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<br />.:r."r',lDIT:::U~,l~; Ci.c ,,'EI<i'1IT .',:"'j~ID;\'.'I.,.
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<br />A. NO':' T CE OF r..~,::r:::J"?__!jEJ:;Tr< I cor TONS
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<br />the undersigned unders!ands !het ll,i~ per~it may be sublect to "deed restrictions' which ~ay b~ oore reslr.ictiyc than Cily
<br />rcgulalior,s. the undersi~nd "c~t::;~S r~spDns!bi1it{';'for co~pliance l1ith any applicable deed restrictions.
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<br />E. UNL I Cr::~!SE~':L.~.rlJ.:.~I.[lQ~roRS AND CONTRACTOR RESPO!'IS I II I 1_ I T I r:;S
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<br />If the owner has hircd a cDn!r~c\Dr or contraclors
<br />slate and local regulalion~. If Ih~ contractor Is
<br />cilrd for a nisde~eanor vi01~liDn under state IaN,
<br />requin:enls eo'! "Pi,!Y fc:r l.hL' inlcnde;\ li~rk, they
<br />788-6611.
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<br />to undertake 110rt, .they Day be required 10 be licensed in accordance "ilh
<br />not I icenHd as required by I iill , br,lh I in: r,uner "nd Cunlrac\c.r r.,y be
<br />If the Oliner or Intended conlractor are unccrtain as 10 "hal licensing
<br />arc advisrd \0 cDntact Ihe Cily of 2ephyrhills ?uilding Dfparl:en!, (813)
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<br />Further:ore, if Ihe OHner has hired a cDnlractor or contractDrs, hr is advised to have lhe contr~[tor(s) SIgn portions of the
<br />'Conlr;clor Sections' of this ~~p!ication for lihlch they Hill be responsible. If you, ,,5 lhe Duner sign as !he contractor,
<br />you are indicating lhat ye,'", r.ii.iiLT th:lll the contractor, arc 'respc.nsiblr for Hie Hc.rl:. Ii Ihc' [(,n\r;:cl[,r 111ch25 yc.u 10 sign
<br />as cc,nlractc,r l'lal ~ay be ":1 jdllic,li[.n tl1,,\ he is not pre,perly licenser! ~nd is nol rnlilled lc, pH"ittiilg privileS2s h the
<br />Ci II' clf Zephyrhi lie.
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<br />C. TRANSpmH8J:"I~JLL.JJ:.1.r::DCT FEES AND UT I L I TY COf\If\Ir::CT I gi:L-E5r::~i
<br />
<br />D.
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<br />CON S T RUe T J J2!:L_.L-_LEl:L- L A ~.1.
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<br />(CHAPTER 713~ FLORIDA STATUTES, AS AMENDED)
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<br />I cerlify that I, thr applicant, have been provi~ed with d copy of 'Florida's Construction Lien La" - HG~2GHner'S PrDteclion
<br />Guide' prrpared hy the Flc.;!,:;] !Jq,;jf\=;ent of Agriculturr and Consu~er Mfairs. If lhe "[_plican! is sc,:cc;ne ol~,cr thail the
<br />'oliner', I certify H,ilt I :,..,'/" ,.b\:,illed d. celpy of the abr,ve drscribed dc,cumenl and pre,~d,e in ~l,oJ [;;ith b delivH il Ic, the
<br />.oHn~r. prior to co~~~n:r~~nt.
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<br />:1.,,;7' ..
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<br />E. CONTRACTOR'5/0WNER'S AFFIDAVIT
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<br />I certify thaI all the infDr~Jtion In this application is accurate and that all Mork "ill be done in co~pliance "ilh all
<br />applicable liHS regul~ting c0nstructlDn, zDning, and land developcent.
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<br />Application is hereby nade tD obtain a permit to'do Hork and install~tiDn as indicated. I certify Ihat nD HDrk Dr
<br />installalion has co~~enced prior to issuance of a permit and that all MDrk liill be periDr~ed tD meel standards of all
<br />rrgulating constructiDn, City codes, zoning reguIatiDns, and land develr,pmrnt regulations in Ihe jurisdic!ion. I also
<br />certify lhal I understand Ihat thr regulations r,f other gDvern~enlal agencies ~ay apply.ID lhe intended "Dik, and lhat
<br />r.y respoTlsibility Ie. identify lihat actir,ns I ,]ust tal:e to be in cOMpliu,ce. Such i1Qe:lcies ir,clueD bid ~I e lil,l Ii,~i!ed te,:
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<br />laws
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<br />., .
<br />1... 15
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<br />. J" ..,.. ,--~. .
<br />I Deparlcenl elf Environmental Rro\llalil)n - Cypress Bayheaos, I1dl,md nreas and En'lirc.n"enlol]y Sensi tjie LdiIGS,
<br />Haler/l1asteHater Treatment
<br />I r'e,ulh~e5t Flr,rida Hider l~~naQe~ent District - \Jells,' Cypress Bayheads, l1etL;nd Meos, f,]tHing 'd2\erou;s25
<br />I Ar~y CDrDs~f EnQineer~ - SeaHalls, Docks, Navigable l1aterHays
<br />I Dep"rtoer,t c,j l\e"II,b.J,-.J:~~:h.iJl~iltivr. Services, Environrrlentall\r,dlh Unil - Ildls, 1I;,sle"Jler Trc.ct,:c:::. '3eptic T2n~s
<br />I US En'lire,n:[.!~j! PrdeIJic,n finency - Asbestos abatc~ent
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<br />;,150 Certify th"t, if fill r,;)tl!rial is tr, be used in FIt.od Ze.ne "n" c,r 'il,dc.', it is unMr~te,e,J tL"t :, Juinag(' plan
<br />addressin~ a 'co~pensating vDlu~e' NIII be submittrd lihich is prepared by a pr~f('ssional en~in[er i[0i~t0f0J iil t~(' 51ale of
<br />Florida priDr tD per~it i~suancl!.
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<br />A perbit issued shall be conslrued Ir, be a ]i~ens~ to procerd with the liDrl: and nol ~5 aulhDrity ID yi8j~I~1 c2ncel alter, Dr
<br />set aside any provisions 8f lhe lechnlcal cDdes, nor shall Issuance of a permit prcvent the Building Orrici~1 frD~ Ihereaftrr
<br />requiring a corrEction ~f errors In plans; constructiDn, Dr viDlations of any code. Every p~rQi l isst!~J ~hJll becotc invalid
<br />unless lhe lll,rk aulltc'l i~d t,y such perl!ill is ce'lIlilenced llllhin six months [,f issuancc" e,r ij Ill"1. ",ilk'l )~('d hI' lhr per.,il is
<br />suspended Dr abandoned f~r a pcriod Df six ~onths after the ti~e Ihe liork is commenced. One 70 day 0;1~~5ioll or li~e, DJY be
<br />alle'lied fc.r the prr~illlilh fel' chiirge of ~15.00. The exlrnsir,n shall be rer,ul:sI('d in \Hitin~ Ie. th~ 8c;ilJir.:J Official. An
<br />apprc"ed ir,s[;l'clic.n ,.ust bE lC'\jgeJ during pach six mr,nth period, c.r the pre.jl~cl Ilill be c[ol,si,!['r('d dl',.Jluc'"c.d.
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<br />WARNING TO mnlEF\: YOUR FAILURE TO RECORD A NOTICl:: m~ COr1f':E[,ICEnENT r.1AY
<br />RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER.I.Y. IF YOU
<br />INTEND TO 08TAIN FINANCING, CONSULT WITH YOUR LENDER OR AN Al.TORNEY
<br />BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JODS UNDeR $2,500 IN VALUE
<br />DO !'lOT NEED TO F{ECOfm AND POST A "NOT I CE OF COI'H'lr::f\IC[:::.]C::I'JT".
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<br />SIG"ATURE___~___________~-- SIGNATURE ---------b-----
<br />~-~INE~ OR AGENT CONT~ACTOR
<br />DATE ---~4f!{A'K-----------_.~-----.-------
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<br />DATE
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<br />
<br />NOTARY AS TO
<br />OWNEf1 Oil (',GEtH
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<br />
<br />NOTARY AS TO
<br />CONTRACTOil_____________________________
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<br />..
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<br />MY COMMISSION ExrrnES
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<br />MY COMMISSION EXPIRES
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