and that all work Mill be donp in [o.plian[e with all
<br />applicable laws regulating cllnstructilln, loning, and land develop.ent.
<br />
<br />Application is hereby lade tll obtain a perlit to do wllrk ilnd installation as indicated. I certify that no Nork llr
<br />installation has coa,enced prillr to issuance of a perlit and that all work "ill be perforted tll teet standards llf all la"s
<br />rpglllating cllnstructilln, City clldes, 211ning re~ulations, and land dpvelllplent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of lither governlental agencies lay apply to the intended work, and that it is
<br />.y responsibility to identify "hat actions I lust take to be in co'pliance. Such agencies include but are nllt li.ited to:
<br />. Departlent of Environl!ntal Requlation - Cypress 9ayheads, Wetland Areas and Environl!ntally Sensitive Lands,
<br />Water/Waste"atpr Treat~ent
<br />. SlluthNest Florida Water nanaqelent District - Wells, Cypress 9ayheilds, Wetland Areas, Altering Watercourses
<br />. ~~orps of Enqineers -- Seawalls, Doc\s, Navigable Waterways
<br />. Departlent of Health L Rehabilitative Servi[es, Environlental Health U~it - Wells, Wastewater Treatlent, Septic Tanks
<br />, US Environ.ental Protection Aqency - A~bestos abatplent
<br />I also certify that, if fill laterial is to be used in Flo~d lone "A" or "A,et[.", it is understood that a drainage plan
<br />adrtres~ing a "[o'pensating volu~e" "ill be sub.itted whi[h is prepared by a prllfessional engineer registered in the State of
<br />Florida prior to per.it issuance.
<br />
<br />n per.it issued shall be construed tll be a license to proceed with the work 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 9uilding Official frot thereafter
<br />requiring a corre[tion of errors in plans, construction, or violations of any code. Every per.it issued shall becll.e invalid
<br />unless the Nor\ authorized by such per-it is co"enced within si~ Illnths of issuan[e, or if "or\ authllrized by the per.it is
<br />suspendpd or abandoned for a period of six Months after the tile the "llrk is cll.lenced. One 90 day extension of ti~e, lay be
<br />allllwed for the per.it Kith fee charge of $\5.00. The extension shall be requ!sted in writing to the Building Official. An
<br />approved inspection Must be logged during each six lonth period, Dr the proje[t will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT nAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PRUPERTY. IF YOU INTEND TO OBIAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED 10 RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />
<br />"...~~
<br />
<br />""A1~'tl./'-~
<br />
<br />STATE OF FLORID~
<br />COlfNTY OF 't'ASC.O
<br />The foregoing instrument
<br />before me this r--E.~ ~q
<br />
<br />",as ackno",ledged
<br />, 19 ~ by
<br />
<br />STAlE OF FLORIDA
<br />COUNTY OF fhse ';}
<br />The foregoing instrument was acknowledged
<br />before me this F/3B &1.( ~ 19~ by
<br />
<br />
<br />
<br />:nDI'I11 to me Dr Nho has
<br />
<br />(-th~
<br />personally knDI'Hl to me,c.,- l'~ho has
<br />produced
<br />as identificatiDn and whD did/did not
<br />take n oath.
<br />
<br />and ,,~ho did/did nClt
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOT ARY PUBLIC :'-' JAMeS A. STOtl~
<br />Notary Public, State of Florida
<br />My comm. expires May 16. 1995
<br />CC110274
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />r:l.QI AR'LE..UBL I C
<br />
<br />JAMES A. STONE
<br />Notary Public, State of Florida
<br />My camm. expires May i 6, i 995
<br />. .' CCil0274
<br />.... 4 ~. .
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