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<br />COIWITIUl-n; vV I'lmMIT 1\"'(QIJ1\VIT
<br />1\. 'NOTICI~ 01;' IJE:E:IJ JU;::l'I'IUC'I'I.()r~:l
<br />The undersigned undeJ:sl:ands I:hill: I:Ids pennlt lIIay be subject to "deed restrictions" which
<br />may he mOJ:e restrictive than City reqlllat.iolls. The undersigned assumes responsibility for
<br />cOll1pl J.<'lllce with any appl:\ c<'ll;le deed r.e!'ltr.ict.i onf!.
<br />B. UNJ.ICfo:NSl.m CONTH1\CTOHS 1\NIJ CUII'I'Il1\CTOIl IUi::ll'uIWlBII,J'I'U:S
<br />If l:he owilel h<'ls hil:eu a cunllilcl:ol or cunLI:ilc\;"l:S tu IIIH.leLtake work, they may be required
<br />to be 1 i.censed .ill accot.c);lIll:e wil:ll ntill.e nlld I.ocnl reyulilL.lolls. If the contractor is not
<br />llcensed ilS n~qulred by JilW, bol:h Ihe owneJ. alld cOIII:1:ilcLor lIIay be cited for a misdemeanor
<br />v1uliltJon under stale .Law. .if the OWllel: 01: lnl:emled contractor are uncertain as to what
<br />11cens1ng re(luJ.Lements milY ilpply [01: the .illl:ended work, they a.r:e advised to contact' the
<br />City of Zephydlills l3uildillg Department, OJ.3-'/OU-6611.
<br />Furthermore, lf the owneJ: has hireu a contJ:ilctor or cOlltractors, he is advised to have the
<br />contractor (s) sign porU.ons of the "Contractor :1ectlonR" of this application for which they.
<br />will be responsible. l[ you, as the owner s.lyns <'lS the contractor, you are indicating that
<br />you, rather than the conLulctor, ar:e l:espunRJ.Ld,e for the work. If the contractor wishes
<br />you to sign as contractor that may be an indlcill:ion that he is not properly licensed and is
<br />nol: entitled to permil:ting pLl.vlleges ill the City of Zephyrhills.
<br />C. TH1\IISPOHT1\TION IMP1\CT F'EI~S 1\NiJ UTJI,ITY CONNECTION n:E:S
<br />D. CONSTRUCTUION l,lfm 1.AW (C1ml"I'F:H '113, ';'I,UHI))1\ STATUTES, 1\S /\MENDED)
<br />I cerl:ify l:hat 1, the applicant, have heelJ provided wlth a copy of "Florida's Construction
<br />lien I,aw - Homeowner's Protectioll Guide" pJ:epared by l:he Florida Department of Agriculture
<br />and Consumer 1\ffairs. If the applicant Is someone other that the "owner", I cerify that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to COllllnenCemelll:.
<br />E. CONTRACTOR' S/OWNER' S 1\1"f'IIJ1\VIT
<br />I ce.r:tify that all the .lll[ounatloll in this application is accurate alld that all. work wil.l
<br />be dOlle in compliance wiLh all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby maue to obtain a permit to do work and installation as indit:ated. I
<br />certify that 110 work or insl:allation has cOllllnenced prior to issuance of a permit and that
<br />all work will be per[oJ:lned l:o meet sl<'lndards of all laws regulating construction, City
<br />codes, zoning regulations, anu land developmenl: regulations in the jurisdiction. I also
<br />ce.r:tify that I understand that the regulations of other governmental agencies may apply to
<br />the intended work, and that it is my responsibility to identify what actions I must take to
<br />be in compliance. Such agencies Include but ate not limited to: *Department of I
<br />Envirolllnental Regulation-Cypress Bayheads, Wetland 1\reas and EnvirolUlIentally Sensitive
<br />Lands, WateJ:'/Wastewater Treatment
<br />*Southwest f'lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercou.r:ses
<br />*Army Corps of EngiIJeers-Seawalls, \Jocks, Navigable Wate.r:ways
<br />*Department of Health & Rehabilitative Services, Envirolllnental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />"U.S. Environmental Protection 1\gency-1\sbestos abatement
<br />I also certify that, if fill malerJaJ. .1.s to he lIsed 111 E'lood Zone "A" or "A,etc,", it is
<br />understood that a drainage pIau addressing a "compensating volwlle" will be submitted which
<br />is prepared by a professional ellg.illeer registered in the State of Florida prior to permit
<br />issuance.
<br />A pe.r:mit issued shall be construed to be a license to proceed with the work and not as
<br />authority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors ill plalls, construction, or violations of any code. Every permit
<br />issued shall become invalid unless the work authorized by such permit is commenced within
<br />six months of issuance, or if work authorized by the pennit is suspended or abandoned for a
<br />period of six months after the time the work is cOllunenced. One 90 day extension of time
<br />may be allowed for the permIt with fee charge of $15.00, The extension shall be requested
<br />in writing to the Building Official. 1\n approveu illspectlon must be logged during each six
<br />month pl"J'i.od, or the pl:oject wIll be considen',J iluandoned.
<br />W1\HNING '1'0 OWNl.m: YOUR F'1\lLUHE TO HE:COHD A NOTiCE 01" COMMENCEMEN'l' MAY RESULT IN YOUR
<br />PAYING TWICE f'OR IMPROVEMENTS '1'0 YoUH PROPERTY. I F YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WI'l'1l YOUR LENDER oR AN A'l"l'ORHEY BEFORE RECOmnNG YoUR NO'l'lCE OF COMMENCEMENT, JOBS UNDER
<br />$2,500 IN VALUE VO NOT NEEV '1'0 HECOHV J\NV POST 1\ "NOTiCE OF COMMENCEMEN'r".
<br />
<br />~:fg:E:/ -' ~ fir ~
<br />t'.- ~ ~ .e..-Xk.U:to-n(..d
<br />SIGN1\TURE:: OWNER OH 1\GENT
<br />
<br />&0 (~/(€;
<br />, p~ U~ ,--t..--\./ ,.~
<br />
<br />SlGN1\TURE: CONTRACTOR
<br />
<br />ST1\'l'E Of' FLOIU V1\ ~
<br />COUNTY OF 'lJ..SC1)
<br />The fo.r:egoin(j instr menl: was acklHJwledgetl
<br />Before me this day of rYlOf~ , ~~O
<br />by . . IWS
<br />(name of person acknowledged)
<br />~JO is personally kllown to me, or
<br />
<br />ST1\TE Of' FLoIUD1\ r2
<br />COUNTY OF I c.zse!}
<br />The foregoing instrument was ack~wledged
<br />Be [o.r:e me this d~~ day of .111-t1A/. ,i1F ~
<br />hy m/k~ ~?:V77/,'t:A""" S
<br />(name of person acknowledged) ,
<br />~o is personally known to me, or
<br />
<br />o who hilS pt'oduced
<br />(type ot
<br />Odid not
<br />
<br />
<br />
<br />I.J who has produced
<br />(type of
<br />C}jid not
<br />
<br />
<br />takiJlg acknowledgement
<br />
<br />Name
<br />
<br />",III'" "";,nne Bahr
<br />typed,1' . ~~idmmr;si(ml#l'^ii.iQB17
<br />;~, .~~ F)(f..:'t'S NOV. 15,2002
<br />~~i'"'''''~''' r'1ED THRU
<br />""IR~,~\"'" ^'~ ,\1" nNOING CO., INC.
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