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<br />A. NOTICE OF PEED RES'i'RIC','IONS
<br />~'!\" "'Od,,nli\ln~d und,,;r;atal'lcl.e th.,t this p..rmit may b.ll "'''!:lj ..et to ..d....d "....tericteicns" which
<br />,nay b.. ".ora r<ilst:C1.ct,iVE> than Ci ty regulations. The '"ndel:",siqned assumes, responsibility tor
<br />,:;amp] lance wi (,h any applicable deed re'5triction3.
<br />8. llN~,rCENSED CONTAACTOHS AND CONTRACTO:!l. RESPONSraILIT1E5
<br />if th.. Q~..r has hired a contractor or cOntractors to undertake wo~~. they may be required
<br />to bE. licensed in accordance with stat.. and local r'eQu:'ations, If ch.. contractor i.. not
<br />lu,..n"ed as required by law, both the owner and cont:ractor ma:; be cit..d fur a !ni.sdemea"or
<br />viol..tion under state laN. 'If the owner or 1nt..nct"ct contractor ..re, '.u-.c,u't.:lin .:15 :0 what
<br />j,,:'_'Jer,si09 requirements "'ilY apply fo:r:' thEt incliind",d work, they a:rli ad.yi$;<:! to oontllot the
<br />City of 2ephyrhill~ Building Department, 813-780-00201
<br />F'..lrt:.t~e:'more, .if the c,"vner ha.s hirftci il ~ont.ractor or cOllt:t:aoto;!'s, he i.9 advise.d to [laVe t.oe
<br />contrac:torl,,) .!Ii..r: po~'tiona ot the "Conr.:rac1:or S..ctioosw of this ilpplioati.on fo::: which th~y
<br />w~ll be responsible. If you, as the owner signs &s the contractor, you are indicat1nQ'that
<br />you, ,..athe~' f:han the contx:actoL, aLe L'I!:.!Iponsible for 'tlu~ wOi.^k. If the contractor wishes
<br />y,~u 1,0 519n as contractor tha1: may be '''' l.ndlcat;lon that he is not: pra"el.-ly l~.cenaed and :9
<br />r.ot: ~<nt!1:J..c! t" perJni_t.l.O'J privileges 1... th.. City of Z..phyrhiUs.
<br />e. ~'RANSE!ORT"T10N IMPACT Fi:ES AND UTILITY CONNEC~'r()N F~ES
<br />o. CONs'tRUCTUIO~ LIEII LAtJ teMPTER '713, r'!.OR:;:CA STNfO'J'!S, AS Atoll!:t'IDl!:D)
<br />1 c"rtity that I, the ilppl1.0ant, hilV.. be.on provict"d with.. copy of "'I'loridil' OS Con5truQtiort
<br />lian Law - Homeowner'. Proteotion Cuida" prep*red by ene Fl~rida Dapartemanr of Agriculture
<br />"net C;OnSUl'Iler Aft'aiL'~. 1,1: the applicant is someone oT;her that the "Olinlir", 1 c..rit'y that I
<br />h~v~ Obtalned a copy of "he above described document and promise in ~cod t'ai1:h ~o deliver
<br />.:..t "t:u the \'Q\.lnerN p:o:ior t::o oommoncement.
<br />;;:, C;ON'l'AACTOH' S/O'ilNE.R' S AFHDAV J:T
<br />i eel. tify that ..11 the information ,,-", thill ap..lication i~ accurate ~nd th..t~ all wo~k will
<br />0.. Clone il' compliance ".ith all <>pplicsble 1",',",s l..'eQul",tinq con=truction, zoning, "rod lano
<br />deve:_opment.
<br />Appl'.cation ia r.<<rebJi !':lade t.o obtain a per"'~t '=0 d::J ,work and in..t"lldl:ion ".. ind~L"'t..d. I
<br />ceLL,fy that no work or iI15tal1;.,t10'O has ::ornrn;;oncecl prior t:> 1$"l.Iano;;o at' .. pelOIf.i t and tho e
<br />",11 "o:ek will be perfol"m"o to meet atandan'ls of all laws r''''9ul"ting cc:,slrucl:ion, C;!.ty
<br />o::Jd.6>J, ~onl"'Q re'Julat!on.., ane land dev..~opm""t: regulations in th.. juri.;ocliction, I ..lioN
<br />cartl.ty tha~ I ~nderstand that the regulations or other gov$rnrn,ant.l _9,anoi$6 may apply ,to
<br />the J.ntended worr.:, and that it 18 my responsil'lll.it,y to l(:i..ntlf~' what .erion" I rnuat take to
<br />b.. in compllanCll. SUCh agencies include but are note, lill'.i t"d to I "uapart:llEnr ot
<br />Envil..'oomental Re<;Jl.llation-Cypre"s bayl1e;OQlI, Wetland Me.s and Ji:n'lirQnJl1.Emtally S"nsitive
<br />Land!., l'illt<lr/Wast"liater Treatment
<br />.Soul:h"....t li'lor1d<. Water Hanagement [;i"trict-\'/ells, Cypr..s~ Bayn,,;eds, W..t18~d Ar.o&8,
<br />Altering W~terccursea
<br />""Ml\.rrny Corps of Engirlf~.;.).'.tJ-S"eL\"Jall:s1' Dock:5, Navit;la.ble W'o.terWl:V:S
<br />"Dep..rtment 0:: Health & R..habilit"tiv& Services, E:nvironr1ec.tal Health Unit-Wells,
<br />W~.:5tfI'W~ter TretA":.rnent, SeptJ.~ Tanks .
<br />*U, s, Envircnruental Protection Agency-Asbadto,", aba t,"n..nt
<br />I al,!jo ...:~Qrtify that, if fill lI~atelrial i~i to DS llSiild in FIt} j Z.on~ "A" or "A, etc.", it i5
<br />'undal.:s,ood thot if" drainage plan a::u:iressi ng a "comp.msatln" volume" ',",ill be "ubmittl!d which
<br />i.. prep;ned by a protes!lional engin...r registered i<1 the" _'It.. oJ: 1i'10r1d.. prl.o:t' to plirmi,:
<br />.issu.ance.
<br />}>, pe,,,,,ite iss\:ed Shall be constr'ued to be a li<ler..s.. to 1"=,' "ed ,...i.'Ch the worK and not as
<br />.."th<ll..'i'oy tc vic.lat.", cancel, alter, Of: "at aside any pre' ,sio,,'I cof tbit t..chnical ccdefl,
<br />nor ,'oElll i83'2"I'.oe of a perl!lic pr&vent the S\.lild.inq Of tic II from thereafter requiring a
<br />Oo~r.,otjon of e~ror6 1n plan~, construction, or violatior of any code. Ever~ perm!t
<br />i:l",,,,,,d ",hll.ll "'..com.. invalid unl""" t.he work aut.horized b ueh permit is C01lUll911ca;:! within
<br />six n,:>otJ~8 of i,.ELlance, or if work authorized by the per, ..L is suepended or' aband.)ned ror a
<br />pa=:-iod c.( $ix montl'ul .aftar the! time thE wC?r~ 1.8 COIlUr...,na50l On. 90 day ext.ension at ~1me
<br />m..y be allowed for the perm!t wit:h t.... cnilrq.. or $15,00. :'he ..xt;ti!~~1on shell be r..qu...t..d
<br />:I." ..",itlr:;I to the Building OrriOiirt.l,i>.n approved :i.nspecl.(Jll must be loq....d during ..aoh 6lilC
<br />'M.HIt" pericd. ,:>r th.. proj"ct ",1.11 b", oOliai<.i.."o:oct ;t.b..ndon.,j.
<br />WARNING '1'0 OWNER, Y'JUR FA.ILUR>: ~'O RECORD A NO'fICa: DB' CC oIHENCi:MEloll' MAY Ri:SU:i.T IN \'OlJ~
<br />l?,...i:!rIG 'fI\"ICE FOR IMI?ROVlilMEN'l'9 TO YOUR PROPERT:i. IF YOU rWTIU;D TO OBTAiN i'IWAHCHIG, CONSUL~'
<br />WIT~ "{OUR LENDER OR AH ATTORNEY BE~RI!: RECORDING ,OUR N(fICi: Qf COHMEWCEMEN'r, JOSS UNOE~
<br />$2,500, III VALUii: (,00 NO'!: NEF;D TO Ji<E:CORD l!.ND POST A "NOT'lel OF COHMENCEt.IENT".
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<br />~~~d--_u~ ,,;i;bz::~~
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<br />S'I'ATl:: OP E'LORfD_~
<br />COUN'!"!' t:F
<br />'Thes for~goi.n(.:f .:.nstrul{u;~r,;.t ",as ack.!1owledgad
<br />Br.rctQ~~1Ii I1\e this _ day of , 2~
<br />b;, ___,___-.:.__, ~ ,..___
<br />\nauL8 ar p::iCSOtl aCknowle,:igE:di
<br />o whet is ps:t'sl.."'\nally known to D~ei or
<br />
<br />S~ATE OF FLOa1DA
<br />CO::Jl~IY 01' ~___..______,..,___.___
<br />Th.. tcre lo1n';/ 1.nstr:um~ot "'"... acJ(no,~1"d9",d
<br />S"for.. Ill. !:his --J1ay oi , 20_
<br />by
<br />: ,am~ or pe~8o~ ElCknowledged;
<br />C1ho O' PQrsonally known to me, or
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<br />Cl who ,l"S producild~_______ _____
<br />(type o,t: iaen': iti.eation:
<br />and \ih. DOld Qjjd nOte take an oath
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<br />o who has FJ"o,d:l;;Sd
<br />(type
<br />and .,r,::>O ai,::! rJ cti.;; no,;;
<br />
<br />of l~entlticatiQli)
<br />take, an oath.
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<br />S <9oa'Cure of p"r:>ou ta:,in,,;, ackoowlt.dgement
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<br />Siqnllt1.('" c.t pa:.:eon ta.king aCknol..ledgment
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<br />N-~_~;.~ypeci.. p~'intec or' ateunped
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<br />-------I
<br />Name
<br />
<br />,-d. prin.ted or stamp.ed
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