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<br />SIGNATURE i
<br />
<br />A. - NOT1CE or DtiD RtSTRICTIONS
<br />Thll W1'der'.igned undentan<i8 that this pendt I14Y be .ubject to "ceed restrictions" which
<br />may be mOre re.triotive than City requlationl, The undersigned aseumes respon.~bility for
<br />conpliance with any applicable deed r..trictiona~
<br />B, ~~ICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />, It the owner has hired a contractor or contnotora to undertake work. 'they may be required
<br />to be liceneed in accordanoe wit~ at.te and local reQulationa. If the contr.ctor i.not
<br />lioenaed a. required by la.., both the owner and contractor may be cited for a &iademeanor
<br />violation under atate law. If the'owner or intended contractor are uncertain a. to what
<br />licensing requiremants may apply for the intended 'work, they are advised to contact the
<br />City ot Zephyrhill. Building Department, 813-780-0020.
<br />runnemore, if the owner has hired a contraotor or contractor.. he 1a adviaed to have the
<br />contrectorls) eign po~tions ot the ~Contractor Seotiona- of this applioation to~ which they
<br />will be responsible. It you. .88 the owner .iqna as the oontractor. you are indicating thAt
<br />you, rather than the contractor, are re.ponsible tor the work. ,If the contractor wishee
<br />you to s1gn a. contractor that may be 'an ind1ea~ion that'he is not properly lic~naed and i.
<br />not entitled to permittinq privilege. in the City or ZePhyrhilla.
<br />C. TRANSPORTATION IHPACT rtts AND OTUITr CONNECTION FEU
<br />0, CONSTROCTUIOll LICI LAH (CliAl''l'tlt 71,3, noaIDA STATUTE/J, AS ~!:NDED)
<br />I certiry that I, the ,pplicant, haye been provided with. oopy'of -rlorida', Conatruction
<br />lien Law - Homeowner's,Protection Guide" prepared by the rloria. Department ot Aqrioulture
<br />and Consuncr Affairs. If thc applicant 1. 'OIUone other that tile ~own8r", I,cerity that I
<br />have obtained a COpy or th~ above desoribed document and promi.e in qood taith to deliver
<br />it to the .owner" prior to oODVII.no....nt.
<br />E. OOWTaACTOR'S/ONllER'S ArrIOAVIT
<br />1 certify that all the intormation in thi. application is accurate Ind that all work will
<br />be done 1n compliance with all applioable laws raqulltlnq con.truotion. zoninq, ana l.nd
<br />devclopnent.
<br />Appli~ation ia hereby made to obtain a perRit to do work and in.taliation a8 indioated. I
<br />certity that no Wor~ or instellation haa ooma.need prior to i,.uahoe ot a permit and that
<br />all work will be performed to maat .tandard. of all law. requlatlng construction, City
<br />code't 10nin9 requlations, and land- dev'lo~rit re9ulations in the jur1.diotion. I also
<br />certify that I understand that the reOUlatlon. or other qovernmental Iq8nci8' may appiy to
<br />the intended work, and that it i8 my r'8Pon.ibility to identlty wn.t aotion. I muet take to
<br />be in compliance. Such agenei~. include but are not limited to: ~Oepartment ot
<br />Environmental RegUlation-Cypress Bayhe.d., Wetland ~rea. and invironnentally Sensitive
<br />Landa, Water/Wa.tewater Tre.tm~nt
<br />.Southw.st Florida Wot~i MA~9eaant District-Welle, Cyprees Bayheads, WetlanO Areaa,
<br />Alterinq "'atercouree,
<br />'Army Corp. of Engineers-Seawalla. Docke, Nlv1qable Waterwaya ,
<br />.Department or Health' Rehabilitative Service., Environmental Health Onit-Wella,
<br />Wa.tewater Treatment, S~ptic Tank. - ,
<br />.U.S. ~nvironaental Protection Agency-Asbestos .b.teMen~
<br />I also certify that, if fill mdterial i. to be uaad in Flood Zone .AN or ~A.etc.N, it i.
<br />und.r~tood that a drainage plan addressing I .oo~en'at1ng volume" wl11 be .ubmitted which
<br />i. prepared by a proteaaionel engineer regi.tered in the State ot Florida prior to permit
<br />iuuance.
<br />A permit issued shall,be construed to be a licen.e to proceed with the work and not as
<br />authority to violate. cancel, a.lter, or .et adde any provisionll at the technical codee,
<br />nor shall issuance ot a permit prevent the Build1nq 0ttioial from thereafter requiring a
<br />correction of errors in plans, conetruotion, or, violations ot any code. Every pernit
<br />is.ued shall becOMe invalid unle.. the work author~zed by .uch permit i, commenced within
<br />.1~ ~nth. ot i..uance, or it work authorized by the pernit i. .u.pended or abandoned tor 'a
<br />period of .ix ~onths after the t~e,tha work is coam~ne.d. One 90 'day extension of time
<br />may be allowed tor the permit with fee charqe of $15.00. The extension enall be requested
<br />in writlnQ to'the Building Otrioial. An approved inspection .u.t be logged during each six
<br />month period, or the project will be c~n.idered abandoned.
<br />~ING TO OWNER: YOOR rAILOR! TO 1tEC0ao A NOTICE OF COMMENCEMENT HAY ~B/JULT IN YOUR
<br />PAYING TWICE FOR INPROVEMENTS TO'YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR llO'I'ICE OF COIDlE DfEN'!'. JOB'S UNDER
<br />$2,500 IN VALUE 00 >>aT NEED TO RECOROAND POST A ~NOTICE or QOHNEN T"
<br />
<br />~~LA
<br />
<br />SIGNATURE I CONTRACTOR
<br />
<br />~~~y O~F F1.OIlIDA H1Jlsbav ~
<br />
<br />The foregoing i\~~nt ...~:~knoWladged
<br />:~for. ,e..~&~YLff~~~' 20QJ",
<br />
<br />Wt.~ (n~ ot per,on aoknowledged)
<br />~o ia personally known to me, or
<br />
<br />o who has produoed
<br />(type ot
<br />id n t t
<br />
<br />OWNiR OR AGtllT
<br />
<br />
<br />STATE or rLORIDA
<br />COOll7l' Of
<br />The foreq01nq in.trunent was acknowledged
<br />Setoro me this _ day of r '2L
<br />by
<br />
<br />lname or person aCknowledged)
<br />o wllo 1e J)<lreonally known to "e, or
<br />
<br />Owho hos prodUced
<br />(type of identification)
<br />and wrioD did Ddid not take an oath.
<br />
<br />
<br />Signature of person ta~in9 acknowledqe.ent
<br />
<br />~ typed, printed or stamped
<br />
<br />NllIUI4~f~.~~~.UJ\
<br />"'~'" - andra L. OW
<br />~.~ .iCo~sjon II D0615374
<br />......".... ExplTes: NOY. 16,2010
<br />BONDED THRU ATlA....'TIC BONDING Co.. INe.
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