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<br />CDNDI' U/I'.IS flF F'EHIHI m:FID{WIT
<br />;\. I'!QI!.~_~_~.lJ::h..J,~~.~!LB~I:lIP,JJLL!JJJ"~3
<br />The undersigned understands that this per.it .ay be subject to "~eed restricti~ns" Hhich lay be .ore restrictive than City
<br />regulations. Ihe undersigned assu.es responsibility f~r c~~pliance Hith any applicable deed restrictions.
<br />
<br />Fe - UH!"'J..1;.I;;NS.I;;lt~Qt{[lli~~I:.P.Bl?... (.)1.Jl>... LOUT HDL,:.I [)13_RE8P[Jr~l?IJ:.lJb IIJ.~l?
<br />If the OHner has hired a contractor or contractors to undertake Hork, they may be required t~ be licensed in accordance Mith
<br />state and IDcal regulations. If the contractor is not licensed as required by laH, both the OMner and contractor .ay be
<br />cited for a .isdeteanor violation under state laM. If the OHner or intended contractor are uncertain as to Hhat licensing
<br />leQuirelents .ay apply for the intended "ork, they are advised to contact the City of lephyrhills Building Departlent, IBI31
<br />7BB-bbll.
<br />
<br />Further.ore, if the o"ner has hired a contractor or contractors, he is advised to have the cDntractor(s) sign portions of the
<br />"Contractor Sections. of this application for "hich they Hill be responsible. If you, as the o"ner sign as the contractor,
<br />you are indicating that you, rather than the contractor, ale responsible for the "ork, If the contractor Mishes you to sign
<br />as contractor that .ay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of lephyrhills.
<br />
<br />(: . IJ30N!?F'OR T AIlQJLJ t'l['t~~LL..F;;-';:J?_..nIJILJ)JJ.'==.I.LL.,.~QHH~c;.I.LQtLhFEE!?.
<br />
<br />D - ~QNSTRUGT I Qt"_I",LEIL1-DH (CI "'PIEr< '7 j :'=J ~ FLUn I Vi) ST{HUTES ~ ()S (WIENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien La" - 1I0.eo"ner's Protection
<br />Guide' prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is sOleone other than the
<br />"owner", I cprtify that I have obtained a copy of the above described do(u~ent and promise in good faith to deliver it to thp
<br />"oHner" prior to co..ence.ent.
<br />
<br />F. ~otf!:f<()J;TQR ' SdJ.!i!jF;:B~i;LJ~.EEJ'p'(l\lJI
<br />I (ertify that all the inforlation in this application is acculate and that all "ork Hill be done in co.pliance with all
<br />applicable laws regulating construction, loning, and land develop_ent.
<br />
<br />Appli(ation is hereby aade to obtain a per.it to do "ork and installation as indicated. I certify that no work or
<br />installation has cOI.enced prior to issuance of a per.it and that all work will be perforled to leet standards of all laMs
<br />regulating construction, City codes, zoning regulations, and land develop~ent regulations in the jurisdiction. 1 also
<br />certify that I understand that the regulations of other govern~ental 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 not li.ited to:
<br />. Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />Water/Wastewater Treatment
<br />. Southwest Florida Nater nanaqe.ent District - Hells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />· ~rlY Corps of Enqineers - Sea"alls, Docks, Navigable Waterways
<br />. ~!part.ent of Health & Rehabilitative Services, Env~ron.ental lIealth U~t - Wells, Wastewater Treat.ent, Septic Tanks
<br />J US Environsental Protection Aqenty - Asbestos abateMent
<br />I also certify that, if fill .aterial is to be used in Flood Zone 'n" or "A,etc,", it is understood that a drainage plan
<br />addre~sing a .co.pensating volu.e. Mill be sub.itted "hi(h is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it issuance.
<br />
<br />A per.it issued shall be construed to be a license to proceed with the work 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, or violations of any code. Every perait issued shall beco.e invalid
<br />unless the work authorized by such per.it is co.,enced "ithin six Months of issuance, or if Mork authorized by the perlit is
<br />suspended or abandoned for a period of six lonths after the ti.e the work is co.,enced. One 90 day extension of time, lay be
<br />allo"ed for the perlit "ith fee charge of $15.00. The extension shall be requested in Mriting to the Building Official. An
<br />approved inspection lust be logged ~uring each six .onth period, or the project Mill 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 />PROPERTY. IF YOU INTEND TO OBTAIN 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 />
<br />
<br />
<br />STATE OF FLORI~
<br />COUNTY OF 'f/?tS CD
<br />The for.egoing instnlment I'las acknol'lledged
<br />befc,,-e me this 7l'b1J?, 19Y by
<br />
<br />iJIo,u /Jh'A r<e P
<br />known to me or who has
<br />
<br />STATE OF FLORIDA ~
<br />COUNTY OF tJt...s;'C:'0
<br />The foregoing instrument was acknowledged
<br />before me this /J'l/Jj( /7 , 19~ by
<br />
<br />~
<br />
<br />
<br />~ ~~/2~>~
<br />",her is. I?l- _ona y I(no to me or Nho has
<br />pl-oduCl?d
<br />as identification and I'lho did/did no!;
<br />tak an oath. tl ~
<br />_ ~_k:7 C-I'. ~
<br />natuCf' )
<br />
<br />and .,,110 did/did not
<br />
<br />(Name Typed, Printed or Stamped)
<br />tllJ..1 AfD' PUBLI C
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />NQI AR~LfJJ.f3L !~
<br />
<br />JAMES A. STONE
<br />. Notary Public, State of Florida
<br />My comm. expires May 16, 1995
<br />CC110274
<br />
<br />JAMES A. STONE
<br />Notary Public, State of Florida
<br />~ly camm. expires May 16, 1995
<br />CC110274
<br />
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