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<br />~~~Lr-1D:rT:OJ'\IS C:i".:'" ,i::>Ef:-;;i'"1IT rl;=-FIDr'I'.JT-;-
<br />
<br />A. NOT I CE OF L~F:r::E)_!.J~:;Tr, I CT r ONS
<br />
<br />Theuncersign~d undersbnds \h;,t \hi" p~fllji~ lIlay hI! subject to "deed res\rictie,ns' ~Ihich r.ay be ~c're re5trictive than City
<br />r~9ulation~. Th~ undersi~n[d ,,~5tl~e5 r~5ponsibili~\r~'for. co~pliance llith any applicable deed re5\ridions.
<br />
<br />B. UNL r CF:HS[::O CC~tiI.o.E.LCTORS AND CONTRACTOR RESPOJ:IS I n I 1_ I T I ~S
<br />
<br />If the owner h~s hired a contractDr or conlractors to undertake Hork, .they ~~y be required 10 t~ Jic~n5ed in aCCDrdanc~ with
<br />slal~ and local regulatiDns. If the cDntractor is not licensed a5 required by I,,", boll. \h~ Duner and contractDr nay be
<br />ciled for a nisdeleanDr viol~liDn under 5tate laH. If the OHner Dr inlended conlraclor are tlnc~rtiin as \0 llhat licensing
<br />require:enls adY cpply fC<J" tk. int~nde;! liork, they are advised te, ce,nlact Ihe City e,f 2ephyrhilJs 8uilding Dfparb~rlt, (813)
<br />788-6611.
<br />
<br />Further:ore, if the OHner h~s hired a cDntractor or contractors, he is advised 10 have the conlractor(s) sign porlions of the
<br />'Contractor S~cliDns' of this ~pplicition fDr Hhich they will be respDnsible. If you, as the o"ner sign as the contractor,
<br />you are indicating that yo',;, r.1tlilT Ihan the contractor, arc ;respe,nsible for the lie,rk. If lh~ ((,ntri:cte,r ui5hes yc,u tD si~n
<br />as ce,ntractc,r Ihat J.ay be 0:1 iildicCl\ie,n thai he is not properly licensed ~r,d is r,Dt enli \ led Ie, per"i llirlg privi leges ir, the
<br />City e,f Zephyrhills.
<br />
<br />C. TRANSPQRT81:1iJ1LU':1f::.0CT FEES AND UT r L I TY CONNECT I gJ~'-E.f:E~?_
<br />
<br />D.
<br />
<br />CONSTRU~T J OiJ._"L-.J EN l_A~l.
<br />
<br />(CHAPTER 713~ FLORIDA STnTUTES, AS AMENDED)
<br />
<br />I certify t~a\ I, Ihe appliur:\, l1ii'10 been provi'ded with a copy of 'Fle,rida's Ce,nstructie,n Lien Lil)1 - H[,.~ec'rme;'s Prc,leclion
<br />Guide' prepared by \he Flc.,iJ;) !!r.parl::;cr.\ of Agriculture and Consuller flffairs. If the "H,lieilnt i, 5c,:06,,0 ol~'Dr th"n the
<br />'oHner', I certify Ihol I :,.-,'/2 e,b\:,ined a. ce.py of the above described dCoCumC'nl "fill pr(o~,jc[' in 0cc,ou f"ilh \0 deliver i\ tc, the
<br />'oHner' prior \0 eD~~en:e~[nt.
<br />
<br />;1,":;::,"" I:.
<br />
<br />E. CONTRACTOR'S/PWNER'S AFFIDAVIT
<br />
<br />I certify Ihat all the infsrcCltiDn in Ihis application is accurale and that all work Hill be done in co!p!ianc! "ilh all
<br />applicable laMS regulating e~nstruction, zonirig, and land developcent.
<br />
<br />'. .
<br />ApplicatiDn is h~r!by nad~ to oblain a perDit to"do ~ork and ins\all~tion as indicated. I cerllfy Ihal no work Dr
<br />installation has cD~~en[vd priDr to issuance of a permit and thai all Hork Hill he perfofQcd to ~~ct standards of all laws
<br />regulating c(onstructi(on, Cily cDdC's, z0ning rD9ulali~ns, and land development regulations in the jurisdiction. I also
<br />certify thai I undersland Ih~1 the regulatiDns of other governaenlal agC'ncies may apply. 1(0 t~e intended "ork, and !hal i~ is
<br />ny responsibility te, identify llhol actions I oust take to be in cDmpliance. Such ;)g[':leles include bit! ,'10: nc,! lir.ited to:
<br />
<br />.-.
<br />
<br />. ,.
<br />I ~Dar\~cnt (,f Environ~['nlal Reoulation - CyprDss Bayheads, 1I~lland nredS and EiI'Iirc'n'lcnLd]; Sensi ti'ie L3i:ds,
<br />UatDr/HasteHater Treatment
<br />t SouthMes\ FIDrida \later "an~Qe~cnt District - lIells; CyprDss Bayheads, Helland Areds, Altering "alcrcoufsfS
<br />i Arty CorDS ~f EnQineer~ - Seaualls, Docks, Navigable "aterHays
<br />f D['p"rt~erll (,f IJ.0:JJ~:f:hJ:.h-L!.H2UYe Services, Environment,,1 Ile,,]tl~ - 1,)[.115, lIi,steHatcr Trc'aL~.,:,t, Septic Tanks
<br />I US En'lir:,n;~nt"~LtiHI line~ - Asbestos abatel~ent
<br />
<br />als[; certify Ihdl, if fillllaterial is to be used in Flclod Ze,ne 'n' e,r '1I,e(C.', it is \JnGc.rs[e>[,J t:,.d d dujn~gc plan
<br />addressin~ a 'cD~pensaling volu~e' Hill be submitted Hhich is prepared by a prDfes5iDn~J cngin~cr fCGi5l~fCJ in lhe Slate of
<br />Florida prie,r te, per~it i;:suancc.
<br />
<br />A per~it issued shdll be construed to be a lirens~ 10 proceed .Iith the He,r!: "nll n(,l as cllth(,rity te, "i[,j"li', uncd "ltu, (or
<br />set aside any pr(ovisions of the lechnlcal codes, nor shall issuance of a permit prevent the DlIi Iding Ufficii! frD~ thereafter
<br />requiring a ce,rrce tic,n (,f errors in plans; constructie,n, or '1ieolations c,f any ([,dc. [veri p;'r_i l i 5SI!L'J shJ J 1 becc,1C in'!al id
<br />unlcss \he >lc,rk autl,[,r i~d by such perr.iit is C(,/uenced Hithin six r.ionlhs of issll.1ncc" c,r if IIC"1. :"rll,['1 i;d oJ" th~ pn1it is
<br />suspcnd~d Dr abandDned f(or " period of six months after the tlJe the HDrl. is eonmenccd. One 90 day c~lcnsi0li Df ti~~, ~JY be
<br />a11('Hed for the per;.;it ,,1\1, fee charge of $15.00. The extensie,n 5ha11 be reQur:slc.rj in IJrilin0 Ie, ~I,,' 8~lilJir.g Official. An
<br />approved insp~ctiDn ~tlst be logged during each six month period, or the project "ill be cDnsid~r[d dbiJld0ncd.
<br />
<br />\..JARNH1G TO Ol.-n.IErl: YOUR FAILURE TO RECORD A I\IOTICI:: or=- Cm1~lEr,ICE1'1ENT r'1AY
<br />RESUL TIN YOUI'I PAY I NG TW I CE FOR I MPROVEMENTS TO YOUI-~ PROPERTY. I F YOU
<br />INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN Al"TORNEY
<br />BEFORE RECORDII~G YOUR NOTICE OF COMMENCEMENT. JOOS UNDER $2,500 IN VALUE
<br />DO NOT NEED TO m::COFm AND POST A "NOTICE OF Cm'H"lENCr::i'l[:I'!T".
<br />
<br />
<br />SIGNATUnE___ L(l1:.J~ I".-_____~______ SIGNATUnE~__~_ ___n-n
<br />f~[R on AGENT P~'L'fJALL-Y I(;J/UJ,J cmlTn"~c~~At-LY K(JhJN
<br />
<br />DATE _ __ _.____ _ -1L=fi=--xS-----.;.--------.-------
<br />
<br />DATE______jl~_i_~~~___________________
<br />
<br />NOTARY AS TO J/' z9B/~.
<br />OWNER Of( fiGErH__r~--1 -_.iL);tp~.'
<br />KII7l-ILEEN J" RD W,J .
<br />MY COMMISSION EXP!nES______________________
<br />
<br />NOTARY AS TO / ~,- -i~,
<br />CONmACTOf(____-=-t:~4{_?_~ '_ _kdtdJ.-Gf">..--
<br />~ j( ;(,..;:;; i.-EE tJ J; _ c) WN
<br />MY COMMISSION EXrIf([S__________________
<br />
<br />:\~I'y Pile
<br />+'> n ""<0 KATHLEEN J BROI/VN
<br />*.* My Commlssion CC449029
<br />ElCpires~. 02.1999
<br />~". ~~ Bonded by NFNU
<br />~ OF fl.G~ 800-224-6368
<br />
<br />",\~'io'i' ~IJIJ
<br />""_.~~("<o
<br />
<br />*)"'11' ",' *
<br />e"::t. \
<br />"~;> ~~
<br />,. OF fl.G~
<br />
<br />KATHLEEN J BROWN
<br />My CommIssion CC449029
<br />EIlpW" ~. 02. 1999
<br />Bonded by NFNU
<br />800-224.6368
<br />
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