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<br />; UIlUercii"",i ,,;;at tbJ.~ :,;;.!.!'li:~ 22'j J€ subjec:: to "deed restrictions" whicb. lay be IIOre restrictive tb~CitY';;"i
<br />: .regulations. the undersigned assUJes res[{)nsibili ty for cOlpliance with any applicable .de,ed ,restrictions. .' . .. \~~
<br />
<br />. ..~...~
<br />SI G1lATURE: OR'llER OR AGENT
<br />
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<br />
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<br />
<br />
<br />,:~:;; (1{~'1i
<br />
<br />B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONS1BILITIES
<br />If the owner has hired a contractor or contractors to undertake wort, they lay be required to be licensed. inacc6rcr".
<br />state and local regulations. If the contlactor is not licp.nsed as required by law, bOth'the'owneraIl{eontractor'.a
<br />cited for a aisdeaeanor violation under state law. If the owner or intended contractor are uncertain as towbat';llc
<br />requireJIents Jlay apply for the intended work, they are advis€~d to contact the city of ZephyrhiUs BUilding Dep~r1ien~;:rr 'na
<br />788-6611. . ..
<br />
<br />FurtherJlore, if the owner has hired a contractor or contractors, he is advised to have ,the qmtractor(s) sign portion
<br />"Contrac~or.Sec~ionsu of this application for~hicb they will be res~nsible. If you, as the owner sign as ,th~(~o.r.~.
<br />you are Indlcatlngthat you, rather than the contractor, are responsIble fo~ the work. J.f. the contractoC'jfishesfyo,aJ..
<br />as contractor that lay be an indication that he is not properly licensed and is not entitled to peraitting privileg~;,
<br />. . .1.......-.'.'." _.;;',"!'.
<br />CI ty of Zephyrhills. .. ....~::;1; :l.'r;'~
<br />
<br />c.
<br />
<br />TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES '.- :.'ti::t(:!::;~J('
<br />..,............... .,.:',' ,rL..;
<br />
<br />D. CONSTRUCTION LIEN LAW I: CHAPTER 713, FLORIDA STATUTES" 'AS. AMEND
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law _ HOJeowIJer's'f
<br />Guide" p~epared by the Florida DepartJIent (,f Asriculture and ConsUler Affairs. If the applicant:i8(So..e9.0~.otli€~~
<br />uownerU, I certify that I have obtained a copy of the above described docUlent and prOlise in good faith todeli,vli"
<br />"owner" prior to couenceJent. i " . ,'! .;~';~.:H
<br />
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT . .. .....,~ . .
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cOllpliancewith'a
<br />applicable laws regulating construction, tening, and land develop.ent. : ~.I ;t>t,
<br />
<br />Application is hereby lade to obtain a penH to do work and installation as indicated. I certify that :nowork6r.l,
<br />installation has cODenced prior to issuance of a penH and that all work will be perfor>>ed to leet standards:otlal
<br />regulating construction, City codes, zoning regulations, and land developllentregulations in the 'jurisdiction."Ii'al
<br />certify that I understand that the regulations of other govefDIental agencies lay apply to the intendedliorktandt.
<br />IIY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but ar'e not lii'i
<br />A Department of EnviroDllental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands; ";;:\
<br />~ater/Wastewater Treal:Jent ..' ',i'l'G;:
<br />A Southwest Florida Water Hanage.aent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />A Auy Corps of Engineers - Seawalls, Docks" Na'ligable Waterways ..... .:l;:d:T~
<br />A Departaent of Health & Rehabilitative Serlices, EnvirOIDlental Health Unit - Wells, Wastewater Treataent, Septic!
<br />A US EnviroIlllental Protection Agency - Asbestos abatement . .. . ... ..J ,,;i<::i,1':::{
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or "A, etc. ", it is understood tbat a drainage/e,
<br />addressing a uCOlpensating volUle" will be subli tted wbich is prepared by a professional engineerr.~gistered in.:tJ!el~"
<br />Florida prior to peuit issuance..:,
<br />-,' ;,j ":'\r'~:J:~H'f~~,\~J~,bd:I~~:
<br />A perlit issued sball be construed to be a license to proceed wi th tbe work and not as authority to violate, carlceta
<br />set aside any provisions of tbe technical codes, nor shall issuance of a perlit prevent the Building.Official~,(ro.-;tti
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued sball b~cOl'
<br />unless the work autborized by such penH is couenced within six lonths of issuance, or if work authorizedbyit.ha~ple
<br />suspended or abandoned for a period of six BOnths after the tile the work is cOlllenced. One 90 day extension; of,.r "
<br />allowed for the perait with fee charge of $15.00. The extension shall be requested in writing to tbe.BuiI4iDg~9{(~.
<br />approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned~}i\'.'"
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCKHENT KAY RESULT IN YOUR PAYING T1iICE FORJHP
<br />PROPERTi. IF YOU INTEND TO OBTADI FINANCING I CONSULT WITH YOUR LEHDKR OR AJr AnORBEY BEFORE RECORDING YOUR j{OtfCB;~
<br />COHHENCKHENT. JOBS UNDER $2,500 IN VALUR DO NOT NEED TO RECORD AND POST A "NOTICE OF COKHHHCEHEHT- .':::1,
<br />
<br />STATE OF FLORIDA ~
<br />COUNTY OF /15 C ()
<br />The foregoing ~~~was acknowledged
<br />before me this . , 19~ by
<br />
<br />./'... K-LUlfIJ /?YI1AIf!
<br /><....~~rsona~ly know.n ~>IIl~ or who has
<br />produced . ... .. .__._'m
<br />as identification and who did/did not
<br />take an. ~~ ~ ~ -d?7vC/~'
<br />
<br />(Signature)
<br />
<br />STATE OF FLORIDA.
<br />COUNTY OF 'jJ /1 S c: 0 . . ~ ,......, "l'F"
<br />The foregOin~ i~~!~8 aCkn~wl.e.~g.>.'
<br />before me thlS, /. 19 o?s by,
<br />.;, ,"
<br />
<br />{tt //;11/ & Yt1~iU .. ... '\"
<br />/-~>.., . v .... .. ........::
<br />Cw~o is pets nally known to m~, or who "ba '
<br />prOduced
<br />as identification
<br />take an
<br />
<br />(Nam~ Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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<br />..W*
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<br />">.f./t I1F f\.~~'"
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />DONNA M SINCLAIR
<br />My Commission 00382618
<br />Expires Jun. 14, 1998
<br />
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<br />."'.o/l "A-
<br />"/t OF f\.0""
<br />
<br />,.
<br />,.1"""'0';
<br />
<br />DONNA M SINCX.AIA
<br />My Commlnion CC3$a81~ . '." ." .
<br />Expire. Jun. 14. 1998.. "ki,
<br />
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