|
<br />A. NO'j'TCE: OIJ' DillED RE:I3'I'RIC'l'IONS
<br />'j'he Ilnderslgned lll1del.'stands that thj s pe:nnl _ liB Y' be ~Jllb.l e;.;t 1:0 "deed rest:rlctlo11S'" \'Shlelf
<br />way be mOl:e restricLive than City reglllatioJls. the lldl.lEn;jlqned assumes respollsibt ltt:y for
<br />(~()t11pl{anl1e \lJth any applJcabl e deed L!lS t 1.:1 C ~i(JJl,=.
<br />B. IlNl,ICHlNSH:D CON'1'Rf.\C'1'ORS AND CON'l'H!IC'1'(IH RE:S,?UI'J 9 IH [,['l'[ a:,3
<br />If the Ol'lller has hil:ed a oontl:actor Ol: C'ollt.:a.-J'::oUI to ll11dt:rtake HOl:k, Lhey Illay be requjred
<br />I:u be .lJeensed .In anuordanoe v/Jth state and local. J:egll.laLJons. If the contractor Is /loL
<br />IJ,oellsed as reqll1.red by law, both the Ol'lIIer and contractor may be olLed for a ndsdemeannr
<br />\lJ()laLioll IIndel.' sLate laH. If the OHIHH or Jlltt~llclmt (Jolltr6utor: ate llllcerta.ln as t.o \-Iha\:
<br />liu6nslng r6'lllirelllellt:s llIay apply 1:0,( Lhe intend!~d \"Iork, they at'e advlsed to con taut the
<br />CILy of Zephydd l.1s BuJldl.ng Department. 013-c1flll--6611"
<br />!i'ur.Lhermore, if the OI'lIIer has hired a contract(J); or CClIlt:r:aotors, he J6 advIsed to have the
<br />OOl1tj;'aGtol." (s I sign port.ions of. the "Contractol: Sections" of tld.s app.llcatJon for Hhlch they
<br />Hil:l. ue respona.lble. If you, as the OHner SlYllS as the contractor, you are Jnd.l oal:il1g that:
<br />you, rather than the contraotqr, arerElsponsible fot I:he I/Drle. I f. the contranl:ot HJshes
<br />you to 8.1g11 as contt'actor I:hat llIay be an indical:joll that he is nol: properly l..1censed and is
<br />IIDL ent:lLled to perudtting privileges 111 the CIty of ZephyrhUls.
<br /><: . 'l'Hl\I" S POn'I'll.'!'T ON I HPAC'l' FEEJS AI/I) U'l'I LI'l'Y CONlJEC'('ION I.!'EH:S
<br />n. CONS'I'RIIC'I'IIIOH I,TEN I,AW (CH~P'I'ER '713, FLORIDl\ ,'3'l'A'l'U'I'E:8, AS At11!:NDE:n)
<br />"I oer.t:j ty that: I, the appLloalll:, have beell proviqed H.lLh a copy of "F,'.lor.1.da's Construution
<br />.I ten I.aH - lIollleol,/l1er's Protection Gulde" prepared by the B'lor.ida Department of Ayrlclll\:llre
<br />and COllslImer AffaJrs. If the applIcant: is someone othet. l:hat the "o~lIIe,tJJ, T (jet:l fy 1.:llat 1
<br />have obta:lned a copy of the above descrJbed rjOCLunent and promise 1n goodfa1t:h 1:0 de11ver'
<br />i I'. to the "o\'lI1er" prJor to comrnencemell L.
<br />Ii:. CON'I'Hl\C'I'OH' S!OWUffiH' S AFE'rDl\Vl'I'
<br />I cert.l fy that: all the infonnat:Jol1 in this applicatIon 1$ accllr:ate and tbat all Hor" III 1,1
<br />be dOlle 1.11 oompliance HJth aU, applioable laws regHlatJlIg construotion, zonl.ng, and land
<br />developmellt.
<br />ApplJcaLioll I.s hereby nlqete to obtaln a perrolt 1:0 do ~wrk and J.nstallatloll as lndioated. I
<br />certify that: no 1/01.1. or lnstal.latJon has oommenoed pr.1.pt" to lss\!a1lcB of f:I perrnt\: allet I:hat
<br />a:ll vlod( HLll be perfDrmed to llIeet standards of all laws regulating oonsl:ulCll:lon, C,ll:y
<br />(J(ides, zon.lng reglllal;j.ons, and land development reglllatJons in the Jur.lsdlol:jon. I also
<br />ccrl:.\fy that: ':( lIiHierst:and that the r:eglllations of. other govetnmental agencies may apply to
<br />the intended Hork, and that it is my r!jlsponsibiU.ty to idenU,fy \'IlIat autions I IlIlltlt: take 1:0
<br />be ill compl.lallue. SlIch agenc.l.ea .inclllde bllt are not limlt:ed to: "Department: of.
<br />R:nvirolllllental. Regulat:ioll-Cypreas Bi'lyheads, Wetland Areas alld EnvironmentaLly Sensitive
<br />Lands, Wal:er/WastsHal:er 'I'r:eal:ment
<br />A 801l1.l1l'l6ti I: H'lod.da Water Mqnagem6u t Dis t r.t ct-Wells, Cypt:eas Bayheads, We LJaud l\J:eas,
<br />A Iledny Wa l:er:collrses
<br />^lHIIlY COl.pS of Eng.ineers-SeaHaLl.s, flooks, Navigable WaterHays
<br />Allepartment: of Heal th & RehabJUt:at:J.ve Services, EnvL:olllllental Health IlulL-Wells,
<br />~Vast:eHat:er Treatment, Septic '['anI,s
<br />AI). S. ffinvlt:rllunental ProtEwtJou Agency-Asbestos abatement
<br />I also cel.l:Jfy that, Jf fl.lllllater.l.al 16 to be used.ln H'lood Zone "A" or "A,el:o.", it 16
<br />llllderst:ood that a draJnage plall addr.'ssslng a "compensating volume" VILLI. be suhwi t:t:ed Hld.ch
<br />Is pl:epared by a pl.ofessional enginef:ll: t'eg.l.stered in the state of l!'lodda prIor 1:0 pennl.t:
<br />issuance.
<br />~ peuult j sSlled shall be construed to be a license to proceed I-I1th the work lwd not as
<br />allthorH.y to vlolal:a, canoel, alter, or set aside any provisions of the teohnJcal oodes,
<br />nor shall issuance of a permlt prevent the BuJldlng Offlcialfrom l:hereafter requiring Cl
<br />correuLJoll of ettars ill plalls, aanstruatlo/l, or viulatiollS of any aode. /il\ltiu:y permit
<br />isslled shall heoome invalid unlesa the wO.r:k au~hodzed by suoh permit is nOllllllerlOed witld II
<br />silt llllHlths of issuance, or If \wrk f\uthorj,zed by I:he pernd.t is suspended or aballdoned for a
<br />ped.od of. sh, Il\onths atter the time the work is oommenced, One 90 day eJttenSlioll uf. time
<br />lIIay ue aUoHed for the permit vlith fee charge of $15.00. 'rhe elttenston shall be r.eqUflsted
<br />j n vlr.i LIng to the Bul1.dlng Offi()ial. An approved inspeotion mus t be 1o\Jged duLl ng eaoh 8.1l(
<br />month period, or the project Hill be cOllsJdered abandoned.
<br />Wl\I1NJ.I/G 'J'O oWNERI 'tOUR Ii'AII,URE '1'0 RECORD A NO'l'IeE OF.' COMHH:NCIDNE:N'I' Nl\Y mlflllf,'l' 111 YlHJH
<br />Pl\YUIG 'l'WICE: IroR n.1PHOVEMENTS 'I'D YOUR PHOPER'1'Y. IF YOll IWI'END 'J'O OB'I'~nl !i'HIAI-JUHI(#, COIISIIL'l'
<br />WITH YOUR I,H:tllJElR OR AN A'I"1'ORNFlY eEIfORE RECORDING YOUR NO'l'Iem OF COMtIJENCf.;t1EN'l', .JOBS IJlWfl:n
<br />$2,5110 III VAl,UE no NUl' Nl!:Iil1J '1'0 RECDHD AND POB'I' A "NOTICE DE' Cot1Hl!:NCE:ME:lI'I'/I.
<br />
<br />\.~U!:'I.') -.'. '.'.'.L f,).~..! S () .?' ,J? '~'~4\~~_':'~t_\ j-\ ~1~'~~ ~)A VI rr
<br />
<br />, -,~-~.._---,---_._---
<br />
<br />SIGl'~'I'URml OWNH:R OR AGEN'f
<br />
<br />
<br />SIGNA'I'IIRE: CON'l'R1\(;'l'On
<br />
<br />. ._--_._-_.'---,-_._-~~. .'..----...-----.-. ~ ,
<br />
<br />,~'l'A'l',W: UIl' ,nORTlll\ Pfi S"e.o
<br />
<br />COIlN 1 'i DE" .__.___'____'_._.__.___._________,___....
<br />
<br />'J'he toreyo.lng instrllment was acknowledged
<br />Before lIIe 1:111s -1?:::_ day ofSlie.,_.__, ~ZQoZ--
<br />
<br />by _,_______'_.____.______..__._.._,__. ____~__,_________.______,_
<br />(name of persoll aClkno\~ledgedl
<br />[Jl-lho .\.S personal.ly known to file, 0.1:
<br />
<br />S'I'A'I'E DB' FLORIDA P/1g-C'~
<br />cmlH'l'Y Oli' ____..______._,......._.__... .___...__.____..______."'_
<br />
<br />'j'he foregoing instrument Has auknoYlledged
<br />Before me this L.~___{iay of-SeI'...C_._____, -Hl~ Z-
<br />
<br />by ___.___._____,___.___ _ _______.___...___..____,__......, ....'..'_._.
<br />(name of person aolmowledgced)
<br />[1ho 1s peL'F.lcmally Imo\vn La me, cn:
<br />
<br />LI who has p r.odlloer\____..,_.__.__~.___.____..__,__
<br />(type of identJf1aatJoll)
<br />awl whol] d.l.d [JdJd not take an oath,
<br />
<br />[J ":1110 has prodllced_________._..__..__....__.___.._._,_.
<br />(type of Idslll:JficaLJon)
<br />and ~~ho []dld DUd not tal(e an oath
<br />
<br />... ',--_.', --- --_.,-_._-~-~,,- .-., _._--_._~_._~ ......_--~.._._.~-
<br />
<br />S J Ylla I: Ilte 0 f persoll ta k.ln9 a CkllO~ll edgemen t
<br />
<br />S:J.gnat:uJ::e of person tald.ng aoltnm/l edgment j
<br />
<br />-_...~._+- --_._--_.._._~._-~.~...-..__._-, - ,.-. -.. -_.._..----~-_... -....-.. ._-..- -.__.- ..- -" -,- ",'-..- - -~ -..--+
<br />
<br />-,'--.',- ----..... --.- .-. -_. .._,.~_.-.__~___ .u.__....._._ '___,__,,,~,,.,~__~_____,__.,.
<br />11allle I:yped, pd Ill'ed 01. stamped
<br />
<br />Harne typed, t-HI nted or sl:alllped
<br />
<br />., "'+-'_.'--'---'~-----",-- -_..-- .-. '---'-~,,- ...
<br />
|