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<br />__,__~~"",,--,,---""--'r--- -,a .__' __~...__ _ __ --__..._..._ -,-,-- -......--,--..-----............'- ---I.
<br />r~ations. I'be undersigned assU1e8 responsibility for COIpliance litb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe 0IR1el' bas hired a contractor or contractors to undertake IOrk, they lilY be required to be licensed in accordance "itb
<br />state and local regulations. If tbe contractor is not licensed as required by lal, botb tbe mmer and contractor lilY be
<br />cited for a IisdeJeanor violation under state lal. If tbe OllJler or intended contractor are uncertain as to "bat licensing
<br />requirell!llu lilY apply for the intended IOrk, tbey are advised to contact tbe City of ZepbyrbUls Building DepartElt, (813)
<br />788-6611. '
<br />
<br />FurtbeIllOre, if tbe ower bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portiODl of tbe
<br />.Contractor SectiOO8. of this application for "hieb tbey lill be responsible. If you, as tbe OlDer sign as the CIIltractor,
<br />you are inc1icating that JOU, rather tban the contractor, are responsible for tbe lark. If tbe contractor wiabes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to perlitting privileges in the
<br />City of zepbyrbills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, ASAHBHDED)
<br />I certify that I, the applicant, bave been provided litb a copy of .Ploric1a's Construction Lien LaI "!' s..o.mer's Protection
<br />Guicle. prepared by tbe Florida DepartJent of Agriculture and ConsUII8I Affairs. If the applicant is ... other than the
<br />.000er., I certify that I bave obtained a copy of the above described docuJent and PreEU in good faith to deliver it to the
<br />.000er. prior to co.enceleDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIliltion in tbis application is accurate and that all IOrk "ill be done in COIPliance litb all
<br />applicable lals regulating construction, loning, and land deve1opElt.
<br />
<br />Application is hereby lilCle to obtain a peIlit to do IOrk and installation as indicated. I certify that. no ak or
<br />installation baa cc.I8Jlced prior to issuance of a perait and that all IOrk "ill be perf OIled to .et st:aDc1ards of all 1l1ls
<br />regulating construction, City codes, loning regulations, and land developll!llt regulations in the juris4ictilll. ,1 also
<br />certify that I understand that tbe regulatiODl of other goveruental agencies lilY apply to the intended at, and that it is
<br />Ii responsibility to identify lbat actions I lust take to be in COIPliance. Sueb agencies include but are not lilited to:
<br />I Departlent of InvirODll8lltal Regulation - Cypress Baybeada, lIetland Areas and Invirolll8lltallr Sensitive Lands,
<br />lIater /IIaste1tater !reatlent
<br />I Soutblest Floric1a lIater ManageleDt District - lIells, Cypress Barbea4s, lIetland Areas, Altering Ilatercour888
<br />I lIlY Corps of lDgineers - Sea"alls, Docks, Xavigable lIatenays
<br />I DepartJent of Health' Rehabilitative Services, InvirDDl8lltal Bealtb Unit - lIells, lIaste"ater I'reatlent, Septic !anks
<br />I US Invirouental Protection Agency - Asbestos abateEllt ' "
<br />I also certify that, if flllllterial is to be used in Flood ZOne .A. or .A,etc.., it is understood that a drainage plan
<br />addressing a .cmpensating vol.. lill be suhlitted whieb is prepared bJ a professiODal.engineer registered in..tJIe State of
<br />Florida prior to perllt issuance. '
<br />
<br />A perIIit issued shall be construed to be a license to proceed lith tbe IOrk and not as authority to violate, cancel alter, or
<br />set uide anJ provisions of tbe technical codes, nor sball issuance of a perlit prevent tbe Building Official fa thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery peIlit issued sball ~ invalid
<br />unless tbe 1IOrt autboriled,br Bueb perait is co.enced "itbin slllOlltbs of issuance, or itlOrt autboriled bl tile pettit is
<br />suspended or abandoned for a period of sil IODtbs after tbe tile the ak is ~ced. One 90 c1aJ atensiCll of tile, lilY be
<br />allOled for tbe perait lith fee charge of $15.00. !be atension sball be requested in lriUng to the, Building Official. An
<br />approved inspection at be logged during eaeb sillODtb period, or the project "ill be consic1ered abanl1oned.
<br />IIARJIIXG '10 CMIIR: YOOR FAlLURB 1'0 RECORD A IO'IICI OP CCJIIIICIIIII'I MAY RISUL! 0 , FOIl '10 YOOR
<br />PROPIR'IY. IF YOU UIIXD '10 OBt'AII PIlIAIICIIG, COISOL! Ill!! YOOR D lnoRllY BIroII tOOl lmICI OF
<br />CIIIBI'I. JOBS $2,500 II vnUl DO 10'1 KDD 1'0 RECORD . )A 'MICI OF CCJRI '0
<br />
<br />S'IA'fE OF PLORIDA tkT
<br />coum OF t'\8nd(')
<br />The foregoing instrument was acknowledged
<br />before lie this 01a1T~ ~ , 19~ by
<br />
<br />-Johl'\' A La. G r~s..s e..
<br />who is personally know.o to lie ~ whe, bas
<br />pPOClucetl '
<br />as identification and who
<br />take an 0
<br />
<br />
<br />1'1 OP FLORIDA
<br />OP Pasco
<br />he foregoing inst1'Ull8Dt was acknowledged
<br />before me this1J1oAcLcX 0 , 19~ by
<br />
<br />:IXU0;e L k' s,c.1,Vl');+ +-
<br />who is personally know.o to ~ or who has
<br />produced
<br />as identificati
<br />take an oQ.th.
<br />
<br />
<br />
<br />~
<br />
<br />(Signat ~~. ~ht"&
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />NOTARY PUBLIC STATE OF FLORIDA \
<br />MY CO..".,ISSION EXP JUNi. ZS.lH& ;
<br />BONDED THRU GENERAL It~S. lJII). ~,"
<br />
<br />
<br />Idid not
<br />
<br />'(Signatu~. A /' b
<br />11-1 . we '~~
<br />(Rame Typed, Printed or Stuped)'
<br />ROTARY PUBLIC "
<br />
<br />t-~Y PI./8.. OPPICIAL NOTARY IIAL
<br />0" ~;!: GAIL A WlllfIl
<br />~ W ~ COMMI"ION HUMU"
<br />; < CC407572
<br />'7',1] j My.coMMlUlON IXP.
<br />(C'OFf\.O SEPT 111908
<br />
<br />1 '~':
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