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<br />U)ll')"_'.'.~ ()~ I e I)': p";nJ"~"' l\':f'I '.lAV' n.'
<br />
<br />1\, NO'rICE Ol!' DillED HESrl'rnC'l'IONS
<br />'1'be llndel:s.!gned understands that: t.ills pennJ t: may h'3 sllb\eul: ::0 "deed t:estdctlolls" I,rhlch
<br />may be lIIon. resl:r..icl:ille than CJ.tynlgl\latiolls. 'l'h'3 lllld'3Lsl';Jlled assumes respollslhJl.i.t:y' ror
<br />compli.ance \1Jth any applicable deed [t3st:d.otioIl8.
<br />B.. 1/I.JJ,ICffiNSI!:n COH'l'H1\Crl'OnS AND COtl'l'HAI;'['OH HmSPUIIEI (BILl'l' [F,g
<br />If the ulmer: has Idr.ed a uontr:actor ,)[ uont:ract:OL3 to undertake \1ork, they n\ay be reqll:l red
<br />Lo be 1.icensed ln auuordance vd.t:1l stC:ll~e and local regulation,s. If the contractor is not:
<br />lJoensed as reiptJ.r'ed by laH, both tile Ol'/TIer and cOlltracl:or llIay be oJted for a nd sdemeannr
<br />vJulatioll IlIldsL' state laH, If the O\'meL or .1.ntend,ad COlltl:actor are IInr:ertain as to Hhat
<br />I luellsl ng rSllld.relnents may apply 1'o.t: tIle intended 'owrk, tlle\' are advised to COil tact the
<br />ell:y of Zephyr:ldUs BuJldl.ng Department, fl13-c/BB'6611.
<br />1!'1l1.t:heLlIIcH:e, if the OHllel: has h.i.J:ed a contract:ot: or: contraotors, be is advlsed to have the
<br />oOlltraotol: (s) sign portions of the "Cont.racto1: S~lctions" of thls app,U.oatiol1 for I'lhlel1 they
<br />Hill be responsible. If YOII, as the molDer signs as l:he (Jontr:actoJ.:, you are ind.loat:ing that-,
<br />YOIl, l.'aLhet: than the conl:raotor:', are responsible for the worh:. If the oontran\.:or I,d shes
<br />\lOll 1:0 13,1 yn as cOlltractol that may be an .ind.l.catioll t:hat he is not: properly L1 censed and Is
<br />!lilt: anti tIed 1.,0 pennU:tillg privileges In the Clty of Z,ephYIJdlls.
<br />c. '1'Rl\HSPOH'!'l\'J'IOH H1PAC'l'lfEElS ,AlID U'l'ILITY CONllffiC'I'ION E'ElES
<br />lJ, COHS'l'RIIG'j'UI01'1 l,[EN 1J1\W (CIIAP'l'ER '713, FLORIDA S'l'Arl'IJ'I'ES, AS Al'1EN\lIW)
<br />I cel:t.i ty that I, the appllcanl:, have been provided 1.i.1l:h' a copy of "Wlorida's ConstrllctJ.on
<br />1 ten 1,all .- lIomeol-mer's Protection Guide" prepared by the E'.lorida Department: of Agr:lalllt:llre
<br />and COllsumer A1'faJ1.'s. If the app,Ucant 1s somli:one other that l:he "oHner", I ccn:\fy t:hat I
<br />have obta.ined a r:opy of the above desorlbed docllment: and prom1se 1n good :falth to delllrer
<br />it to the "ol-/ner" prlor: to commencement:.
<br />E:. CON'('Hl\C'I'OH' B/OWNH:R' S AFE'IDAVl'I'
<br />( oert:.1,fy that: all the informaUoll in tills appllcat.loIl.ls accurate and t.hat:, all llOrk 111:1.1
<br />be dOlle 1u compl:l.ance H1th aU, applJ.oab.le 1a"'l13 reglllaU.ng constrllction, zon.lng, and land
<br />dE:lle1.opmellt.
<br />Appl.l.caU Dn :I 13 herehy made to obtaj 11 a perrnlt to do work and :Installation as indloated. I
<br />cel.U fV thaI: no \/Ork or installation has oomrnenced pr.1.or to lsallance of a pennil'. and that:
<br />al.l Horl, \'/11 1 be performed to lIIeet standards of all laHs regulating uonstuwtJon, Cll:y
<br />codes, zonlng regulal:.i.ons, anrl land development reglllat.Lons 1n the j\ll..lsd.i.ctJon. I also
<br />ceLl: I f:y LIla t: . I 1Il1l1ersl:and that the regulatlons of other gover:mnent:al agellClles IIlay apply to
<br />Lhe In\:ended v/Cnk, and that: it 113 my responsibi.llty to ldellU fy l'lhat aut:ions I mllst talie 1:0
<br />be in cOInplJallce. SlIch a\]encl.es :Include but are not J il\lited to: *neparl:menL of:
<br />H:nvJt'olllllenta 1 Hegulatioll'-Cypr:es.:I Bayheads, Wetland AJ:eas and n:nvlrollTnElntally Sensltlve
<br />l,ands, WaLer:-!Wasl:eHaLer 'l'reat:llIent:
<br />'Solllhvlesl: 1!'l.ol:J.da \'1ater Hanagelllent llistr.\ at-Wells, Cypress Bayheads, Wetland 1\reas,
<br />l\J.t:Bdllg WaterCOllJ:ses
<br />'!-Il:IllY CULpa of E1llgllleel:s-BeaHalls, Docks, Navigable Wat:er\'/ays
<br />+, lJepattll\enl: of Ileal th & HehabilJta\:Jve Services, l!:nvJrolJlnenl:al Health lJnlt-Wells,
<br />Wastellat:er Treatment, Septic 'I'anl~s
<br />+.u. s. E:nv1 L0ll10Ellltal t'l'otection Agency-Asbestos abatement:
<br />1 also cerLI fy that, lf fLU Illat:er\.al \.S to be used .In F.'lood Zone "A" or "A,eLe.", l.t .is
<br />lllHlel:sl:ood that a dralnage plan addressing a "compensatlng volume" ...11.11 be submitt:ed \'Ih1Gh
<br />is prepared by a professional eng!.nser. registered in the state of I!'lorlda priot' to penn!.\:
<br />.issllance.
<br />1\. perm.! t .I Bsued shall be construed to be a Ii-cense 1:.0 proceed Hi th the work and not as
<br />aut:hod Ly to vlolat:e, caneel, alter, or set aside any prov.i.sions of the te(]hnlcal codes,
<br />nor shall i BSllance of a penni l: prevent the BuLlcUng otUciaJ. from l:hereafter requld.ng a
<br />cou:euLlon of errors ln pl.ans, construction, or violations of any aode. Everv permlt
<br />isslled shall. heDome inval.!.d unless the wot:k authol:'ized by suoh perm.!.\: .!.s rJollllllenced \'/,i l:ld n
<br />sill mouths of lssuBuoe, or .i.f \V017k authod.zed hy the permit: is suspended or abandoned ror a
<br />pedod uE S1.b, months after: the l:Jme the \'lor}, 1s commenced. One 90 day e}{t:ens.loll of t.lme
<br />lIIay be alloHed for tile pertnit Hith fee chal:ge of $Hi, no, '['he e}{tenslOll shall be reqnes\:ed
<br />ill \11:1\:il1g 1.0 the BIIlldlng Offic:ial. An appr.oved inspection IIII1St be logged dllr:l ng eac:h s.l J(
<br />month perlod, (n the proj ect: 1'l111 he consldered abancloned.
<br />Wl\RNJllG '1'0 OWmjHI YOUH jj'AII.\JnE '1'0 RJilCORD A NO'l'Iell', OF COMttEHCITIHE\U'I.' NAY nrr.SlJI,'I' IN YOIJ[\
<br />PAYHIG 'l'WICn: ll'OH THPROVEMENTS '1'0 YOUR PROPF.:R'l'Y, IE' YOU IH'l'll',ND '1'0 OR'l'AHI F.'IHAIICHIl3, COlISIIUI'
<br />WITH YOUR l.n:JWF.lR OH AN A'l"l'ORl-IF.:Y Bffili'ORJr, RI!'.CORDlllG YOlm lW'l'ICm OF C()[YI!'111\NCI!;HEH'!'. ,fOBI'! l1IWF.',H
<br />~2, 511ll 111 VALUE DO !lO'I' HE:En 'i'O RE:COHD AND POS'I' A "/'jO'I'ICE: elf COHHE',I'ICEHE:N'!'''.
<br />
<br />SIGlIA'1'UHm I OWNER UR AGffitl'I'
<br />
<br />SIC;Nl\'I'URE:: CON'l'RT\.C'l'OH
<br />
<br />S'j'NI'E\ Ol!' l!'l,OHUH\
<br />
<br />CUlJIl'1'Y o Ii' .--..--..--,.-..-..-..----.-..--.--..---,-...
<br />
<br />'J'lle foreyo.tllg instrument \las acknmrledged
<br />Before me I:hls_..__._,.. day of...__.___..., l~_....
<br />
<br />by ,_......_.._...._..._ ..._.._._'~_h________.___....__...____.__..__..
<br />(name of person acknowledged)
<br />[) I~ho is personally IUIOHn to me, or
<br />
<br />[I Hha has p I:odllced___,______.____......___
<br />(type of: identJf1eatJon)
<br />and \.Jho[} dld []clJd 1I0t tal,e an oath.
<br />
<br />fJ'r1\'l' E: CW FLORI \)A
<br />
<br />COlIN'I'Y ()h~ ____,___......_..,__..,.._.._..___.__h_'__._
<br />
<br />'1'he foregoing i.nstr\llllent Has aolOlol-lledgsd
<br />Before me th.is ____JIey of-..-.......,--.-.., 19 _.:.....
<br />
<br />by ..___.....__.__________..,_._....._......___.._.._,____,.....
<br />(name of person aoknowledged)
<br />[1ho is personaUy known 1.:0 me, 01:
<br />
<br />[J 1-1110 has prodllot;jd__,.... _.._._~._,___.__.
<br />(type of Jdell!:il'leaUon)
<br />and 1'1110 []dJd DHd noL I:ake an oath
<br />
<br />SiYllature of person tak.illg f.lckllovlledgement
<br />
<br />81gnal:llr:e of persoll takll1g aclolO\lledgment I
<br />
<br />Name typed, pd IIted OJ: stamped
<br />
<br />Name typed, p1'l, nted or s l:amped
<br />
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