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<br />---".--~-.,~_.._- --'-r--- -..--".-......-.... -- ---...-........__....,.__.... -..r."..../-....._..--...........,......~_ _..,..
<br />r.egulati~. !he undersigned asSUles responsibility for COIpliance with any applicable deed ~estricfiCll8. .
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertake wort, they IIY he required to he liceD8ed in accordaDce with
<br />state and local regulations. If the contractor is not licensed as required by law, both the IJIID8I and contractor IIY he
<br />cited for a lisdl!lll!anor violation under state law. If the owner or intended contractor are uncertain as to what liceuing
<br />requirelellts IIY apply for the intended wort, they are advised to contact the City of Jepbyrhills Building Departlent, (813)
<br />788-6611. '
<br />
<br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portiCllS of the
<br />-Contractor Sections- of this application for which they will he responsible. If you, as the OIIDer sign as the COI1tractor,
<br />you are indicating that fOu, rather than the contractor, are responsible for the work. If the contractor wishes JOU to sign
<br />as contractor that lIy he an indication that he is not properly liceued and is not entiUed to pmitting privileges in the
<br />City of Zephyrhills.
<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, have heen provided with a copy of -Plorida's construction Lien Law ":' ......er's Protection
<br />Guide- prepared by the Florida DepartJent of Agriculture and ConsUIIeI Affairs. If the applicant is 8OII!OIlI other than the
<br />-owner-, I certify that I have obtained a copy of the above described docuIent and proaise in good faith to deliver it to the
<br />-owner- prior to co.enCl!l8Jlt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIliltlon in this application is accurate and that all work will he done in COIpliance with all
<br />applicable 1_ regulating construction, laning, and land develOlElt.
<br />
<br />Application is hereby lade to obtain a perlit to do wort and installation as indicated. I certify that no work or
<br />installation bas ~ced prior to issuance of a perlit and that all work will he perf OIled to leet staDdard8 of all laws
<br />regulating construction, City codes, loning regulations, and land develoPll!l1t regulations in the juriadict1l1l. I also
<br />. certify that I underltand that the regulations of other gov8IDl8llW agencies IIY apply to the intendeclwort, and that it is
<br />If responsibility to identify what actions I lUSt take to be in COIpliance. Such agencies include but are ,not lilited to:
<br />I Departlent of InviIODll8Dtal Revulation - Cypress Baybeads, lIeUand Areas and InviIODleDWlr Sensitive Lands,
<br />lIater/llastewater !reatleDt
<br />t Southwest Florida lIater lIanagl!l8llt District - lIells, Cypress Bayhea4s, lIetland Areas, Altering IIatercours88
<br />t ArIy Corps' of Engineers - Seawalls, Docts, Navigable IIatenafS
<br />I Departlent of Health i Rehabilitative Services, InvirOJllental Health Unit - lIells, lIastewater !reatl8lit, Septic !ants
<br />I US InvirODleDtal Protection Agency - Asbestos abatl!l8llt ;
<br />I also certify that, if fllluterial is to be used in Flood Zone -I- or -I, etc. -, it il underltood that a drainage plan
<br />addressing a IcmpensatiDg vol.- will be lublitted which II prepared by a professional engineer regiBterec11D the State of
<br />Florida prior to pmit issuance. .
<br />
<br />A pmit issued shall be construed to 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 pmit prevent the Building Official fa thereafter
<br />requiring a correction of errors in plans, construction, or violatiOll8 of anr code. 1v8lJ pemit issued shall becme invalid
<br />unless the wort authoriJectby such perlit is co.enced wiWn sillODtbs of issuance, or if,work autboriJec111J the penit is
<br />luspended or abandoned for a period of sil IODths after the tile the wort is co.enced. One gO dar a_ion of tile, II' be
<br />allowed for the perlit with fee charge of $15.00. the atension shall he requested in writing to the.~ ()fflcial. An
<br />approved inspection lUSt be logged during each sUlOIlth period, or the project will be considered abanl1oDed.
<br />IIARIIIlfG to <*DR: YOUR FAILURE to RECORD A DICK OF alllDCllllllllIII RlSULr II 1001 PIIIIG. IIIICS fOI IIIPIOVIIIIftS to 1001
<br />PROPmY. IF YOU IIUID fO OB!JIJI PIUlCIIG, COJISUL! liD YOOR LIIDIR OR AI AnoRDY BIPORI RICOJIDIIG YOOJI JIO!ICB Of
<br />allllBICIIIIN!. JOBS UJmIR',2 ,SOD II VALUE DO NO! NDD !O RECORD AID POS! I IDlCE OF CCIIIIDCIIIIftI.
<br />
<br />
<br />\2J~ t. (j.~MA- ~ 2- 2-::>f
<br />SIGIlfURl: (IfJIR OR AGIJII SIGUIURI: ComlCfOlI'
<br />
<br />:O~,'LORIDl -P~
<br />
<br />Tbe foregoing instruaent was aCknowledged
<br />before - this . 3n 11!q;y-19.!i..:i::by
<br />
<br />"J)oV"",s' L. A~OYltA
<br />who is personall Y known' to me or who, has
<br />produced
<br />as identif~~~~ who did/did not
<br />take an oa~ U~ ~
<br />
<br />(Signature) 1/ 11 I A I I I
<br />f'.~L[/j LeeF! a. t::1eJtLv
<br />(Name Typed, Printed or S'tamped) ,
<br />NOTARY PUBLIC
<br />
<br />
<br />,.......~~
<br />
<br />. (Si~ature) .
<br />E.L.UiJ LL jZ(;) V 0
<br />(Nue Typed, Printed or Stuped)
<br />NOTARY PUBLIC '
<br />
<br />KATHLEEN A. HENK
<br />Nota1y Public, Stale 01 Rodda
<br />My Comm. Expires July 5. 1998
<br />No. CC 376761
<br />Bonded Thru .Uklal .."11/ >>.1_ltr
<br />
<br />
<br />II 0III0r 10 .
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