|
<br />~;". W'-"ICE Or;' DE:J:;I) HE:5'I'RI(:'L'IONS
<br />'I'hE! undfilr8igne<.l understa11cls that this permit may be lSllbj6ict: t:a "deQ<:l ~'el!;t.l:i"'t-.Jonl:l" which
<br />,may b"'l more re.str.i.ctivB t:Man City ~-e9ulatj uns, The unde1;'signed ~.sSluhas l:'espOllsLb_tlity for
<br />QOlllpli'-"nc..: wit.h any appLlpiil)le deed restl.-iCl.ions.
<br />B. UI'U,ICElNSJ:;D CON'l'AAl:TOR9 AND CON'J'RAC'l'OR Rli:St"OI'lSn:lll.I'fTES
<br />] f the O\vner has hirect a contractor OJ.: contractors \.:0 underLake work, t:hey Ill"lY t)t~ .r-eq1l1red
<br />to be li~ensed in aocord~nce witl. stst& and local ra9ul~liona. It th~ Gon\.:raoto~ is not
<br />licenStid bS required by law, both the OWI.er and conL.t-actor may he G1 Led fCJr. eo rnlsdelll...anor
<br />viol.ation under state law, 1 f the owner or, inl.:endtid Con'tractor ar'e .ulnert.ain as to wh<lt;
<br />licensing ':t"equirements Ini;3.y apply :t0l: the intended work, tl;Jey are advised to contact the'
<br />City or Zephyrhills BU~~ding Pepartmenc, 813-780-0020.
<br />Furthermore, if the owner has h1red Ii contractor or c.:ontractors, he is advi~ed to h/5ve I:h..
<br />oontractor(a) siqn portions of the ~Contractor SeQt~onsN of thi~ appliaatioxl for which thwy
<br />wil.l be responsible, If you, as che owner S.1."P~B as the contractor, YOu are Ind,Lcati.ny t-llalc
<br />you, rather than t.1l... oontractor, al::e respons.i..ble t:or the work:, If the l"'!ont,1-ac1:o,!:' wLshee
<br />you to sign as contracta~ th~t may be an ind~ca~ion that ha i8 not prop~rly )jcen3ed and ~B
<br />not ent-ieled to pe1."~.\~tting privileges in th& Cit:y or Zephyrhilla.
<br />c. 'l'RANSl?OR.'!'A'l'ION IMFAC1' F!!~F.S AWr) UTILITY CONNECTION io'Eh:S
<br />D. COI\lS'!'RUCTIJION r.lEt-:I l-.AW (CHAPTER 713. ~I.ORIDA S'l'A'!'lJ'l'ES, AS J\MeNbEO)
<br />I certiry tlla~ I, the applicant, hav~ been prov1ded with a Cupy nf "F~o~~da's Con8truct~nn
<br />lien La,.., - tlonleown6r' ~ t>rotect:i.on Gu:t,ue" prepared by 'the F'lo~i da Depj;lrt:ment of Agric:ulture
<br />and C:Ol'liilun.8r Affairs. !.t the aPl-'1-icant '--.. SOUleone other t:hat the "own ef,' II , :r ce.rtty t.hat: I
<br />have ob~ain~d a oopy or the abovQ describtid dooument and promise in ~ood faith to del1~er
<br />it; to the '~OWntill:" ~')l,-;l.or to conUlLenl~f;Onlent,
<br />E. CON'l'RACTOR' S/OWNER' S AifF.lDAVl'i'
<br />1 certify ~hat all th~ information in this application is accuratti alld that all work will
<br />bQ dOne in compl_iancB with aJ.l appl icabls .l,aws reQulatiilg CO\"lstrUcl.:ioT" Zoning, and land
<br />dlotvelopm..:nt.
<br />J>.pl-'lic;at'.1.on is het'eby made to obtain a permit to do work and installatc-1...n A~ illcU.cated. I
<br />certify ttl&t no wark or insLa.1J atiOll hae commenced prj,or to issLlan<:le Qf a pel'...:il: IInd t,hal::
<br />all WOrk w~ll be performed 1::0 me$t standards of all laws regulating conseruation, City
<br />codeiS, zoning r"'Qul.at:l ons, a.nd ~and dev&~oJ?ment rtl9ulation~ 1n the jn.cis;d.1ctiOl). r al so
<br />certify tllat I Unde~stand ~hat thfil regu1ationB o~ other governmental agana1es ~aY apply to
<br />the intende(l work, and. that it is my l"l!lsponsibllity to ldl!llltify what: aCl.,iollEil I must: take t.o
<br />be in compliance. Sllch agencie~ incll~Qe but are not: Iitnited to; "'Depart.ment. o.f
<br />EnVironmental Requl.tjDn-CYpr~sa BAyheads, Wetland Areas and EnvironmentallY Sensitive
<br />L.nds, Wat.x/WsBtewa.ter Treat~."t
<br />.Southw8Bt Florida Water Management District-Wells, Cypre~a Bayheads, Wetland Areas,
<br />Altl!lring Wat~rcourses
<br />"'Army Corp~ of E:nqin6lers-Seawa.1.1a, Dock:s, Navigab:lQ Wat:erways
<br />'''l)..partmen~ or Health 6< RE:hillb11it~tLv61 Services, Environmental Health tlnit-~el.l.51
<br />Was~ewater Treatment, Septic TanKS
<br />.u.s. EnVironmental Vrotftot~on Agency-Asbestos ab~Lern~nt
<br />r also cert:l.fy that, -i..f fill material is to be USIolQ j,,.. FlOod Zone "A" or "A, atc..., it is
<br />undlilrstood 't.hal; a dr'ainagt< plan aadr..ss1.ng a "compensating volume" wi.ll be sUbl\dtted which
<br />is prepared by a protes~lon~l engineer registered Ln the St~t61 of F~orida prjnr to p~rmit
<br />iS8UanOE:.
<br />A pertt\it ~l!I$ued shall be construed ~o t,)l!!!1 a lic..nse to proc6sd wJth tha wO.L'k !I1\r} no'!:. as
<br />author~cy to vjolatfil, car.cel, <er, or set as.i.d~ an~' proviSions of the t.ecludcal cqdQs,
<br />l'letr .stlall issuanc.. Qf g r~ermit prevent Lh.. Buil,('l.1.ng Of.f.i.cial -troll\ tbereafte:c: l'-Cilquirin~ a
<br />COrz:-ection of 8rrore in pla.ns, c.:;onstruceion, Or v;l.oiations of any Clade. l!:v"ry pflu:mit
<br />issued shall b"'collle in~alid unles3 thE> wOl:k authorized by such perntll J.~ cC>LOJlIenoecJ w1l:hJ.n
<br />si}l: months of i..sSUIiUIC6, or if work author ize'i by the permit :I." ~\Jspend"'d Or abandoned for ..
<br />p..r!od 0:1: s~}( months lolfter tl'le t-i.me t.he work ~s cOlrunenced, One 90 day exten.sd.on o~ time
<br />tl\ay be .dlowe<i ror: ch.. permit with f." chal'ge o~ $15.00. Th.. Qxten!>.tl>1l shalt be requl,tsteu
<br />~n writing to tha Building OffiQial. An approved in~pection must be logged dur~ng each ~i~
<br />IHont:h periOd, or the proj$ct wil.l b~ considered abi\.ndoned,.
<br />WARNING 'j'O OWNER; YOUR FAILURE TO RECORD A NO'frCE 011' COMMENCEMF,NT MAY RESULT IN VmH~
<br />PAYING TtoUCE FOR IMPROVEMENTS '1:'0 YOUR PROPERTY. IF YOU INTEND '!'O OS'l'AlN "'lNANCING, CONSUI,T
<br />WI'rfi YOUR LENDER OR AN l\T'l'ORNEY BEFORE RE.:CORDING YOUR NOTICE OF COMMb:NCl!:MF.:N'I'. OUl3S llNP~,R
<br />$2,500 IN VAI,UE DO NO'l' NEE:D TO 'ft!!~CORD AND E'OST A "NO'rICE OF C()MMII~NCmH'EN'l"'.
<br />
<br />SIQNATUREt
<br />
<br />OWNER OR AGILN'l'
<br />
<br />SIGNATURE;
<br />
<br />CONTRACTCJR
<br />
<br />STATE OF Fl,ORIDA
<br />COUN'I'Y OF_
<br />Th~ fo~e9oin9 instrumfilnt was acknowledged
<br />a.fore me thj,a ~__ day of _ 20___.
<br />
<br />by_______
<br />(name. of person ac)cnow~"d<1led)
<br />[J who is personally known to Ji'ltil, or
<br />
<br />0'''110 h.as produced__,_
<br />(typa of ident~fication)
<br />and wtioCld:i.d Dd~d nOI: -Lake ~n oath.
<br />
<br />STATE OF FLOR!DA
<br />COllN'rY Of"
<br />The foregoing .instrument was acknowl ectoed
<br />ae.forQ m6 t:lli.... -----&iay o.f-~., 20 ___
<br />by
<br />(name of perSOll acknow,ledge<:!)
<br />01110 .t~ p$l"SOniiil.1 Y known Lo me, or
<br />
<br />lJwho has p~oduCQd
<br />(I;ype of id8nt:ific~tJon)
<br />and <~ho Dd.lei CJ:lid flol: t.ake !In aiith
<br />
<br />Signature o~ pec,Son takf ng acknOWl.ed9iuner.t
<br />
<br />Sign<!'tura of p"'l:'.90n takil'.g awkn(,)w,lf>dgm",ut
<br />
<br />- --.---...-----..--..---
<br />Name typed, pr:l,nl:ed or 9tampect
<br />
<br />Na;;;;-'~7'p~---:int.ed-(~~7i:::;,;U-~-'''~
<br />
<br />Z . d
<br />
<br />0999'ON
<br />
<br />SllIH~AHd3Z jO A1IQ
<br />
<br />~dgv:8
<br />
<br />vOOZ'LI'unr
<br />
<br />i.r;,~
<br />
|