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<br />_ .-- ....-- ,. ----- --. -- --.J--- -- -- -------- --- -I -- -'- -------- - ---..
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<br />regulations. l'be u'.1dersigned assUJe8 responsibility for COIpliance litb any applicable deed restrictions.
<br />
<br />.B." 'UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the ower bas hired a contractor or contractors to undertake IOIk, tbey lilY be required to be licensed in accordaDce litb
<br />state and local regulations. If the contractor is not licensed as required by lal, both the 0ItneI and contractor lilY be
<br />cited for a Dsdaeanor violation under state lal. If the 01llleI or intended contractor are uncertain as to wbat licensing
<br />~equiruents lilY apply for tbe intended IOrt, they are advised to contact tbe City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the OIII1er bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of tbe
<br />-Contractor SectiOO8- of tbis application for Ibieb they will be respoosible. If you, as the 011I18I' sign as tile contractor,
<br />you are indicating that you, rather than tbe contractor, are responsible for tbe IOrk. If the contractor wishes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to pemitting privileges in tbe
<br />City of Zepbyrbills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D.' CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided with a copy of -Plorida's construction Lien Lal - BoIeoImer'a Protection
<br />Guide- prepared by the Florida Departlent of Agriculture and consUlll!l' Affairs. If the applicant is 8OIeODI other than the
<br />-OIII1er-, I certify that I have obtained a copy of the above described docuIent and prom88 in good faith to deliver it to tbe
<br />-DIller- prior to co.encuent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all tbe infomation in Ws application is accurate and that all IOrt lill be done in cmpliance lith all
<br />applicable Ian regulating construction, loning, and land developll!llt.
<br />
<br />Application is hereby Jade to obtain a penit to do IOrt and InsWlation as indicated. I certify that DO IOrk or
<br />insWlation baa CDlenced prior to issuance of a perIIit and that all IOrk lill be perfoIJed to Met atandarda of all Ins
<br />regu1ating construction, City codes, loning regulations, and land de,elo(lMllt regulations in the jurisdictilll., I also
<br />certify that I understand that the regulations of other gDYerJlllenW agencies lilY apply to the intended IIOIk, and that it is
<br />II responsibility to identify lbat actions I lUSt take to be in COIpliance. Such agencies include bat are DOt lUited to:
<br />t Departlent of BnviIOlllelltal Regulation - Cypress Baybeads, Vetland Areas and Bn,iIODlellWly Sensitive Landa,
<br />Vater,Vastelater !reablent
<br />t Soutlnlest Florida Vater Managl!ll!llt District - VeIls, Cypress Baybeads, Vetland Areas, Altering Vatercoursea
<br />t AnI, Corps of Engineers - Sealalls, Docks, Navigable Vaterlays
<br />t DepartJent of Health i Rehabilitative Senices, BnvirODlental Health Unit - Vells, Vastewater !reablent, Septie !anb
<br />t US BnvirODlelltal Protection Agency - Asbestos abatl!ll8llt ,
<br />I also certify that, if fill_terial is to be used in Flood ZOne -I- or -I,ete. -, it is understood that a draiDage plan
<br />adcJresaing a -CCJIpID8ating vol.- will be sublitted lhich is preparecl bl a professional engineer registerecl in the State of
<br />Florida prior to petlit issuance.
<br />
<br />A p~it issued shall be construed to be a license to proceed lith the IOrt and DOt as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent tbe Building Official f~ thereafter
<br />requirinq a correction of errors in plans, construction, or violations of any code. Bvery pemit issued shall becme invalid
<br />unless the IIOrk authoriled by such penit is COII8IlCed within sil IODtbs of issuance, or if ,lOrk authodled by the penit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the IOIk is COII8Ilced. One 90 day atensim of tile, lilY be
<br />allOled for the pmit litb fee charge of $15.00. !be atension shall be requested in lriting to the Building Official. An
<br />approved inspection nst be logged during eaeb sil moth period, or the project will be considered ablndoDed.
<br />VARNIIIG to ODD: YOUR FAILURB !O RlCORD A NOnCE OF aJIMDCBIIBIft' MAY RBSULr III YOUR PAYIIIG niCE FOR DIPROVBIIBI!S !O YOUR
<br />PROPBRtY. IF YOU InBllD !O OB!AIII FIIWICING, COIISOLr Ium YOUR LBlIDBR OR II AnomY IIBFOIIB RBCOIDIIIG YOOI DICE OF
<br />aJOIBIICEMIIII. JOBS UlmER '2,500 IN VALUE DO NOI HBID !O RBCOJID POS! I -ROIICE OF CCJIIIIII -.
<br />
<br />(\2.' (~ .
<br />c 1~62>- D fuO~L1
<br />SIGIIA!URB: OIOIBR OR IGm \
<br />
<br />
<br />SrAfE OF FLORIDA P
<br />coum OF A.s C G
<br />The foregoing instrum~t was acknowledged
<br />before me this cDJ 110 , 19..1..:.L. by
<br />
<br />f3()f3 f\.J" 11 A/./.JE Y
<br />who is personally known to me or who has
<br />produced '
<br />as identification and who did id not
<br />take an oath
<br />
<br />(Signature)
<br />(Name. Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />
<br />STAR OF FLORIDA
<br />coum OF P~SC0
<br />The foregoing instrument was acknowledged
<br />before me this oJ /;0 , 19 9...\/ by
<br />
<br />tAU I h L. /!c-leL,fY
<br />who is personally known to me or who has
<br />produced
<br />as identificat"on and who d.
<br />take an oath .
<br />
<br />
<br />.,~H L. ~I
<br /><?,-V ...... ~;/ I
<br />....~OTAI1j;.~
<br />it" ..
<br />, My Comm. EllpIree \
<br />:-; Apr113. 1998 :
<br />~ ". No. CC 222m: Ii:
<br />
<br />'~'t' ; I
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<br />. t::: OF f\...U:A~
<br />'''11I011,,"''''''-
<br />
<br />
<br />, (Signature)
<br />
<br />(Name Typed, Printed or Stuped)
<br />NOTARY PUBLIC .
<br />
<br /><,~:j~0,~.~.G// I ;:,
<br />i~' '/~OTAI1j;.:<
<br />~/ , "'.
<br />.- ~.~y Comm. &piree'"
<br />:: '. Apr113, 1998 :
<br />~ ~ No. CC 222722 J i
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