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<br />1\. NO'I'ICE Oil' DH:JUJ HEB'l'RIC'j'IOHS
<br />TIle tlnders.lgned IIndet:stands that: th:s p,,,-nnlt: IliaI' be s\lbJeut t:o "deed l'esl:dntions" Hhlch
<br />IHay be 1II01:e l'eal:rJct:ive than C.l.ty regulations, J'he undersigned aaSUllles resPQllsHllIJty Eor
<br />compliance Hith any applicable deed t:flS t. d.ccion.3,
<br />B. l1HloICENSI!:D COH'l'nAC'l'OHS AND COl'J'I'HAC'l'OR RITISPOIISIBUII'l'Iffi.'l
<br />tf the Ollnel: has hIred a conl:l:actor or contractors to \1I1dertake \-Iork, I:hey n\ay be reqll:lred
<br />to be licensed in auuorclance y/ll:h staLe and loc"l J:egulatJolls. If the Clonl:ract:ot' Js not
<br />l.lcensed as .requ.l.r:ecl by laH, both t:he OJ.mer and cont.l<lct:OJ: may be n1l:ed for. a mIsdemeanor
<br />vJulation und.n state lall. If the Ol'iner or intended contractor EIre uncertain as to \lhat
<br />I tuellslllY req\d.lelllents lIIay apply for the .lnlended Iwrk, they are advised to (Jonl:ac:t the
<br />I~U~y of Zephvrhil.1s BuJldJng Department, fl13'-'/flB'6611.
<br />F.'lltLllEllJlIore, If the O\/Ilel: has hLJ:ecl a contractor or cont.ractors, he 1s advised to have the
<br />GontractOl: (s) sJgn portions of l:he "Contractor Sections" of tlds applicatJon for Hhl eh they
<br />H,1.1 1 be responsible. If YOII, as the m'1ner s.lgns i'lS the conl1:actor, you are .tnd.lcaU.ng that
<br />YOIl, rather than the contractor, ene responsible for the Horle, If the aontrantor I-i.lshes
<br />YOII 1:0 s.1yn as contractoJ: that may be an .l.l)dicatJoll that he.ls not p!:operly licensed and is
<br />not entl tled Lo penllltting privileges in the City of Zephyrhills.
<br />c, 'l'Rill-ISPOH'l'A'l'TON H1PAC'l' IfH:I1JB .1\111) UTILITY CONl1EC'I'ION F.'EES
<br />n. COlH::l'1'RIlC'I'UHHI 1,[ EN LAW (CIIAP'j'E:R '713, FI,ORI DA S'l'A'l'IJ'I'ES, AS At1ENIlED)
<br />I cert.i fy that: I, l:he <IppLtcanL, have bean pro\J.l.ded H.l Lh a copy of "1l'Jor:J.da' a COllsttllGt.lon
<br />.I i en J,all .. lIollleo\'mer's Protection Guide" prepared by the B'lorJda Department of Agr:lc\lltlll'e
<br />and COllsumer Ai' f:aiJ:S, I f the applJ cant 1. 6 someone other that. I:he "ol'Hler", T cel::l fy Lha t I
<br />have ohl:a.1ned a oopy ot the above desoribed clocument and promise ill good :fa.l.t.h to deLiver
<br />it' tn the "o\<lnen" prior to COlllmencement.
<br />Ii:. CON'['H/\C'I'OH' B/OWHfi:f\' B AE'E'IDAVl'1'
<br />I oerUfy Lhal: alJ the .lnformatJoll in this appllcatJon Js accurate and thai: aU \<lori, \il11
<br />}le done .l.n COII\pU,anc:e IItlh al.l. applJ.eable la\-lS reglllaU.ng const.ruction, zoning, alld land
<br />development.
<br />ApplJeaLI DII :Is hereby made to obtaIn a permJt to do work and JllstallaU.on as 1lldloated. I
<br />cetU fy thaI: no Hark or .installation has oomrnenced prJol: 1:0 Jssuaucs of a pennlt: and Lhat
<br />a.ll vlork 1,1111 be pe.rfDnned to meet standards of all laws regulat.:lng {jonsh:uction, CJ ty
<br />codes, zoning regula l:.i.cms, and land development reg1l1at.l.ons in the JUl:.1.sdJct.l on, T a.l So
<br />cerl:i fy 1Ilat I IInderstand that the l:egu1atlon8 of other govenunental agencies llIay applV \:0
<br />the Jnl:ended vl<H'k, and that It is my responsibility to JdenU fV I'That autJolIs I lnust: I:ake 1:0
<br />be ill cDlnpJ lance. Sllch agencies :lnc.lude but are no\: limited to: *Department: of
<br />H:l\vl 1: Olllllt:lll l:a 1 Hegula tion'-C.VP!:ess Bayheads, We tland Al:ea:> and l!:nvironmentaLI y Sens j I-..t I/e
<br />Lands, WaLer'/Wasl:elvaLar 'j',reaLllIent
<br />*Southwesl: Il')or.l.da \vater Nanagelllent LHstr.1 at-Wells, Cyp.t:ess Bayheads, Wetland Areas,
<br />AJ.terJlIg Wateroo\ll:ses
<br />*lulIlV corps of m\lgl neeJ:s-Bea\,/alls, !Jocks, Nav.l.gable WaterHays
<br />"]Jepal:t:menL of Ileal t:h & RehabJJJtat:.lve Services, H:nvi.rolllusntal Health lInlt'-Wells,
<br />Wastewater 'l'reatmenl:, SaptLc 'l'an]{s
<br />"II, S. IJ:nvi LOll1nentaJ Protection Agency-Asbestos abatement:
<br />I /:llsD ceLUfy I:hal:" Jf fJlllllat:erl.al:Ls t.o be used In E'lood Zone "A" or "A,et:c.", it.is
<br />understood that a dralnage plan adch:essing a "compensaLi.ng VOllllne" \'1111 be submitted Illdch
<br />j s pr€lpa red by a [.)J:ofessiollal engineer regi.steu~cl in the ,'nat.e of l!'lor1da pdor to penn!.t
<br />iSBUallCJ6,
<br />1\ penlll t .i saIled shall be construed to lJ6 a license to proceed Hith the \-lark and llot as
<br />ClIIl:JlOr.i \.y \.0 vloJaLe, cancel, alter, or set aside any prov.i.sions of the teollllicaJ codes,
<br />nor shall i SSlIance of a permU: prevent: the BIIJlcUng OffJcial from t:hereafter reql\.l.d ng a
<br />cou:euUoll of errors in plans, construotion, or violations of any oode. Every perrnlt
<br />issued shall bSDome invalid unless the work author:ized by s\lch permit, 1.s connllenced Hi LId n
<br />fdu mouths of iSsllBuue, or if \'iork authorized by Lhe permit 1s slIspellcled OJ: abandoned for a
<br />pet;j,od (j f 131}1 months after the tJ.me the I/ork 1s commenced. One 90 day 6}ll:ensJoll of t illle
<br />liIay be a1101/6d for the permit I'r.ith fee cllal:ge of $15. no. '['he extensIon shall he t,eqllesl:ed
<br />III 11l'11:in9 \.0 the AuiJdlng Official. ,An approved lnspect:.ion mllst be logged duclng each Silt
<br />month pedod, (n: U~e pt'oject: I/J11 he considered abandoned.
<br />WARllHlG '1'0 OWNmH: YOUR lI'AII.\JHE '1'0 Hl<JCORD J\ NOTICE OF COMNIr.NCI!1NE:t~'1' NAY HESlJJi1' TN YOIIR
<br />PAYHIG TWICn: H'OH H1PROVEMIlJN'I'S '1'0 YOUR PROPER'I'Y, IF.' YOU IH'l'END 'l'() OA'l'lUtI F.'JNAIICIJ.ll3, CONSIII,'I'
<br />WITH YOIIR l,n:IIIJH1H OH AN A'l"1'ORHF~Y Bl!lH'ORIi', RECORDIIIG Ycmn NO'l'ICI!1 OF COMMIi:NCI!~t1EH'I'. ,lOBS tJHDEH
<br />$2,500 HI VALUE: no 1'10'1' HE:ED '1'0 RECOil\) AND POS'!' A "NO'I'le!!: OF COt1l1E:NCEl'1E:N'l"'.
<br />
<br />\"U!I'!.!','jOIrS OF 2E;mn'l' l\F!!'IfJAV1'r
<br />
<br />S I GNJ\.'l'tJ HI!: I UWIIER IlR ]\GEtI'r
<br />
<br />-_., .__ ___~4_' ._~._._.. ._....._ ___ _.~_._..,____.__._.,____._.__.,._,_.___~._~....,~__._._
<br />
<br />-......-."---..-.-...-----.--------~.-,..- "---. .,-,---~_.. _._ ~. H._____._._____ ..
<br />
<br />STGHJ\'l'IIHIl:: CUN'L'fU\C'l'OH
<br />
<br />STNI'E: Ul!' E'f,(lHlIIA
<br />COIJlj'l'Y OIl' .---._.__.__.n___..___~_._________,_...
<br />'l'he foregoIng illstrtllnellt Vias acknovlledged
<br />Befol:e lI\e tlds _.____._ day of -____..___.--.1 leL_..
<br />
<br />b y .~ ....,_,...._____.._. .__....'_'___._..____________ .__._..______,__.___,.
<br />(name of 12ersoll a9lmowl.edged)
<br />[J \Vha is peuwna.l.ly krlO\VO to me, or
<br />
<br />S'I'A'I'E: CW FLORIDA
<br />
<br />COt IN'I'Y 0 b~ ___'_"_ _______._,_._. _.___.______,_.. "_'_'_'_
<br />
<br />'l'he foregoing IllS l:rlllnen I: \Vas aOkll()\-iledged
<br />l:1f:l fo re me tiLL S ._____l.tay of --_.,- .-...--_._ _, 19
<br />
<br />by ..___"_'_._._________._._....___...__,___,__...__.....
<br />(name of person aokno\-lledged)
<br />[Lllo .is personally known to me, or
<br />
<br />[I Hho has pl:oclllced_______.______......,__
<br />(type of JdentJ.fJ.catiolll
<br />and \vlto[) did l]dld not take an oath.
<br />
<br />[] y/ho has prodl1c~d__..__ _.____..._____,
<br />(type of J.denl'J.f\(JOilLlon)
<br />and vlllO [Jdl d nUd llClL I:alre an oath
<br />
<br />~----_._-.- -"..- ....--.-....---.... --.------ --- ---'-___~~__n_,_ .____.__.._..~_.."_.____
<br />
<br />31 gnal:\lre of perSall tald.ng ilck\lovlledgement
<br />
<br />--- -..-.. ---------_,_'~__._h._.________, ....___._.._. _....__________ _"_'._"___,~
<br />
<br />Signature of persoll taking aclrn0lIl,edgment I
<br />
<br />tlcllne typed, pdllted 01: stamped
<br />
<br />-""'-'- ~--'-""-."-"- .-. .'.- ~- -~.- '-~'-'-------"----' -.-.., -- ..~_.~--__~.___...r"_....._..._ _.
<br />
<br />--.---------..- .--....-----.--- '" .~_.__._-~---._---~..-~---. .-.-.--.---.-- ,.---.-..-.~-~--~.-.
<br />
<br />Hame typed, Pl:J.Ilted or sl:amped
<br />
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