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<br />cc;~. ,~ T I '::JNC
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<br />PCFU'1:" ' ',FTc; D(\\,) I T
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<br />A. NOT I OE OF Q.c.r::j!_n~'~I.r2.l.~~~
<br />
<br />Th~,und~rsigned understands th~t this parroit may b~ subl~ct to "decd rcstrictions' which may b~ ~or~ rcslrictiv~ than City
<br />r~gulations. Th~ undcrsiQn~d "sS\J~e5 responsibilit'r:'forco~rnancc !lith any appliCilblE: deed r~stridions.
<br />
<br />B. UNL I CENSED CC1r'lTr<ACTORS AND CONTRACTOR RESPO!'L5 I 1l I l_ I T I E;S
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<br />If the owntr has hired a contractDr ur cDntr~ctors to undertake Hork, they may be r~quired to be licensed in accordance Mith
<br />state and IDcal regulatlDns. If th~ contractor is not licensed ~s required by law, both \hE: ouner and contractDr nay be
<br />cit~d for a ~isdeneanor viDlatiDn under state la>>" If th~ DHner Dr intended contractor arc uncertain as to "hat licensing
<br />requirelents aay apply fDr lhe intendrd HDrk, they are advised tD cDntact the City Df Zephyrhills Building Departaent, (813)
<br />7B8-6611.
<br />
<br />Furtheraore, if the D"n2r has hired a cDntractor or contractDrs, he is advised tD have the contractDrlsJ sign pDrtions Df th~
<br />'Contractor Sections' of this 2pplication for which th~y will be r~spDn5ibl~. If you, as the Dwner sign as the contractor,
<br />you ar~ indicating that YDU1 rather than the contractor, ar~ responsible for the Hork. If the contractor "i5h~s you to sign
<br />as contractor that cay be 2~ indication that he is not properly licensed ~nd is nol enlillrd to permitting privilegos in \~e
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTAT T_~ll'l-IJ::1P(~CT FEES AND UT I L I TY C01\ll\IECT I 01\1 FEES
<br />
<br />D.
<br />
<br />CONSTRUCT lOr i_LIF:l'! u~\,-,_
<br />
<br />(cHAPTER 713, FLORID~ STATUTES, AS AMENDED)
<br />
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien La" - Ho~eDKner's PrDteclion
<br />Guide' prepared by the Florida D~2~rlment of Agriculture and Consucer Affairs. If the ~pplicant is so:e~ne other than the
<br />'Dwn~r', I certify that I h2~~ obtained a, c~py of th~ abov~ described document and pro~iso in good faith \0 d~liver it to the
<br />'Dwner' priDr 10 CD~~ence~ent.
<br />
<br />.,_..'{: "
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<br />E. CONTRACTOR' 5LDt-I1:;1r::R I S AFF IDAV I T
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<br />I c~rtify that all the infDrlation in this applicatiDn is accurate and that all Mork Hill be d~n~ in co!pliance Kith all
<br />applicable laHs regulating construction, zoning, and land dev~lopcent.
<br />
<br />Application is h~reby ~ade to obtain a permit to'do ~ork and install~tion as indicated. I certify that no work or
<br />installation has com2encEd priDr to issuance of a per~it and that all work Hill be perfor~ed to ~eet standards of all laMS
<br />regulating construction, City codcs, zoning regulations, and land dev~IDpment regulations in the jurisdictiDn. I also
<br />certify that 1 understand Ihat the regulations of Dther gDv~rnrnental agencirs may apply to the intended HGrk, and that it is
<br />"y responsibility te, identify lihat actions I /!lust take to be in compli"ncc:. Sucl, age"clos incluje [Id :'Ie !'Ie,;' li'1ited tD:
<br />
<br />, ..
<br />i ~parhent e,f EnvirDni!l2ntdl ReoulatiDn - Cypress Bayheads, Hetland ~reds and [nvir(,nrrI2r,~211y S0nsiti','~ Lands,
<br />Hater/HasteHater Treatment
<br />i Se,uthilEst Flc<rida Ilater l\anaQer.ent District - \Jells; Cypress Bayheads, \ld];jnd r,reas, ri1tuing H21ercGurs2S
<br />i Ar~y CorDS ~f EnQineers - SeaHalls, Docks, Navigable \laterHays
<br />I Depart~ent c,f He,,!th L Rehahilitatiye Services, EnviroMent,,1 fle"lth Unit - Iklls, \iasterl31er Tre3t':'C'lt, Septic Tjn~s
<br />I US Enyiron~ental ProlEction Aoency - nsbestos abat~m~nt
<br />
<br />also certify that, if fill ~atC'rial is to be used in Flood Zone "n" or "n,dc,', it is lIi,dHste,e,d l:,~l d drainage plan
<br />addressing a 'cotp~nsating YDlume" Hill be sub~ittrd "hich is pr~pared by a professional enqlneer ioqi5t~roJ in the Slale Df
<br />Florida pri8r to per~it issuance.
<br />
<br />A p~r~it issued shall be construed to be a licens!! to proceed ~lith the "e,rk i,nil ne.t as Jllthe"il)' Ie, ,'ie,j"te, cancel elter, or
<br />set aside any provisions Df thr technical cod~s, nor shall issuance of a permit prevent Ihe Building Officidl frD~ thereafter
<br />requiring a ce,rre:c!ie,n e,f errDrs in plans; conslructie,n, e,r violations of any [(,ue. Eyny p,'r;::! I isslIl'd =~.al 1 be:CC'le invalid
<br />unless the ~e.rk aulhe,ri,e:d by slIch permit is c(,m~enc~d "ithin six months [,r iss\I.\n((" e,r if lI(',}: 2\ilk.. i;cd bi the per.it is
<br />suspended Dr abandoned f[,r a peric'[\ (,f six =onths after tlw ti:l~ the \1Drk is ce.Mlcnced, D,;e q,:, day o;!c"sic>\, of \iH, lJ.ay be
<br />alle'Hed fe,r the pHJ.'\\t \lilh fee charg~ of $15.00. Th~ extensie,n shall b~ rC~III:s\cd in \nitin~ te, tho 8uilding Official. An
<br />approved inspecti[,n !;Usl be le,ggrd during each six month p~riod, or th~ pre'it'd Ili I ] be ce,r,si,!cre:G dt,,;\,Je"lcd.
<br />
<br />WARN I NG TO O\.-J1\IEF~: YOUR FA I LURE TO RECORD A 1\IOT I Cf::: OJ=- C0I'1i'1Ef,ICEMENT r1AY
<br />RESUL TIN YOUR F'AY I NG TW I CE FOR I MPROVEMENTS TO YOUlc< PROPERTY. I F YOU
<br />INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN Al-TORNEY
<br />BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS U~IDER $2,500 IN VALUE
<br />DO NOT NEED TO FlECORD AND POST A "[\lOT I CE OF COMr1Ef'ICLr'10JT".
<br />
<br />DATE
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<br />SIGNATunE
<br />--~Afj0"-:k-~-;=='~-
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<br />
<br />
<br />DATE___________________________________
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<br />SIGNATURE
<br />----------~~-a~-.--~~-------------
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<br />~~~/AG~n.Jr-
<br />
<br />NOTARY AS TO A/ _ j'i /
<br />OWNER OR AGENT__~~~~-f2-~ tl1A~~~'
<br />, ~ !77-Il%?# J/y-rt-:z:;;;-
<br />MY COhM 1 S5 1 ml Ey.r j i ([5______________________
<br />
<br />NOTARY 0.S TO ...,/ ,.)
<br />CONTR(\CTOR__:~~:.:-~~~;;L:J::;L,,~!;?j.~/
<br />... YtrTH Lb c:- jJ ::fj!S f) tit 1..1.J
<br />MY COMMISSION EXPIRES__________________
<br />
<br />,,~,,~ 1'//4-
<br />~~(~
<br />~W:
<br />
<br />""t OF f\.fI>~
<br />
<br />KATHLEEN J BROWN
<br />My ComrnInk>n CC449029
<br />Explree~. 02.1999
<br />Bondl>d by NF.NU
<br />800-224-6368
<br />
<br />fI>'\~4(
<br />'" ~
<br />~W~
<br />
<br />, ,J'~OF 'f\.fI>"~
<br />
<br />KATHLEEN J BROWN
<br />~y ~OITllTlia.ion CC449029
<br />>eptres Apr. 02. 1999
<br />Bonded by NFNU
<br />800-224-6368
<br />
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