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<br />.,,'" unaersigned understands that this permit b
<br />may be more re.trictive than Cit may e ,ubject to "deed re.triction." which
<br />compliance with any ap Ii bl Y regulationa. The under.igned a"ume. re,pon.ibility for
<br />B. UNLICENSED CONT P cae deed restrictions.
<br />If the owner has hi~;TORS AND CONTRACTOR RESPONSIBILITIES
<br />e a Contractor or contractors to d k
<br />to be licen.ed in accordance with .tate d 1 1 un erta e work, they may be required
<br />licen.ed a. required by law both th an oca regulation.. If the Contractor i. not
<br />violation under state law ' If th e owner and contractor may be cited for a misdemeanor
<br />1 . . e owner or intended contra t
<br />~censing requirements may apply for the intend c or are uncertain as to what
<br />Crty of Zephyrhill. BUilding Department, .'3-7.:~6:~~k, they are odvi.ed to Contact the
<br />Furthermore, if the owner has hired a contractor .
<br />contractor(s) sign Portions of the"c t t or contractors, h, is advised to have the
<br />will be re.pon.ible. If you, a. the ~:n~;c.~r Section." of this applicotion for which they
<br />you, rather than the contractor, are re.pon'i~~: ~~rt~~econt~octor, you are indicating that
<br />you to sign as contractor that ma b i di wor. If the contractor w~shes
<br />not entitled to permitting privil~ge: iann thn CCiattionfthat he is not properly licensed and is
<br />e y 0 Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIn. STATUTES AS AMENDED)
<br />I certify that I the appli t h b '
<br />l' L ' can, ave een provided with a copy of "Florida's Construction
<br />a~~nc aw - Homeowner'. Protection Guide" prepared by the Florida Department of Agriculture
<br />have ~~;~~dAffair.. If the apPlicant i. '~meone other that the "owner", I cerify that I
<br />' '" a copy 0 f t he above de. cribed documen t and p romis e in good fa i t h to de li ve r
<br />~t to the ownerH prior to commencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />
<br />I Certify that all the information in thia apPlication ia accurate and that all Work will
<br />be done in compliance with all applicable law. regUlating con.truction, zoning, and land
<br />development.
<br />
<br />Application is hereby made to obtsin s permit to do work and installation es indicated. I
<br />certify that no work or in.tallation,has commenced prior to i'.uance of a permit and that
<br />all Work will be performed to meet standards of all laws regulating con.truction, City
<br />Codes, zoning regulation., and land development regUlation. in the juri.diction. I also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the,intende~ work, and that it is my respon.ibility to identify what action. I mu.t tske to
<br />be rn complrance. Such agencie. include but are not limited to, 'Department of
<br />Environmental Regulation-Cyprea. Bayhead., Wetland Area. and EnVironmentally Sen.itivs
<br />Lands, Water/Wastewater Treatment
<br />'Southwest Florida Water Management Di.trict-Well., Cypress Bayhead., Wetland Areaa,
<br />Altering Watercourses
<br />*Army Corps of EngineerS-Seawalls, Docks, Navigable Waterways
<br />'Department of Health · Rehabilitative Service., Environmental Health Unit-Well.,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. EnVironmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in FlOod Zone "AH or "A,etc.H, it is
<br />understood that a drainage plan addressing a "compensating volumeH will be submitted which
<br />is prepared by a profe..ional engineer regi.tered in the State of Florida prior to permit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />authority to violate, cancel, alter, or set aside any prOVisions of the technical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requirin~ a
<br />correction of errors in plans, construction, or violations of any code. Every permit
<br />issued shall become invalid unless the work authorized by such permit is commenced within
<br />six months of issuance, or if work authorized by the permit is suspended .or abandoned for a
<br />period of six months after the time the work is commenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered ~bandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL1' IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENTH.
<br />
<br />
<br />:J~ 13-&h
<br />
<br />SIGNATURE' OWNER OR AGENT
<br />
<br />...... -.....v""u
<br />
<br />- - -..........J. J.
<br />
<br />d;J./j~ 7]-atr
<br />SI NATURE:, CONTRACTOR
<br />
<br />STATE OF FLORIDA 17~c }
<br />COUNTY OF L
<br />The foregoing instrument was acknowledged
<br />Befo2 me this -21 day of ~Jftll1, 20JfJ.
<br />by {2c~ (3f:$~~ ,
<br />- ~name of person acknowledged)
<br />~o is personally known to me, or
<br />
<br />STATE OF FLORIDA D A 5 ( 0
<br />COUNTY OF 11
<br />The foregoing instrument wa~ck~~~}e~e~u
<br />Betore me this 2r day of ..J/::J64i/.I7W7 , LU 0---1-
<br />by &l2Fth !SE/f4F
<br />(name of person acknowledged)
<br />~ is personally known to me, or
<br />
<br />Owho has produced
<br />~type of identification)
<br />and whoO did rMt'fid not take an oath.
<br />
<br />~ ~- fl1y~
<br />
<br />.
<br />Signature of person taking acknowledgement
<br />
<br />Owho has produced
<br />. (~pe of identification)
<br />and who Odid [Qd'fCI not take an oath
<br />
<br />BA.<; JJ - fUJ!
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Bf2-vcc jJ. AS-;?I5L
<br />
<br />Name typed, printed or stamped
<br />
<br />~t.t\. Bruce A Asbel
<br />!~ ~ My Commission D0116710
<br />~Of...:I' Expires June 22,2006
<br />
<br />13RL-GE A ~ 4Sf5[L
<br />
<br />Name typed, printed or stamped
<br />
<br />~"t\. Bruce A Asbel
<br />!~J ~ My Commission D0116710
<br />\.~# Expires June 22,2006
<br />
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