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<br />~_~J_.ji.,!D I -r I O~._~~~ C [';-' j' L::J <1':1 I -r ;~l:::-F I C ('I'.: T "t-.
<br />
<br />A . t! 0 -: UT,- 0 F I~ r:: G:J ~__!J .!::.2 T n I GJ::...LQl:! s
<br />
<br />1h~ undersigned uJdcrs::lnlls th.,: \Li', p~rd~ may hI) subject to "deed rcstridit,ns" ~Ihich ~ay I'c "[,n re5\ric\ivc than City
<br />regulations. The undersi~ncd ~~5u~es responslbllitY:fo~ co~pliance Hith any applicablc deed restrictions.
<br />
<br />E. UNL I CE~.!SJ::D Cr.~ri:rnQ.cTORS AND CONTRACTOR RESPO!'IS I Tl I I I T I E;S
<br />
<br />If the OKner has hired a cDnlr~ct~r or contractors to undertake Hork, .they nay be required tD t~ licensed in accordance "ith
<br />slate and local resula\iDns. If the cDntractor is not licen5ed as required by I~\I, both \h~ D"n~r and cDntraclDr .ay be
<br />cited for a tisde~2anDr viol~liDn under state la".. If the DHner or Intended contractor are uncertain as to "hat licensing
<br />require:ents r.oy ;;pply ft,r I.:;,> intcnde;! IJOlk, they ~re advised tt, cc,ntact the Ci II' c,f 2ephyrhills Pui Iding DcporbL'r,l, (813)
<br />78B-6611.
<br />
<br />Further:ore, if I~e DMner h~s hirrd ~ cContractor or contractors, he is advised to have Ihe eonlr2elor(sl sign porlions of the
<br />'Contrictar Sections' of lh~s ~~plication for Hhich they will be responsible. If YDU, as the DHncr siQn as Ihe CDntracl0r,
<br />you are indicating Ihat Yl,',:, r~i\hLT Ih:J1l the contractor, are 'respc'nsible for the \ic,rL If Ih2 ([,nlri:cle,r IIi shes )'c,u to si~n
<br />as cc,r,lraclc,r thet ~ay be i::\ iilllicalion that he is not prc,perly licensed ~r,d is nut enlilled Ie. pU'Jiltir,g pri,'ileses i-, H,e
<br />City of Zephyrhil\:.
<br />
<br />C. TRANSpmH8J:.:rDli-IJ~I=-f\CT FEES AND UT I L I TY COf\If\If::CT I (JtLE.f:r::~
<br />
<br />D.
<br />
<br />CONSTRUCT I QLl._L-.J.l=:~.l Lml.
<br />
<br />(CHAPTER 713~ FLORID~ STnTUTES, AS AMENDED)
<br />
<br />r cedify Ihat I, the appliccJ,t, hiJ','c been provided with a copy (If "Florida's Ce,nslruclie.n Lien L,)l - He....e:,)jner's Pre,leclion
<br />Guide' prepared by the FIDriJa DrpaTI~ent of ngriculture and Consu~er nffairs. If tl,e applicant is SD:e6ne olher than the
<br />'oHner", I certify thut 1 :,,-,'12 c,btc,iner! a. cc'py of the above described dCoCumt:nt ;,r,11 pre,~,i,(' in 0;:'oU f"i lh to del iver it tt, the
<br />'oNner' prior to eD5~encr~cn~.
<br />
<br />..t....: .
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />
<br />I certify that all the \nf~r~ation in this application is accurale and that ~ll Mork Hill be done in coap!ianc! "ith all
<br />applicable laws regul~ling c0nstruction, zDning, and land developcent.
<br />
<br />Application is hereby ~adD Ie' ~blain a per~it to'do Hork and install~tion ~s indicaled. I c~rlify Ihal ~~ work or
<br />installation has co~~enced priDr to issuance of a per~it and that all Mork Hill be p~rror~ed to mert standards of all la~s
<br />regulating cDnstruction, City codt:s, zoning regulatiDns, and land dt:Yelop~ent regulalions in Ihe jurisdiction. J also
<br />certify that I undersl~nd 1~3t the regulatiDns of other governoental agencit:s aay apply. to Ihe Inlended H~r~, and t~at it is
<br />roy respor,sibility Ie, idenlify \lhat actiDns I oust take to be in compliance. Such agt:f,cies include bl1\ ,'I r ile.1 lir.iled tt':
<br />
<br />. J. ~
<br />I Deparl~Dnt of EnvirDn~Dnlal Reoulation - Cypress Dayheadsr IJetland nreas and Environmenlally Sensi tiy~ L~nd5,
<br />Hater/IJasteHater Treatment
<br />+ ~,c.ulhHDst FI~~0.rr )~anaqe~,ent District - \Jells; Cypress L\ayht:ads, Hetland r.reas, r<llfiir,'J 'de\.rrc0u.sr:S
<br />I Arty CorDS ~f EnqjneDr~ - SeaMalls, Docks, Navigable IJaterNays
<br />I Dep"rlocr,t (,i l\('"II.hJ~_[:~tlih_ilit;;tivp. Services, Environrr,entallle,...l.!ll Unit - lie-lIs, \lasIDj,Jlu Tre:\,:c:,:t. Se~tic T2;,ks
<br />I US En'lifColi:['ntid Pre,\['!:tiCorj r,nt:ncy - nsb~stos ilbate~ent
<br />
<br />also certify thdt, if fill r.:J\C'rial is to be used in Flt,od Ze.ne 'no c,r ",",etc.', it is \JfIlh.r,\c,[.J \:,.'l "drainage plan
<br />addressing a 'co~pen5ating yolulD' Hill b~ sub~itted Hhich is prepared by a professional engin~['r f01i,10i0J in l~[' Stale of
<br />Florida pric,r Ic' per~il i,.5uo;-:co.
<br />
<br />n perbit issued shall be construed to be a license to proceed Hilh the HDrt and nol as authority 10 yiDj~te, cancDI aller, or
<br />set aside any provisions of the technical codes, nor shall issuance Df a permit prevent the Duilding 0ffi[i~1 fro~ thereafter
<br />rrquiring a correction Df errDrs in plans; construction, Dr violations of any code. Every p~rmil iSS\!0j 1hall b[,CD%r invalid
<br />unl(.ss the ~I[,rk allil,(,ri7d [,'1 s\Jch perr..it is cc,/uenced llithin six I\:onlhs (,i iSSIlJJiCt:j t.r if ,/C.J \. ,d,tk" 17c-O OJ' the per.\il is
<br />suspended Dr abandonej ior " periDd of six ~onths after the ti~e the uork is CD~menc[d. On[' ~0 daf 0~t0~5io" of ti~e, ~ay be
<br />all('Hed fc,r the p['r~iljliU, fc'e ch;;rgc of ~J5.00, The ~xtension shall be rcqlll'stl:il in \lrilin~ Ie, '.1"02 ",'i\Jir,g Oificial. nn
<br />approved ilisprctiDn ~IIS\ be logged during each six month period, or lhe project Hill be (onsiJ~r['d db~I,J01i['J.
<br />
<br />(..JARN I NG TO m.nIEF~: YOUR FA I LURE TO RECORD PI f\!OT I CE Di-=- COr1~1r:::[,1L:G1r::r"T r'1AY
<br />RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO yoUn PRoPER1.Y. IF YOU
<br />nlTEf\JD TO Ofnrdr'j FIf'JANCING, CONSULT WITH YOUR LENDEr~ OR (.'d\j ATTom~EY
<br />BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 300S U~IDER $2,500 IN VALUE
<br />DO NOT NEED TO F\ECmm (lND POST A II NOT I CE OF COI"H'lE[\ICGE:i.!T".
<br />
<br />." ~
<br />
<br />5 I G"ATURE~____.,__-=:::~- CC::: ,5 I GNATUrf_b-------"""~c------- -
<br />(]LItIEfl [JI1 AGENTPeR.5"o.vftLt/' !4In.J1J cmnrH'iCTOR ft::/aSII1;.JItLL'I f::IJrwA...J
<br />
<br />DATE_______~~_~~~~]C~---------------
<br />
<br />DATE. 0_ Lt:J - 9 g
<br />-------------~-- --------------.-------
<br />
<br />NOTARY AS TO ......4/.,.-,;. /7 tA
<br />OWNER Of( (',GENT _~~~t.1.<- 1L~N
<br />HAm L.I2EJJ:.i'%.. J('illlU N
<br />MY COMMISSION ExPlnEs___________________:_~
<br />
<br />NOTARY AS TO ~ ~
<br />CONT[(ACTOf(___ _ ____ ~Q..: _~":I'U/~
<br />" /h7I t-E;~ p-: ~w IV
<br />MY COMMISSION EXPIRES__________________
<br />
<br />",,\\~ PUB(
<br />+-~ .b. /("
<br />~~.:
<br />
<br />" Of ~I."'"
<br />
<br />KATHLEEN J BROWN
<br />My commission CC<449029
<br />Expires Apr. 02.1999
<br />
<br />""ilV PUB
<br />...f:) n'1rt
<br />~.:
<br />
<br />. '0' floG"
<br />
<br />KATHLEEN J BROWN
<br />My Commillslon CC449029
<br />Expire. Apr. 02, 1999
<br />
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