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<br />AUG/j-2/2004/THU 02: 18 PM ZEPHYRHILLS BUILDING FAX No 813 780 0021
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<br />A. NOTIG! OF DEEP ~~8TRICTIONS. f
<br />TIJEI undeutqn..a utld..r8t~nds that this pertllit may be subject to "de..d 'reittr1ction-''' Hhiel'l
<br />.., .. .." ,,,"".".. 'ho. 0"'...."....... ,.. ","",., ., ,......-,...::.1Oi1", ,,'
<br />o~pliance w~th any appliaabl.. deed restriction~_ .
<br />B, UN!lICEN6IiiO col:t1'RACTOM ANO CON'l':MC'l!O~ RESPONSIBILI:l'IES
<br />. If the O~ar has ~~.d a ~ontraator or cont~aotors to und.r~ate ~k. they ~y ne te~rsd
<br />to be licen~ed in aocordanoe wit~ ~tat..and local re~latl0~S, If the contractor ia not
<br />lioensed as.r..qui~~ hy 110". both the owner and cont~aator fY be oited for a ~sdemeanor
<br />violation unaer state law. Ii the o~r or intended eontra tar are. ~.rta~ as to what
<br />lice~sing requiremen~s may apply for.the int~nded wor~, the are advised to contaot the.
<br />City of ZephyrhUl.s Building Department, IllJ-7BO-o.020~
<br />F~thermore, if tb. owner has hired a oontractor or contra~ors, he is advised to have the
<br />contractor(,,) e1qn po~tions or th.. "Contr.at~r Seotions" or.lthis appliQ_tion for w~ch they
<br />will be respQn:ibl... Ir you I as the owner 5~gns sa tn. con ractor, you are ~n~ioatin;.that
<br />~ou, rather than the contraotor, are r..ponsible tor the wo~, If tbe contraetor wi"he9
<br />~ou to :ign.as contractor that may be an indlca~ion that he is not properlY licensed and is
<br />not cn~1tled to permitting pri~ilege. in the City of Zephyr ills;
<br />c, TRANSPORTATION IM!'AC'I' Ii'EES AND (J'l'II.IT~ CONm:cnObl FEES
<br />D," CONSTRUCTUION LIEN LA" (CHAP~~a 713, FLORIDA 8TATtiT~S.
<br />I certify that I, the spplioant, hay. b..~ prov~ded witn a
<br />lien Law ~ Homeo~gr's.~rotection Guide" prepare~ by the rl
<br />and Consumer Rffa1rs, If the appl~cant is s~one other th
<br />nave obtained a oopy Of th$ above 4esoribed doo~nt and.~~
<br />it to the ~owner" p~ior to c~~oem.ne,
<br />E. OO~TaAOTORIS{OWN&R/~ A.~IDAVIT
<br />I certif~ that all the information in this application i9 o~rate and that all work will
<br />be tione in c~l~ance with all applioable laws rDgUlating t:atruotionl zon~ng. ~nd l~nd
<br />development, .
<br />Appliqation is hereby made to Obtain a permit to dQ ,work an ins~allation as indicated, I
<br />cortify that no work ~ ln~tallatiOA ~.. commenoed prior ~o 19~~oe of a parmit and that
<br />all work will be performed to meet stand.rds of all laws re~ulating eonstructian, City .
<br />OO~E1, zoninlJ req1.>lation". and ~llnd"de....lo~nt re<;lulatioruit in the jw:isdiC'!:.1on, I al:lO ..
<br />certify that. I understand th4t tn- r.9Ulatio~. of other gov rnmenta~ agencies .may apply .to
<br />the intended ~Qrk, and that it is my responsi~1l1ty to id ify what a~tions I mU:lt take'to
<br />b~ in compliance, S~h agencie~ includ. but a~. not. limit to: ~D8pa~tment of
<br />Environment.l aagulation-Cypress Barheads, .etland Areas a tnvironmentally aen:litlve
<br />Landa, Wator~a~tewater Treatment
<br />-Southwest Florida Wa~.r Mana9~ent Diatriot-Wells, C~~ree B.yh~..~, Wetlepd AreaS.
<br />Altering Watercoursee. . !
<br />*AImY Corps o~ Engin..e~8-sea~all~1 Docks, Navi<;lab18 ~a~erw
<br />~Departmant ol Health , lehabilitat~v.. Servi~", Env1~onme
<br />Wastewatek Trgatment, Septic T.nka
<br />.U.8. Environmenta~ Protectio~ Ag.no~A8be"tos abatement
<br />I ;0150 "",rlif~ that, if fill lA8terial is to ba ua.d in 5'10 d Zone ~AP or "AdltO. '" I it J.s
<br />understood that a ~ain~ge plan aQ4ressing a ~oompensatlng volume" will be sUbmltte~ wbich
<br />~5 prepared by a profe~~ional engineer regiat.,ed in the 8 ate or ~lDr1da pr1o~ to peDnit
<br />lllauanoll, .
<br />A permit i-,sucd "hall be oonetrued tQ ~e a lioen.. to p~oc ed with ~h8 work and not a$
<br />a~thority. to violat., oancel, alt.r, or set aside any pro~ sions of th.. technical code~,
<br />. nor shall issuance of a permit prevent t~a auild1ng Offio1 ~ from thareartQr requiring ~
<br />oorrection of errors in plans, const~tion, or violatlons ot any code, .~very permit
<br />issued $h~ll he~~ i~valid unless the work authorized by l~ah pe~mit is oommen~~ within
<br />six monthe or 1sEluance, or it work author1~.d by the permi is ~~spend.d o~ ~bandon..~ tor 'a
<br />period ot $ix mon~hs art~r the t1me the work is oamn.noed. One 9D day extension or time
<br />rnay.be allowed tor the pe~t wi~h ree ~ha~e or $15.00., he ~t..naion shall he requested
<br />in writing to the Buildin~ O:~1Qi~l, An approVlOd inspeatijt'l must be lOQ~QQ d~rinq each &;~
<br />month ~ex1od, or "the ~roj.ot will be Qonsi~~ea abandoned, .
<br />ijARNING TO otiNER: YOll:R f^ILURE TO R!lOOllD A NO'I'ICIi: or COMH NCEHENT MAl' RiSCLT IN rOUk .
<br />PAYING :rItlCp: Ii'OIl. IMPROVEMENTS TO YOUR PlOPERTY, IF yoU IN liIND ~o OBTAIN FINANCING, CONl$lTtT
<br />WITH YOUR lltNOl!:!\ 01\ AN AT'tOMR\' 82&'ORE ll.ECO~DI>>G YOUR NOTI E of COMlENCEMENT. JOIl'S UNDER
<br />"2/500" IN VA1;oUE DO NOT Ne:~D '1'0 ilBCORD ANO 110ST A "NO'l'iCJ;l O~ COMMENCEMENT".
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<br />lU1&1'ltllilO)
<br />opy of ~rlorida's C~p$tru~tion
<br />rida O..partment of AQ'Z';I.oulture
<br />t thQ ~.owner", 1 "erify that i
<br />ise in goo4 raith to deliVSk
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<br />Cl1it~~llj;,
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<br />SIGNATURE l Otffl"tR OR AG~
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<br />SIGl~T.UllE, CONTMC'tOk
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<br />9TlI.Til 9F FL RIDA
<br />COONTY Oli'
<br />The foregoi 9 inetrumGnt,was aoknQwledged
<br />a.fon ae t h. --day or ~O _
<br />by .
<br />(t'llilll\ of person aOlCnowledged)
<br />~o is p.rsonally known to ma, or
<br />
<br />Cl who . Mil pracluced.
<br />(type of itlent:i.fic:ationl.
<br />~nd who D~1d Qiid. not take an oath
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<br />S~A~E OF FLO~IOR
<br />COUNTY OF
<br />The toreqoing instr~ent was ackPo~l.dq.d
<br />Betore me this _ d.ay .ol! . 2Q.....
<br />by . .
<br />(naMe or ?e~san aOknowledoedl
<br />Dl-Iho is penll'nill1ly known to;> me, or
<br />
<br />o who I1n produced .
<br />(type of identification)
<br />and whoO did Odid not talce an oath.
<br />
<br />81Qnature of pa~5on takin9 acknowledgeMent
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<br />BiQnaturQ Of person. ~~kiag ~c~owle~g~~
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<br />Name typed, pkinted or.s~amp.d
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<br />or st"mped
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<br />p, 002
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