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<br />A, NOT1C.E or DtiD Ri:STRIcrIONS
<br />Th'l undersigned w-.derstana.s th~t this permit Ill4Y be subject to "ci8ed restrictions" which
<br />=ay be more restrictive than City regulations, The undersigned alsumes respons~bility for
<br />conpl~ance with any applicable deed restrictions,
<br />B, UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />It the owner ha. hired e contractor or contraotor. to undertake work, 'they may be requ1red
<br />to be liCensed in accordance with state and local regUlation.. If the contractor i. not
<br />lioensed a. required by law, both the owner and oontractor may be cited for a a1sdemeanor
<br />violation ~der atate law, If the'owner or intended contractor are uncerta1n aa to what
<br />licen.ing requirements may apply tor the intended work, they are advi.ed to contact the
<br />City ot Zephyrhilla Building Department, 813-780-0020,
<br />f'urtheI'lllore,. if the owner hu hired a cOntraotor or contractora, he ia lIdvised to have tile
<br />contractor!,) sign po~tions of the "Contractor SeotionaN of thia appl1oation fOr which they
<br />will be responsible. It you, .s the owner siqna as the oontractor, you are ind1cating thAt
<br />you, rather than the contractor, lire responsible for the work, ,If the contractor wishee
<br />you to sign.a contractor that may be an ind10a~ion that'lle 1s not properly licensed and is
<br />not entitled to permitting privilegas in the City ot Zephyrh1l1s.
<br />C, TRANSPORTATION I~PACT n:ES AND UTIl.ITY CONN!:C'1'ION FEU
<br />D. CONSTll.OCTUION LI tN LAw (CMPTtll. 713, n..oaIDA STATUUS, AS ~ENDED)
<br />I oertity th_t I, the ~pplicant, haye been prov1ded w1th . copy of -Flor1da', Conatruction
<br />lien Law - Homeowner' a ,Protection Guide" prepared by the Flor1da Department of Agrioulture
<br />and Consumer "ffairs. I f the "pplicant 1. 80lUona other that tile .owner", I cu:ify that I
<br />nave obtained a copy ot tn" above deaor1bed document and promi.e 1n good faith to deliver
<br />it to the .owner" prior to cOlMlenC8lIIent.
<br />E, COWTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all tne information in this application is accurate and that all work will
<br />be done in compliance with all applioable laws regulating conatruot10n, zoning, and land
<br />developnent,
<br />Appli~ation is hereby made to obta1n a perRit to do work and inataliation a8 indioated. I
<br />certity that no work or installation haa oomnanced prior to i..ulIhoe of a perRit and that
<br />all work will be PQrtormed to meet standards of all laws requlatlng construct10n, City
<br />codes, zoninq regulations, end land' development re9ulations in the jurisdiotion. I alsO
<br />certify that I under at and that the regulation. ot other governmental ag.ne1.. ~y apply to
<br />the intended work, and that it is =y responaib11ity to 1dentity w~t aotionl I mUlt take to
<br />be in compliance, Such agencies include but ar. not limited to: -Department ot
<br />Environmental Regulation-Cypre$s Bayheads, Wetland Arell. and EnVironmentally Sensit1ve
<br />Landa, Water/Wastewater Treatment
<br />'Southwest floride Water Ma~gement District-Welle, Cypre.a Bayheads, Wetland Area.,
<br />Altering Watercourses
<br />'~y Corpa of &ngineer'-Seawalls, Docks, Navigable Waterway.
<br />'Department ot Health ~ Rehabilitat1ve Sarv1cea, Env1ronmental Health Onit-Welle,
<br />Wastewater Treatment, Septic Tanks
<br />'U,S, tnvirOnaQntal ProtQction Agency-Asbestos abatemen~
<br />I alao certify that, if fill material i. to be u.ed in Flood Zone -A~ or ~A,etc.~, 1t i.
<br />understood that a drainage plan addrese1nq a -oompensating volume" will be aubmitted which
<br />18 prepared by a prote~sional engineer reg1stered in the State of rlor1da pr10r to permit
<br />isauallCe ,
<br />" permit issued shall,be construed to be a licen.e to proceed with tne work and not as
<br />authority to violate, cancel, a,lter, or .et a,ide, lIny provision. ot the techn1cal codee,
<br />nor .hall ia.uance ot a permit prevent the Bu11ding 0::101al trom thereatter requir1ng a
<br />correction or errors in plans, oonstruotion, or,violationa ot any code. Every perm1t
<br />i.sued shall becema invalid unl... the work authorlzed by auch permjt i. COMmenced within
<br />.ix ~nths or l.suance, or it work authorized by the pera1t i. suspended or abandoned tor'a
<br />period of six ~onth. after the time,the work 1. co~.nced. One 90 'day extension of time
<br />may b. allowQd tor the permit with tee charge ot '15,00. The extension shall be requested
<br />1n wr1ting to 'the B~ld1ng Ott1c1al. An approved inspectionmu.t be logged during each .1x
<br />month period, or tne pro'ect will be cOnl1dered abandoned.
<br />~ING TO OWNER: YOOR ~ILOR! TO RECOaD A ~OTICi OF CQNMEWCtHENT HAr RESULT IN YOUR
<br />PAYING TWICE FOR IHPROVEHENTS TO'YOOR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEYBEroRE RECOROING YOUR WOTICE 05' COMMENCDfENT. JOBS UNDI:R
<br />", '" " 'AL" 00 "'" "" " """"'" "0 ...., A ~~0
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<br />SIGNATURE i OWNi:R OR AGENT SIGNATURE I CONTRACTOR
<br />
<br />STATE or FLORIDA
<br />COON1Y or
<br />The toreg01nQ in.truaent was acknowledged
<br />Before lIle this _ day of ,2L
<br />by
<br />In4me ot person acknowledged)
<br />Owho 1S ~rSOnally I<nOWTl to l1le, or
<br />
<br />STATE OF ~RIOA
<br />COUNTY OF
<br />The tore90ing _t wft/iT~wl.dgedo I
<br />~~fo~)7~1l. of, 20 _"\?
<br />
<br />~~ 'name ot peraon aoknowledged)
<br />~hO 11 personally known to me, or
<br />
<br />Dwhc has prOduced
<br />(typ
<br />O1i
<br />
<br />fJc0 C1J
<br />
<br />Owho haa produced
<br />(type of ident1ficat10n)
<br />and whoO cUd Odid not take an oath,
<br />
<br />Siqn"ture of person takinq acknowledgeMent
<br />
<br />
<br />of identification)
<br />
<br />t~
<br />
<br />N~ typed, printed or stAmped
<br />
<br />NA11>8 typed,
<br />
<br />printe~~'Al6GN
<br />. ",.. ClP 1'L0lIIl04
<br />CQlIMSSION #I DD481817
<br />EXPIRES W17/2008
<br />"'11tIlU~MY1
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