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<br />A,' NOtl C,E or Dill) RI:S'rRJ:CT IOilS
<br />The \.lAder.~i9neci uncler.tanc1.8 tn;at this perlll1t. ..y be .ubject to "~.d restdctions" which
<br />Illay be 1II0re re.tdQtive than Ci ty uf\l.l.tlon41. The Ilnderalqned uiUlllell re.pone1!b1Hty for
<br />~''3'Pl.ianc. with I.lly appHcable d"d r.stricttons;
<br />8. UNLICENSED OONt'AAC'l'OR8 ,\NO CON'l'RAC'rOR REifOliSIBILI'l'IES
<br />It the owner hu hhod II contractor or con.treatora to undertake work,' they ...y be required
<br />to b~ hc.na.d ln accordanoll with .tate and local reg\l1ltion., If the. contractor hno.t
<br />liDen.ed II required by .law, both the owner and oontr.ctor may be cited for a lII1.sdellleanor
<br />violation unoer .t&t.e law. If the . owner or intended contr.ctor are uncertain al to whn
<br />Hcensing requiremant. may apply for the interll:le~ 'work, they are advised to contact the
<br />City ot Z.phyrhill. Build.ing Deparbllent, 813-780-0020,
<br />Furthenoon.. if the owner h.a nired 1 C()l\traotor or contrlcton, he i. advised to have the
<br />cc>ntr.,ctOr(s) 111qnpo;Uon. of the. "Cotltraoto.!: hotlon," of thh .pp11oat10n to~ whiCh they
<br />wUl be responllib.le, It you,.. th.e owru.r .1cp"8 II the oontractor, you .n incUo.Ung that
<br />you, utbn than tho oontra.otor,are re.pon.ible tor the work. .If the contrllotor whhee
<br />you to dgn u contractor that IIllIY be 'an 11'lc11~t;1on th.t' All 18 not: proper.ly l1c.fI..d lInd h
<br />not llntit1ed topetll\1tllno.pr lvile,.e, Ln the. Cl~.y or Z.s"b,yrh1Ua,
<br />c. TI\ANSPO~TA.T10N rWi-AC'1' fiES 1.)10 "TILITl'~C1'IONFnlS .
<br />0, CO~S'faOCTUION 1.101 LAJ<i (CfIA1I1't1\U3, FLOalDA STATUTtS, ^" AMENDED)
<br />I oertiry that I, the .ppl1cant, haye b.en provided wlth a copy'of -rlorida', Con.tructlon
<br />lien Law - HOlleowner' 's . ~rotectlon Guide" prepated' by the rlori~ Oepllrtlllent or Aqr10ulture
<br />and Con~_er I\Hdrs. If the llppl1cant ie 'OMone other thllt the -owner", I. cedty tllat I
<br />nave obtained a copy ot the above de,orlbed dooUlllent .nd promJ.1ll in qood r..1th to deliver
<br />it to the .owner" prior to cOlMle~oeIMnt. .
<br />IL CO~ItACTOIl' SIOlf"l:Il' S ArFlCAVIT
<br />I certify tnat all the info.lmlation in thJ.. appliclItion 1; accurate and'that 1111 work will
<br />be done 1n COlllp.llance with all appllc~l. .laws regulating conetr\lctlon, zoning, and .land
<br />developnent.
<br />App.li~.tlon i~ hereby mad. to obt.lnll pernlt: to do work and inatalilltion a. 1Ad1oated, I
<br />Certity tnatoo wotk or .inHa.l.lat1on h., ~.nQ.d pdor to luu.hce ot . pemit and thllt
<br />aU work will. b9 P9r'fomod to Ill.et at.~rd.of all lawa r9qulating construction, City
<br />coclea, zoninq regulations, and l.nd' d.v.Iopunt reljulltlono in the :lurie'diotion, I alllO
<br />certity that I.understlll'rd thee the UO'lllat10n. or oth9r gove~ntal agencle, NY apply to
<br />the intended work, and tt\at .1 t 1. illY "e'PQnd.bUity 1;0 identity w~t aot10n. I mu.t ta.ke to
<br />be in COIllp.liance. Such "genci.. inolud. but an not .llll\lhd to: "o.p.rtment of
<br />EnvlroMenhl P.9quJ.;at.iQn-Cypr..~. hyh.a~, Wetland I\n.. l/ld Envlrorvaentlllly Sensitive
<br />J.,anc1a, water/W..t.water treatment
<br />*Southwe$t Floriea Watet MAnAqeaent oi.trlct-Wellll, Cyprll. Beyheadll, Wetland ~.aa,
<br />Mter1ng W.t~rcourae.
<br />"Anly Corp. of tn91.ne.ers-Seawlllll, DocQ, tlav1gab.le W.terwaYll .
<br />*09P'rtI1l9nt. or K_.lth , lI.ehabUJ,.tativI Servic.., >>:nvirolll'llent.l a9alth Onit-Wel1e,
<br />Wa.t.wat.r Tre..taent, Septic ranlea . .
<br />"U. S. i:n'l'ironaental E'rotectiori Agency-AsIbest1)s abatelllen\;
<br />I al.o certify that, if fHi lIl4terialll.to be \lsed 1n Flood tone .A" or "A,etc,", it it
<br />understood thAt a drI11'1.ge phn addrell.1nqa .OOlllllenn.tin9 Y'olWlle" w1llb. .\Jban1tted whlch
<br />1eprepared by aprot.ulona.l liInq1neer reqi.orld in tile Statll or riorida prior to perrait
<br />181uance.
<br />11 penait issued shall.be con. trued .to.be a 1109n.. to proceed with the work and not as
<br />aUthority to violate, c.nca.l, a.lter, or .et a.ide. any provisiOns ot the Uohniclll codu,
<br />ncr sha.11 iSSUAnce or a permlt prevel\t t.he BUUd.1.nq (;)r'10il1 troll ther..ttn J:9q11irinq 4
<br />cornation or errors 1n plans, oOMt,ruotioa, or. vhl.Uon, ot any code. Every pernlt
<br />iuued .116.11 becClnl invdid un.l... the work authorL.zed by .uch peralt 18 cOlUlI.nced within
<br />.i~ nonth. ot i..~., or 1t work .uthor1~ed by the p.mit 1. '\lap.nded or abandOn'd for 'II
<br />periocl of six "onths after tl1e t1ille ..the worl( laco_enced. One 90 "day extension of Ulle
<br />-y 0. allowed tor the perlllit with tee oll.r;e Of $15.00. The extend on el1dl be r.quested
<br />in wl:lt1nq to 'the BuJ.ldi.nq or ricial. An aeproved in.pection '1RU1l; be logged dUrinqeac:hs1x
<br />1lI0nth period, or tn.. projact wi.ll be OOlllid8Z'lId abandoned.
<br />lf1IJ\NING re OWNI:R: YOOR M>;ILOP.& '1'0 QCO.OAtlO'1'ICiI or CoeomNCtHtN'1' HAlt' IU!:SUL'l' ni YOUR
<br />PAYING TWICE &'OR IH1!ROVl1IG:NTSTO' YOOR pRoPERTY. Ir YOU INTEND TO OBTAIN rltlANCINO. CQNSULT
<br />WITH YOUR LENQE:f\ OR Atl I\TTOf\NEY UI'ORB R.IlCG~.ING YOOR NOTLCE OF CO~NC "NT. JOB'S l1NDI:R
<br />$~, 500 III VALUE 00 llO1 NEED TO REOOR.D 'AMD ,6 NOTICE or COHHEN
<br />
<br />
<br />SIGNATURE I CON'l'AAC 1\
<br />
<br />"ATE or ""AZl"'_~~
<br />COUNT'( or
<br />Th.to~egoing i~t w~.a~~owled .
<br />BeforlJ:! th~1I ... ~ ~, 20..J.
<br />I>y rvu L ).. .1--..
<br />...d,_L _ (1'1'" or penon aoknowled9ed)
<br />~ it p.r8ondly known to lIei or
<br />
<br />o who
<br />
<br />SIGNATURE; OWNiR OR AGiNT
<br />
<br />STATE: or rLORlDA
<br />CO!:iNTY or
<br />The tOreqoinq.in'tz>ura.nt wu acknowledged
<br />a.for._ thil_ day of . '2L
<br />by
<br />In6lllt ot penon acknowledglld)
<br />o who 1, pIInon;ally known to "e, . or
<br />
<br />o who hll. produced
<br />(type of identJ.!iCationJ
<br />and wnoOdld Od.id not take an oath.
<br />
<br />
<br />t id.ntLf1cation)
<br />take an o.th
<br />
<br />Signature of person tekinq llcknowledqell\.n1;
<br />
<br />w..- typ9d, pr1nt.ed or $tAJllped
<br />
<br />N~~~ PM~,mU\lol!'e
<br />..."." """ . Sandra L. Sozzi
<br />{~}COIl!-ffiiSSiOn # DD615374
<br />.,,'......,. Expues: NOY. 16, 2010
<br />DO\'DED THRU KI1h"'11C BONDING CO., INC.
<br />
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