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<br />C:(..Ji\~D!l'~rcr',~s Of;"~ ,PEPS'1IT '-IFFI~",\ ~\ "IT
<br />
<br />A. NOT I CE or-- Dr::rLL2__f~<E~5.}F IS:T u:;L.~
<br />
<br />the.undersigned understands that Ihis permit may be subject to "deed restrictions' Mhich ~ay b~ ~ore restrictive than Cily
<br />regulations. The undersigned ilSsu::es responslbilitffor compliance with any applicable deed restrictions.
<br />
<br />E. UNL! CENSED CQi'fTJ:7J-'\CTORS AND CONTRACTOR REsPOtlS I 1l I LIT I ~s
<br />
<br />If the ownEr has hired a cDntr~ctor or contractors to undertake work, .they may be r~quired t~ be licensed in accordance ~ith
<br />state and local regulations. lf the cDntractor \5 not licensed as required by laM, both the ouner and cDntraclDr ~ay be
<br />cited for a nisdeneanor viDI~tion under state law" If the OHner or intended contractor are uncertain as to ~hat licensing
<br />r~quirelents ~ay apply for the intended "ork, they are advised to cDntact the City of Zephyrhills 8uilding Departaenl, (8131
<br />78'iH611.
<br />
<br />Furthermore, if the OMner has hired a cDntractor or contractors, he is advised to have the contractor Is) sign portions of the
<br />'Contractor SectiDns' of this applicJtlon fDr which they Mill be respDnsible. If you, 25 ihe owner sign as the contractor,
<br />you ar~indicating that you, rather than the contractor, are responsible for th~ work. If the contractor ~ishes you \0 sign
<br />as contractor that ~ay be an indication that he is not properly licensed ~nd is not entitled to permitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTAT I ON I MPACT FEES AJ'ID UT I L I TY COf\If\lECT I ON FEt::S
<br />
<br />D.
<br />
<br />CONSTRUCTION LIEN LAW
<br />
<br />(CHAPTER 713~ FLORIDG STATUTES, AS AMENDED)
<br />
<br />I certify that I, the applicant, have been prov(ded with a copy of 'Florida's Construction Ll~n LaM - HoaeoHner's Protection
<br />Guide' prepared by the Florida Department of Agriculture and Consumer Affairs. If the ~pplicant is so=e6ne other than Ihe
<br />'owner', I certify that I ha'le (,btained a. ccipy of the above described delcurnent "ntl prc'ITli~e in ge,od faith Ie ddiver it to the
<br />'owner' prior to cOi~ence~ent.
<br />
<br />~ 1. '. . ~ : "
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />
<br />I certify that all the inforiliation in this application is accurate and that all Mor~ Hill be done In co~pliance with all
<br />applicable laws regulating construction, zoning, and land developoDnt.
<br />
<br />Application is hereby ~ade to o~tain a permit to'do work and installation as indicated. ] certify that no Hork or
<br />installation has coe~enced prior to issuance of a permit and that all work Hill b~ perfor~ed to leet standards of all laMS
<br />regulating construction, City codes, zDning regulations, an~ land develGpm~nt regulations in the jurisdiction. I also
<br />certify that I understand thai the regulations of other governaental agencies may apply to the int~nded "~rk, and that it is
<br />my responsibility te, identify \1ha\ actions I must take to be in conlpliance. ;'Jcll 3ge:lcilos irlclude bill "Ie nd linited to:
<br />
<br />. J" -...
<br />I Depart~ent elf Environmpnlal Reo~ulati(ln - Cypress Bayheads, Hetland ~reas and Environrrlentally Sensi \i'ie L:li,ds,
<br />Hater/Wastewater Treatment
<br />f Seluthwest Florida Ilater l\ana~et';ent District - We\l~; Cypress Bayheads, Hetland ,\reas, rdteriq H2terc0ucses
<br />I Ar~y Coros .of Enqineers - SeaMalls, Docks, Navigable Waterways
<br />t Department (If H~alth !, r-:'J,~hili\"hve Services, Environment,,) Health Unit - \Idls, \hsteHater Treat,~e:tt, Septic Tanks
<br />t US Envinnnc,ntal PreotccJ\.i'!1 t:oenc1. - r,sbestos abatement
<br />
<br />also certify that, if fill m;!terial is to be used in Frc.od Ze,ne "A" or "A,de.', it is undc,rste,e,d til,l d drainage plan
<br />addressing a 'co~ponsating volume" Hill be sub~itted Hhich is prepared by a ~rofessional engineer regi51~r~J in the Stat~ Df
<br />Florida prior to p~roit is~uanc~.
<br />
<br />A perllit issued shall be ([,r.stn:ed to be a licensl! to proceed Ililh the H[.rk "ntl ne,t as aull-Mit)' t(1 \'ie.\"te, cancel alter, Dr
<br />set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official fro~ thereafter
<br />"',',',' ' "",,,\i,.,, ,., ,no" '0 pI,"'; "',',,'"'"' " "01,,,,", of '01 "d,. ''''I p,,,'1 imc.i ,,,,II ,,,"" i",lid
<br />unless the w[,rk authc'ri7~d by s\1ch permit is C(dllll\enced within six llionth5 [of issuance, c,r if \/e,d. au\1lcQ I;Qd by the per~it is
<br />suspended or abarldclnerl flor a peri['{\ (,f silt 1Il0nths after the t.i~e the \fDrk is [['~Imencr:d. l1l,0 9(; do)' c..;I""oi["1 of \i~e, ~ay be
<br />all(1Med fDr the per~i\ Hilh fee charge of 515.00. the extensi(1n shall be requested in \friting to the Building Official. An
<br />approved inspectie,n rJus\ lk lc.;rygd GUrifi1 each six mDnth period, c,r the pre,ject Hill be c(of,si(:crd dDoIIGC,rled.
<br />
<br />WARNING TO OWNeR: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
<br />RESULT IN YOUR PAVING TWICE FOR IMPROVEMENTS TO YOUR PROPER1'Y. IF YOU
<br />I NTEND TO OBTrd \\[ F I f'!(\NC I NG, CONSULT ~JI TH YOUR LEf'lDCR OR AN ATTORNEY
<br />BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT- JOBS UNDER $2,500 IN VALUE
<br />
<br />
<br />:~ G:A~~R~'E~~_.r~~~7::~_~~:-~-:-~':~~ T I cs~ G:: T:',:Mt.~:'C~~t~~~~~. ---------zr----
<br />
<br />/~~~ ?,}fJI'MD~d- ~,,<~
<br />DATE ______S~!i ~_9_~--------------,------- DATE _________..:i'::=- !i~- ~~-- -- - ----- ----
<br />
<br />
<br />~~~~:y O~S A~~NT ___~d (jJ.1._~ ~~~~:~C~~R~~_A~e~d+Lt1fV~
<br />,K/lTJlLbrAJ :ti..BRo-uJA! ' j:AYHLG& AJ .d.[;J5",c~>J
<br />MY COMMISSION EXPIRES______________________ MY COMMISSION EXPIRES__________________
<br />
<br />..;,"~ Plio
<br />...~(...
<br />~'~'.' *
<br />"..;:~Y
<br />., ~
<br />.' 'Ff~'I>"~
<br />
<br />KATHLEEN J BROWN
<br />My commlnion CC449029
<br />Expires Apr. 02.1999
<br />Bonded by NFNU
<br />800-224-8368' '
<br />
<br />~..I\' PilI,
<br />~:&"'...
<br />~.:
<br />
<br />~~ Of f~O~
<br />
<br />KATHLEEN J BH':)W~
<br />My Commission CC44902'.
<br />Expires Apr. 02. 1999
<br />Bonded by NFNU
<br />800-224-8368
<br />
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