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<br />C()]Jj) 1'1'1 ON S 0 F' l:' l:!;HJvlI T AF'FI DA Vl'P
<br />A. NCJ'l'IC~ Off' lJli:JW kES'l'HIC'l'IOHS
<br />'l'he underi:;igncd 11Ilderste:md::; that Lhi::; pE;;uni t way be sllbj",ct to "deed re.f:l!:rict:iCJni:;" vlld eh
<br />lllay be more restrictive tllan City t'cYlll",Lioll::;, 'l'he lHld<n:signed a.::i::;lllIlei:; rel:l[loni:;jbl.l'lty rur:
<br />complicll1ce Hith any, applicp.l;le deed restd,cl:iolls.
<br />B. UllLICl!illSI!:D Co-N'l'RAC'l'ORS AI'lD COI~'l'RP,C'l'uH Rf!;Sl:'ONSIBILI'l'II!:S
<br />If the UIlllt::r has hir-ed a contractor or contnlctor;:; to undertake Hork, t1H::Y may be ro:::qllln",d
<br />too be liCen.::ied in aGeul'danc.:: I-Ji.tl, citate and local J:t:glllal.iolls. It thl: cCJntraeLOL i.::i nut
<br />li.Genf:icd aOi noquired by JaIl, bothLhe; l;,IIJ",r and cO!Jtractor' Hlay be c1 te:cj for Gl wi ;;;d<:llllt::all(H
<br />vi olatiun under ::ltaLe lavl. If tile 01-/11<:;): or l.ntewJt::d c;ontr..ctor aLe 11Ilcc,rt<i11l l'il:l to IJhi;l\.
<br />Ii cen::;ill0 requi relllellLi:; Illay apply for the intended "JOl:k, they C:lLi;o i:ldvj~ed to conLClcl: tilc
<br />Cit~, of Z.::phyddlll:> buildiug Dr::partllH:::nt, 813-'788-6611.
<br />E'urtluHmOl:l:, if the OHlli'H has IdLed a contractor or contrC:lctor~, lit:: ii:; advi::led to Ilave tilt::
<br />contracl.or-(f;i) l:Ii,gn portions of the "Contractor Si;octions" of this app]jcQtion for I-Jllich th=1'
<br />vlill be nospon::;jblc. If YOIl, a::; the ovmer ~.ign", as the c9ntractcn, YOIl itre indicCltlng Lhat
<br />you, ratlier- tliQn Lhe contl:ac.:tor, are responsiule for tile HOLk. If the cnnt:ractOl- vlioEihet:;
<br />1'011 to oEiign at:; contri:lctor that lfIay bc an indicati.on that ht:: i~ lIot pJ:'CJpo:.rly licensed and 11:>
<br />not: .::nti t.1 ed to pi:::nui t ting privilcgel:l in the Ci ty of ~ephyr:llills.
<br />C. 'l'RP.HSI:'OR'l'A'l'IClH IHPAC'l' ff'El!:S AHn IJ'l'IlJI'l'Y CONNEC'I'ION F'1!:l!:S
<br />n. COHS'l'flllCTllION Lnl-l LAW (CHAP'f'I!:H '7i3, ff'LORIDA S'l'A'l'lJ'l'h~S, AS Ai'1ENDli:!J)
<br />I certify that I, the applicant, have beell provided HitJl a copy of \lli'lo,r-i.da's COnl:ltr.lIctJon
<br />l.ten La>l - lJoHlemmel" s Protection Gui de" preparr::d uy the I!'.l oridi;l Depeatlllcllt of Agd cllltllrc
<br />aud COnl:lllmc.L: Attain.. It the applicant 1 s SOIll.;Olle (Jther that thr= "o~m!;:l:", 1 uerify [:,hat 1
<br />hi;l Ve ouLai ned a copy of the i;lbove de.scribcd document and promi se ill good fa.ltll L.o d""lj vcr
<br />it to the "OWIE::r" prior- to COItUllellcelilent.
<br />E:. CON'l'HAC'I'OH' a/OWNER'S M'FllJAVI'j'
<br />]' cerUf:l Lllat a11 t:Il\;::: information ill lhi:> app1.icatJ(JIl is accurate i;lwl t:llC:lt <111 VoW.);: H111
<br />be dOlle in complianc.:l: \'Iltll all C:lpplicable laHs reglllciting cOllstnlCtioll, ~oIlI110, and land
<br />dcvt::lopwl::llt,
<br />Appll GC:ltiull i i:; hereby made tu obtai n a penui t to do ~/Ork and inf:itallat:iol'l a", indj c~tod. I
<br />cer-tJ ty thi;lt: no HOlk Ol in::;tallat.ion hal:l commenced prior' to i::>SllcHlce of CI penuit e:llld tiH:lt
<br />all \'JOrl. ~lil] \Jr:: performr::d to illt::cL I:ltandar-ds of all la~~s regulating COW:itCllutioll, City
<br />codes, zonin\j r-eguli;ltion"" ollld land de\le:loplllent regulations in the juril:ldic.:t}on, I all:lo
<br />cerLify tiled: 1 llnder-I:ltand tlli:lt the regulations ot other- govermnental l'i'jcncit:Hl llIay appl y to
<br />thc Jntdnded ~JO!,k, and Lhat it is my l:i:lsponslbl.lity to identify vlhat actJon.:! I IU\l/;jL Lalit:: to
<br />be: ill cOlClIJ1ieHlCt::. Such C:lgencie::l include but are not limIted to:^'Departll1ent of
<br />h;nvilunmcnti;d Rt::gulCltion-Cypr'el:l~ Bi:lyht:lC:ld~, Wetland Ar:t::as and jj;nviroIllUdnli::llly /'3t;:Ul:d Livt::
<br />Lewd::;, Watcr/Wasti:::~JateL 'J'l'caLlilent
<br />"P011tlnJe.::;l li'lollc.ja WGll:er l1C:lIH.g(::lHcnt Di.striet-Wells, cYPl.,-,SS BaybeCld.:;, WeLlewd An::<:/::;,
<br />A1 ter'illlj \<Jalt::rcollrl:>efo
<br />AAnLlY Cor1='':; ot EIJgillcer::;-St;;C:lIlalls, Docks, HavJyable Wate.LHi:lY.:;
<br />^IJe~l'ir-LlHent: of He,dtlt IX Rdlabilitatlvc Ser-vic.:c::;, !!:nVIl:01ll11ental Health Ullit-'Wt::]l::;,
<br />Via':; t: =\'Ia te r: '1' r ea tlllt:ll t, Sep t i ,; 'l'anks
<br />"U. s, li:nvilCmmental I?rote:ction Agcllcy'-A::lbe.::;tos i:lbatt::ment
<br />I al.:;o certif.l' tbOll, jf fill H1..teri..l is to be. used in li'lood Zone "A" or \lA-,ete.", it: i~
<br />undi:::r::itood lltat a d!.a.inage plall C:lddn:i:;siny a "compen::lating volulHe" vliLI be i:;llbmi LLed Hilleb
<br />J..::i [~!.epared by Cl fJl'ofel:isi(Jlla1 engineer registered in the State of B'lorida prica to penni t
<br />iSl;illi:lnct::.
<br />A pt::rlllit i sSlled sliall bt:: con.::;trlled to be i;l license to proceed "lith tb.:: ~JOrl; i:ll1d llol: i;ll:;l
<br />C:luLho,dty to viol"te, C<:IIICo1, alter, or ::It:lt i;lside: any provisioJIl:i of tilt:: t<::cI1ll1Gi;l1 codel:l,
<br />IlOr: shedl issuance of a penuit: preVl:llt tlH::: Building Official frolll l:hen::.:Itter reqlJ.irlng C:l
<br />correctiol'l of errors in pleHlS, constrncLi,oll, or' violations of any code. lliver~' l'l:I1:'lIl1t
<br />is.::l\led ,:;;hall becollle invalid lmle.:H) tbe ~Jork autl1or.'l~c:d by slIeh penuit Jj;; COjlUHtlIlG;;:d \J:itidn
<br />six montlt:> of i,:;;:H1ancf::, Ot' 1f \'Jork. authorized by the:: peullit: is slH>pended or' abandoned fO.1- C:l
<br />period of sili montlt,:;; after: the ,time the vlOr);: I::; cOlluuenced. One 90 dl'iY f::4{t=n~ioll ot tiJflt::
<br />lIlay be i:lJl (JHed fur the permt t. Ili th fee charge of $15.00. 'rile e..tel)::iI011 :;hc:tll b"" n::qllel:ih::d
<br />in ~J.fi ting to the Blli lding otficial. An approved inspecti,on mllst be j o<Jged dlldnlj bOldl ::ii t(
<br />mouth perIod, or the project will bE;; coni:lidered abandoned.
<br />WARNING '1'0 OWNER; 'fOUl{ fj'A-ILlJRI!: TO RECOHD A NOTICE Ot' COI"il'1ENCEl<1I!lN'1' NAY HIi:SUL'l' HI YOUk
<br />PAYING 'J'\<HCE l!'uR IMPROVEMlliN'I'S 'J'O YOUR PROI?ER'fY. It" YOU IN'fEND 'J'O Ob'I'AIN li'INANCJNG, CONSIIL'J'
<br />WI'l'H YOUR LE1HJER OR AU Nr'l'ORNEY BEli'ORE RECORDING YOUR NO'I'ICI!: Off' COI"ilvII!:HChllvJI!:H'l'. .foBS lIIHJlliH.
<br />$2,500 IN VALliE: DO NO'i' IHi:ED ']'0 RECORD AND 1'OS'I' A "NO'I'ICE OF COlvJlvJE;NCElvJEN'I"'.
<br />
<br />Q~,~.~--~,----------
<br />
<br />SIG1IATURE; OWUER OR AGEI'I'l'
<br />
<br />SIGNA'PURE:
<br />
<br />CON'l'HA(:'fOR
<br />
<br />S'I'A'i'E OE' fj'L~rDA
<br />COUH'J'Y Of ____c::u.~ ___.,_.________
<br />'I'llt: fore.going Instrum.;nt ~Jas aclmoHledged
<br />before Hie tiLb _Lg~daX o~Na"bY\~ ~3
<br />by__~,~o... 'b. "-~~:C~_,__,__ ___,__,._,._____
<br />(lli;lmc of perl:lon i:lcknovJledged)
<br />~ho is pf:::u>onCllly kllOl'JiI 1:0 rue, or
<br />
<br />STA'l'E OF InORIDA
<br />
<br />COliN'l'Y 0 ff' '______,__.' _______.,____,__._____,.,___
<br />
<br />'1'he foregoing instruwe:nt: VJC:lS aGli.no~d edge:d
<br />Before me this ".__.__di:ty of,------,---, l~
<br />
<br />by _ _____..,___,...._,_..__'..,____ '__'.'~""_____".___'_,__,___, _ _...._, _,_.
<br />(nClffit:: of person Clcknow1cdgcd)
<br />OJho is personally known to 1fI~, or
<br />
<br />[I Illio hCl.:l prodnced,__,___
<br />(type
<br />and vlllo[]did - did nol
<br />
<br />
<br />uf p",.f::lon ~t~'~ledgt::ru;;l~~-
<br />
<br />
<br />of id~ntification)
<br />take an uClth.
<br />
<br />[:J wbo IIC:ls. produced__, '_____.._
<br />(typ.:: uf ldldrdi Hcatiull)
<br />and Ilho ["Idid Lthd llOL tClke <ill uatll
<br />
<br />",';.';f.~r;;"'. JAMIE L. MURPHY
<br />ti~~~';~"- t ypt::d ~~tt;~1f1rmW~t1~44-'
<br />
<br />~~~iif:tft-~"'" Bonded Thru Notary Public Underwriters
<br />
<br />SignCltllre of peri:lon tOlldng i;lckllO~1l t:::dSPllent:
<br />
<br />.---.-.--'-.------.--__.._______,___._~...__n..___.~...__".. ._...._._...__.._ ..____._...~_._________
<br />
<br />HCllU", typed, pci.ntl::d or st:C:lJlIIH".l
<br />
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