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<br />B. UN'fiICEN.SED CONTRACTORS AND CONTRACTOR RE:SPONSII?ILITIE~ ..' .'.c""'$~~
<br />IftIJ'_er bas bued a contractor or contractors to undertake 'ork, th.y ..y b. r.guued to .he hC"'ed'10aCCOrd811<;e~lt1J,!",,)
<br />.tate and local r.gu!atioo.. If th. contractor is not licensed" 'equired by I.., both th. o...r and C<lI1traclor "rbe},. ,)i;j'~
<br />; cited for a lisdemeanor violation under state law. If the owner or intended contractor are .uncertain as ;to what licensinif: .~*1!~
<br />requireJJents Jlay apply for the intended liOrk, they are addsed to contact the City of Zephyrbills Building Depart.llent,;(8l3)'<;~i';!;,':
<br />788-6611. :;'f:,'.',' .
<br />
<br />'f....
<br />
<br />.' ~ ::'r
<br />
<br />"'
<br />
<br />. .'fu,tIJer"re, jl th. ovner bas blred a contractor or coo trae tors , b. Is .dvised to bave tbe contractor(.) .lgn portiooi'9t!tbf 9"li
<br />,:' "Contractor Sectioos' of this application for ,bi ch they 'ill b. responaible. If you, as th. avo.r .Ign as th. C<lI1~"till';. "
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractOJi;;wishesyou;,to:tSl-gn\.7::"
<br />as contractor that lay be an indication that he is not properly licensed and is not entitled to per.itting privileges in the ?,~ :'.
<br />City of Zepby,biU.. .'"
<br />
<br />'(, -,
<br />
<br />c. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />, I,':'
<br />
<br />,;
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) 'if, ;:
<br />I Certify that I, th. applicant, bave b.en provided ,i th a copy of "Florida's Construction LiOll L.. _ Hoo_er'. YrotecUQD;;v,'
<br />Guide" p~epared. by the FIg;:ida Depa:t.llent of Agriculture and Cons~er Affairs. If the ~PPI~ca. nt is s~leone other th~ th~, Jl~>\,;.'.'.
<br />'avoer", I certIfy th.t,Have nbtalOed a copy of the above descnb.d doc....t and P'Ollse 10 ,good filth to d.liver It 1o,.the1lr':6
<br />"owner" prior to cOllJlenCeJJent. /' ,'~t;"
<br />il~',.)11~" ':*;~l'),-:{:
<br />
<br />E. CONTRACTOR'S fOWNER · S AFFIDAVIT . ... ,,~~
<br />I cerlify that aU th. infora.tion I. thi, application is accurate and that all vork .iII be done in COIIpliance',illlb 'anr.!'!'~~",,~
<br />applicable la.. r.gulating construction, tOning, Slld ISlld developl"!. ';,: ,.,jtC!(i
<br />I , ),~JJ,~r .' I:,~[~
<br />Application is hereby lade to obtain a penit to do work and installation as indicated. I certify that no' work or \:!~~~~l
<br />installation has cOllenced prior to issuance of a permit and that all work will be performed to leet standards of all laws\L
<br />regulating construction, City codes, zoning regulations, and land developJlent regulations in the jurisdiction. I al~o'"
<br />certify that I understand that the regulations of other ~overnIlental agencies lay apply to the intended work, and that it'is
<br />MY responsibility to identify what actions I lust take to be in cOllpliance. Such agencies include but are not lilited to:;,
<br />* DepartJIent of EnviroOJlental Regulation - Cypress Dayheads, Wetland Areas and RnviroOJlentally Sensitive Landsi"i ~~.:,~.,
<br />. Water/Wastewater Treatlent
<br />* Southwest Florida Water Hanage..ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses,,}
<br />* ArllY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* De artJent of Health & Rehabilitative Services Envirolllm.'ltal Heal th Unit - Wells, Wastewater ~reatJent, Septic. Tanks ":'",
<br />* US EnvironJental Protection Agenc~ - Asbestos abatement J'
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or "A, etc. ", it is understood that a drainage plan':t.'~;,
<br />addreSSing a "cOlpensating volUJe" will be submitted which is prepared by a professional engineer registered in the State of.
<br />Florida prior to peuit issuance. ~',i::,;'
<br />
<br />;":""
<br />f;<;'.'"
<br />
<br />(Namf:! Typed, Printed
<br />NOTARY PUBLIC
<br />
<br />
<br />(Signature)
<br />
<br />
<br />I p"lit Issued ,ball b. coostrued to be a liemlse to proceed >lth the "rl and not as authority to vlolatp,!~",~ alii' .
<br />set aside Slly provisions of the t.chnical codes, nor sball issuance of a perli t prev..t the Building Oiflclil ,"'" there# ..i' '
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued shall become invalid
<br />unles, th. 'orl authorized by ouch p.rall is co....ced 'lthln ,Ix lonths of lsxuance, or if 'ork authorized by the p~ni,
<br />susp"ded or abandoo.d for a period of .ix lOolbo aft'r th. UI. th. ..rk Is c.......d. Ooe gO day ",t...loo ~~J;iIe, "i'i,~,
<br />allowed f~r the ~erlit.wi th fee charge. of $15.00: rh.e ex ten. ~ion shall be r7Quest7d in writi~g to the BUilding. ......'..O.f. :f..lCiab,..';:..;.,~.'. '.'.';.'
<br />approved InspectIon lUst be logged dunng each SIX IOnth penod, or the pro] ect WIll be conSIdered abandoned~'}:".,:>il~\.~j,
<br />WARMING 10 OWHHR: YOOR FIILURR ro RiCORD I NOlICR OF COKHEBcm!BN7 KlY RiSUL! IR YOUR PIYIHG'lWICB FOS IHPR~S roYQOR~
<br />PROPERTY. IF YOU IN FINANCING, CONSULT WITH YOUR LHliDER OR All AT BEF RECORDING YOUJIiN07ICB OFI:-i.}i~~
<br />,....j.......... :'.,...~,.
<br />COKHENCRHENf OBS UNDER' $2,500 N VALUE DO NOT NEED TO RECORD AND POST "NOTI OF COMHE RHENT" . . .' .
<br />
<br />
<br />
<br />~;g,\
<br />f.
<br />STATE OF fLORIDA ~
<br />COUN7Y OF . -3:...C!\. ~.J~ 1\'
<br />The foregoing instrument was acknowledged
<br />before me this ~\\')"t/,_I , 19_~ by
<br />
<br />who is~rso~~y ~to me or who has
<br />produced
<br />as identiflc~n and w. ho d.id{u~. ~;.
<br />take an oath. ~_:\\~ "
<br />~,,~ \\' \ :-.. \"
<br />(Signature)
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF '\?~ 'h-z l'Y .
<br />The foregOing instrumlmt waf, aCknouledged"'1'(Hr"
<br />before me thiS""'-\,"\~ (/ ' 19~ by ,
<br />
<br />
<br />who is~rsonally kno~ to me or who has
<br />produced
<br />as identification
<br />take an oCith.
<br />
<br />(Name Typed, Printed or
<br />NOTARY PUBLIC
<br />
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