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<br />il. tJO'l'LCE; ()F DEED RE:STlUCTIOI1S
<br />rhe undersigned urlrJerstands that tllis pennit may be subject to "deerJ resLric~Li(JlIS" I.,hidl
<br />llldY he lllrne ].8stricl-iIT8 than I:ity regulations, The undelsjqned aSSllllles Leb["'llsihj liL); j'(JJ
<br />C:OJll[1.1 ian(~e l'llth allV applicable deed restricLions,
<br />8. lJi'lI,]('F;J1SEIl -CUII'l'RJIC:TOPS AliI! COI1TRAC'I'OR RESPOllS1BILI'J'1 E;S
<br />.I t tlle e!l'lller lIas hired a contractor or conLractors to undertake \^Iork, they Inay he requJ red
<br />t,) he IJ(;enseJ in accunlance llith stat.e and local regulations, If Lhe COlltli:lcl.OI' is llul
<br />licensed as required by la\.,; both the O\'lller ancl contractor may be ciLed for a J(lisdemealw]
<br />vlulatiull 11Il,ier slate lall, If the mmer or intended contractor ale uncelLain as [(I \'Ihal
<br />.licellsillg requirements Il\ay apply for the intended I'wrl;, l:hey are advised to cOlltact LhE::
<br />(iLy of Zepllyrhi lIs BlIi lding Uepartll\enl; BIJ-78CJ-0020.
<br />Furtllenn')Je, if the UI'Hler has IILred a conLractor or cuntractors, he is advised to llave the
<br />(;ontracl:oJ:(s) siqn portions of the "Contrac.:tar Sectionsll o[ t:lds appl.icatl<)I\ fOI Ilhlcl1 tile)'
<br />IIil1 be re;;;pc)Jtsible. If yuu; as 1:l1e Olll1er signs as the contractor; yuu al e illllicat:Jllfj t llat
<br />you, raLher' Illall the cOlllracLor; are responsible for the 1.lorl:, I f tile contraclul. Ili:'3lles
<br />YOll to SilJll as cuntractor that. Il\ay be all indica~ioll tllat: he is nol prelperl)' J lcensed and is
<br />nut entitled l:c! perlldtting privile~les in the eLt)! clf ZephYlhills.
<br />(', TRAIlSPOR'J'l\T [UN H1PJICT FEES MJD UTI LI'I'Y CutHlEC'I'IOtl fE:E:S
<br />n. C'OllSTRIJC'I'1I1UIl LIE:!I LAI'I (CHAPTER 713, FLORIDA STATUTES; AS 1\H81J[)E:D)
<br />1 certify tllat I, the applicanL; have been provided llith a cupy of "florida's C()[lst:ulction
<br />J Len LaVl HOllleOlmer' 5 Protect ion Guidell j,Jrepared by the F'lorida Departlllent of 1\91 i cuI I.Llle
<br />Blld ('onsIHller l\ffcdrs, It tlle applicant is someone other that the "ovlIler", I eerify that 1
<br />have obtalned a copy of l:he above described document and promise .in <]uod failh 1:0 deliver
<br />.iL to tIle "l'I'Hler.ll prior to COlllmencelllent,
<br />E:, C01ITRl\C'J'UR' S/()vJllEP.' S AFF'LDiWl']'
<br />J certify Ihat aiL jhe inturlllat.lon in this app.lication is accurate and tltat all I)(Jrk \lilI
<br />he dOlle ill cO!l1plian\~e \Iilh all apj,JlicabLe laHs regulating COllstl.T1Clioll; zonJrlY, alld land
<br />developlnelll ,
<br />l\pplicatiuIl is herehy made to obtain a .pellllit Lo do l'iOlk and installaLion as indIcated, T
<br />,~erLifv that 110 1.lur); or iIlstaJ laLion has commenced prlor Lo issuance of a permit and that:
<br />aU VICJ[l; I,JilL be perfonned to meet standards of all .lavls regulating construclioll, ('ity
<br />codes, ZDld/lI;) regulations, and land development regulations ill the jurisc!icl:il)IJ. J also
<br />certLfy IlraL I understand Lhat the regulations of other governmental agE:Il,:1es lilaI,' a~Jply to
<br />tile lntenclE:d vlark, ane! l.hat iL is my 1esponsibiU_I:V to identify l'lhal: actions I must: I:a);e Lo
<br />be ill ,;oIfLpllallce, Sllcll aqencies inc.l ucle but are not 11m i ted to: * Departmenl ()f
<br />r~lIvjrIJJllllelll:a] Requla l: i 'Jl1-C}lpress Bayheads, Ilet land l\r eas arid E:IIViuJllllielil-a 1.1 y Sensi t 1 ve
<br />rands; \'1 a t: er /\'lJas L eHa teL. '1' rea tlllen t
<br />*SUllthl/esl: F'locida vlat E:1 Hallagement District-vlells; ('ypress Bayheads, vlel. land illeas,
<br />II.[ IeI' illY I'laLercour ses
<br />*ArlllY Corps uf Enyil1eelS-Seal'laJ 1s; Docks, l~avigabIe vlaten.lays
<br />*Uepartrll8nt of Health E, Eel1abilitative Services, Environmenta.l Health [JnLL-'vlells;
<br />Wasts\.lal er Tl"eatllifHd; Septic 'l'anks
<br />IU.S, F~l1v.lJ()lllllelltal Protection JIgency-Asbestos abatement
<br />1 also certify thaL, if fill material is teJ be used ill F'lood Zone "A" (J\ "il;el-': 1l. IS
<br />under.sl:ood t:llat a drainage p.lan addressing a "compellsatillCj vO]llIl1e" I'dll be slllmLi.IIp'(j \ditch
<br />1s prepared hy a professional engineer registered ill t:he Stale of lilc11ida prill\. II) pelllli I.
<br />issuance,
<br />J\ penni I: issued silal] be l=Ollslrued to be a Jic::elise Lo prc)l;eed \.,Ji th tile \-lor); alld Ilot as
<br />au L h 0 r 3. t Y I: 0 '1 i 0 1 ate, can u e I, a 1 t e r; 0 r set as i cl e any pro vis i 0 11 S 0 f L he I' e dllli c a 1 I; 0 d 8 S ,
<br />nOl shall issuaIlce ot a pennit prevent tile Buildinr::f Official from t:llereaf1er rerJuLl.iny a
<br />correction of errors in plans, construction, or ,'_tolalions nf allY code. Ever y permit
<br />issued shall become invalid unless the \'Iork authorized by such permit Is CDlllfI\enced 1.Ii.tlllll
<br />s.1:; 1I10llths of issuance, or if I'/ork authorized by the permit is suspended or abandoned for a
<br />period of six IllolJLhs after the time the \'Iork is commenced, One 90 day extension of t.ime
<br />may be aLlo\'led for the f>enlllt \'/ith fee cl1au::f8 of $15,00, Tile extension sllall he requested
<br />in \'lriLillf] to tile Building Official.. An approved illspecLiol1 must: I>e JOlj(::fed during eacll s.i;;
<br />fI\()nth per.1ud, or l.he p:rojec:t I,Jill be conslderecl abandoned,
<br />I'II~Rl1Ilj(, TO mmER.: YUIJH Fl\lLUR.E: Tn FrECOHll A ll(I,],I(~E (IF ('(Wll.1EtlCE[]F~I1'l' ['j1\Y P.E',8UI']'111 YOlfR
<br />Pllflllc; '1'\'neE: FIlH IHPRI)VEI'lE:llTS TU YUUF PPOPERTY, IF YUU IIIJ'E[j[) 'j'U OB']'lllll F'ltll111CU113, ('(JIISUL'I'
<br />~n'J'lI YUUR LEllUER OR i\11 NrTI~IRI1E'i BEE'ORE RECORflUIG YOUR ]](l'l'II:F OF (~OlilIJl:.tICF:I1E;I.I']', ,/II1381IlIUE;f<
<br />$2,5UU ] 11 Vi\LlJE: DO I 1'1' IlEE:ll 'j'() f<ECORD All[) POST A "llOTICE: (IF \-'I.lI']llEllCE:I'lF I'l'fl ,
<br />
<br />Fc.. .' 01 hOr '-I- do '}y, :S. 3, 83
<br />
<br />
<br />
<br />SIGIIA'I'IJRE:
<br />
<br />8'l'1\TE OE' FLcmI [l~
<br />COIJI'J'I'Y OE' ____________a.ag; b___________
<br />The torelJ01.IICj insLr..-..Lllllenl: vJ~knOVlled~ed
<br />Before 11I8 thj~q._/;:<k-C:ja" of /4.<1:.-.-_, !1i1?3
<br />l)y ,-----.~--r--0~~..--., ._____________.
<br />(nallle of person ar;knoviledged)
<br />CI"llo is personally kllolm t.o lIle; or
<br />
<br />~~;~~;:;:yO\EIF' Fl.l JRI [)i~_,___~~Q. ..___.____________
<br />
<br />Tile foregoing .1 nstuHllelll lIa~)~~~~~d(Jed
<br />
<br />~ ~ f 0 L_~. _l~:_,I:,J:d:i-.I~~~"&P. _. __.l"_/(~~-::
<br />
<br />(name of ~{ersoll acknmil edged)
<br />[}Iho is personally kllOl1ll I.() Ine, or
<br />
<br />[J ",lIo lias procJuced____.__.__________
<br />(lype of identification)
<br />alld 1'lllOLJrlid []clid llot t:aki" an oaell,
<br />
<br />[J who has produced,___. _.._._._____.______.__________.__.
<br />(LYfJe uf jdelll1.fJ'~atJon)
<br />amI vilw [] d i 11 LJii cl nol I d I:e all oC! t h
<br />
<br />8i '::fllat.'1 Ie (.J t persull ta I:ln'J ac):no\.,lec1gement
<br />
<br />,Si<,jllat:ure uf person LakiJI'j ackllol-1lecJqmenl:
<br />
<br />[Jallle L yped, pr inted or st:amped
<br />
<br />tlame I_yped; [Hinted or sLallll_'8r1
<br />
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