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<br />CONn T T T (1N~ OF PErm IT i\FF'I Dl"lt,J IT
<br />A . tiQJJJ.':JLQL..I.2.EEI> _..BE 6 l R ~ !=,J LD.!.'l..s..
<br />'h! undersigned und".t.nd. th.t this <"[-It '~y be .ubJ!tt to "deed r!~trlttln~,' _~Irh 'IY b. 'Or, ,~,trictive than City
<br />t.gul,tlons. The und.r"gn.d ",u.~. ",! .'tv for IG'rll~nre ~Ith ~~v '~rlitab)! derd restrlctlonl.
<br />
<br />B. !.lliWCEN$e;O CONTRAC U,:j;b_Ht.::l!>. .CONJJim:~TJ]R.,.B._F.5F.'..Q!\jE;lJUJ:.!.T.l_~f:;!
<br />If thl ~wner hi' hirld I contrlt'~r or contrlctors to und~rtate wor~, they lay be rPQulr~d t& b, llrrn~ld In .ccordanr.. with
<br />state and IDtl' r,gul.tlons. If the c~ntrl[t~r is no\ licenspd as requirpd by laN, both the own.r and contractor lay bp
<br />cited fDr I Illdt.elnor violation under statt IaN, If the oMner or lntpndp.d contractor Irr unT!rtain a~ to "hit licpnsln9
<br />rpquire.ents IIY apply fDr the Intended wor~, they Ire advispd to c~nt~ct the City of 2rphyrhill~ Fulldlng ntpart.,nt, lel3}
<br />788-6611.
<br />
<br />Fur\hrr.or!, if thr own,r hal hired a contractor or tPntractors, he Is advised to have thp CO"trait~r('} ~\gn portion. of the
<br />'Contractor Bections" of thit .pplit~tion for "hlch they will b~ rr~pon5ible, If you, II thr ~Nn,r lion ., thp contractor,
<br />you ar. IndltlUng thlt you, nthu than thr tonh!lctor, ille rnpon!libll! for tht Nor~, Jf thp rnntr.dor whhn you tll 519n
<br />.s contr.ctor that lay be an ln~lt.tion that h, is n~t properly licrn5rd .nd i!l not pntitlpd to p~r.lttln~ rrivlleg!s in thr
<br />City of ltphyrhills,
<br />
<br />r.. IBANSPORTAT ION IMe.ec.L"F"I;I;S__~lir,LWIU:,.JIY.r::QW~r::.r,;,IJ.PlLE.!=:ES
<br />
<br />D. ~ONSTRUl;T I,Ot~LJ....tf.N..J..AW (CHAPTER 713, FLOR t DA STATUTES ~ AS AMENDED)
<br />I ',rtify that I, the applttlnt, have blln prDYided with a copy of 'Florida', Construction Lipn LaN - H~"oNn@r's Protection
<br />6uld," prepafed by the Florida Departlent'Df Agriculture and Con)ul~r Affairs. If the applicant II ,olt~n. othtr th,n the
<br />"owner', I clrtify that I hlvt ~bt.ln,d I tOpy Df the Iboye described dotu.en' end prollle In vo~d filth to dlllv,r It t~ th.
<br />'own.r' prior to tOI.rncf.rnt.
<br />
<br />E. CONTRACTO~ I aL_QHtI~B":~1::\.[C1.'pAV D_
<br />I t,rttfy th,t III lh. inforlltlen in thls appllc.tlon is .tcuratr and that all N~rk will be donp In co.plian~' Nith all
<br />applicable II.' re9ulatlnq con.truction, zoning, and land d~y.lop.pnt,
<br />
<br />Aopllcatlon II h!rpby ..d@ to obtain a pp.rlit to do Nort and installation ~,indir~tpd. 'r~rtifv that no M~r~ ~r
<br />installatiDn hl~ cDII,ncfd prior to 1ssuante of I per.it and that all Mork will hr pprfnrap~ tn le~t stlftdards of ell II~~
<br />rr9ulatin9 construction, City codes, zoning regulations, ,nd land d~v!lopIPnt rrgulations In thp Jurisdiction. I al~~
<br />cprtify that I understlnd that the regulations of Dther governlrntal Iq~nci@~ lay ~pply to the intended work, end that it is
<br />IY respon,ibility to idtntify whit actionl 1 lust tlke to be in cOlplianc!. Stich 1gencie~ Includf but Ire npt lilitrd to:
<br />, ~!rt'~~!f__l~,ir2-"!lntal ~eaul.tiDn - Cypress eayheads, Wetland Areas and Environ.ental1y Sensitive lends,
<br />Uat~r/W.st!N.t!r tr!at~pnt
<br />, $~\!~J1~,~tJl!rid.!Jl.tte_r.)I'!lJJ~JlIL~~~~tlc;!. - lIells, Cypress Bayheads, Wetland Aru~, Altl!rinq "atl!rr:Nlr~~~
<br />, ~U'__~~~r.Lo1..!!I.9.!nt!!1 - SUNaHs, Doeb, Navlqable II,terwey.
<br />. ~rp!tJl!~t of "tilth , Rrh'blllhtlvl!,_~!L~.!!!.h.l!!..~lronlenhLl:!uJl!L.lI!!H - Wel h, wntewahr trlltllnt, s,ptlc hnk~
<br />, US ~n_Yi~.,!'!mtal..PrD!Ir:"on Almu - ~\lb"hs .battllnt
<br />I also c~rtlfy that, If fill I,tlrl.l II to be used in Flood 20n! 'A" or -A,etc.', it II underltood that a drl'nagl plan
<br />.~~r~!5inq a 'colprns.ting volul" Mill b, Illblltt.d which It pt.par'd by e ~rofessionll enqlneer r!qistered In the Stlte of
<br />~lorida prior to pvr.it issuantl.
<br />
<br />A p,rlit i&sued shall be eonstrutd to be a license to proceed wilh thr work ~~d not al authority to vlolat., c,nctl alt.r, ~r
<br />Sft aside any provisions of th. t,chnical codel, nor ;hall i< of a ptrJit prevent tht 8ullding Dfflci.l frol thrrt.fter
<br />requiring I corrl!ctlon of trrors in plans, con~tructI9n, or ,n, of an~ code. EVlry porlit ilculd ~hall bltOI. invalid
<br />unless the work luthorized by .uch pp.rlit i! rOIIl!nCl!d Nith'.' "~nths of ),;uance, or if Mort .uthorited by the perllt is
<br />5u5p~nd,d or .b.ndoned for, period of sir lonths Ifter thr I · ~~ work \~ rnl,pnrpd. One 90 day eKtenslDn of tl.e, lay bf
<br />allDwed for the p,r.lt Mlth ft. charo' of $I~.OO. The exten! c~ll b, requested in writinq to the Building Official. An
<br />approved Inlp.ctlon IUS' b. I0991d during tach Ii. lonth p.rl" th! proj!tt .ill be considered Iblndoned.
<br />W~R"I"G TD OWNERl YOUR FAILUAE TO RECORD A NOTIC~ OF to""[NLt 1~Y P.ESUlT IN YOUR PAYING TWICE FOR IHPRDVE"ENTS TO YOUR
<br />PROPERTY. IF YOU INTE IN FINANCING, CONSUlT HIT" YOUR Ll~rER OR AN ATTORNEY BEFDRE RECORDING YOUR NOTICE or
<br />NOER .~,50 IN VALUE DO HOT "EtD TO RECORD ^HO POST A' T C CO"nEN T'.
<br />
<br />
<br />STAff or ~lO~~~
<br />CDUUY OF _~~ _._____
<br />The foregoing ~n.trument wa& acknowledged
<br />hllltc.l"p mp thl-. !l1~,~--, 193..c;;_ by
<br />
<br />_~ R:.g~~__ _ ---------
<br />
<br />who is p~n5ona 11 y ~tnown to me (.1" who h....
<br />
<br />produced ,____..____________ _" _.._.._,..__~~
<br />e5 identification And who did/did not
<br />
<br />:~~"m&~..... .....
<br />
<br />-
<br />(N~m~ Typ~d, Pri
<br />~\J1 AI~Y. .EYflLJ~
<br />
<br />
<br />1-
<br />
<br />
<br />STATF or HORICh
<br />tOUlI1 V lIF _...:r::-.~----- .
<br />The for&91:.1ng in~trllment was .clmowledged
<br />befc.re ml't thic; 11J.~.~-;-~ lqX:~_- by
<br />
<br />____Li~R_~~-v.. ,-.
<br />
<br />whO is..EG'I"SClnal1y known to me or who has
<br />
<br />['lrc.dllr:ll'd ~__._ ,.____-_._. ~,_.__
<br />;\~~ iden Hc~tic" and whc:> did/did not
<br />
<br />t~,k .e, )~~~)L&~....
<br />
<br />(..l nn-"\t:n-,,)
<br />
<br />(~I~rr'l:I TypUr:I, F'
<br />:,. r :Y?V PYJ~,~t~
<br />
<br />
<br />, · r StFlilT1'!>1r""'
<br />!~ ~~ Notary ~u'Mic. ~t8t8 of F10rfda
<br />~ J.~ My Comm. Exp. Sept. 28. 1998
<br />". .'j'--' Comm. No. CC 409908
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