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<br />A.' ~'l'JCE or DUD Ri:S'l'R1CT.IONS
<br />.11111 Wiclef"igned underttand.8 th.t this peZ'1llit uy be subject to "d..d restrictions" which
<br />lllay be 11I01:. :rntdQthe than City nq\ll,tion.. The undersigned uBUllle. rupone1!bUity for
<br />conpliancl with any appllcable d..dl:l.triction.~
<br />8, UNLICENSED CONt'AAC'l'ORS MID CON'1'RAC1'OI\ I\f)SfOl!SI8ILITIES
<br />It tn. owner has hhed a contra-ctor or contraotors to undertake work, 'thllY IlI8Y b. required
<br />to b. licen8ed 1n accordanoe with .tat. and 10C.l noulation.. If the contractor 11 nO,t
<br />l10ennd u :required by law, both the owner and oontractor IUY be cited for a lll.1..demeanor
<br />viohtion Wlde:r .hte law. If the 'owner or intended oontncto:r ere uncertaln .11 to whn
<br />11cen'lng requiremlnt' may apply tor the intende!1 ''!fOrk, they are advis.d to contact the
<br />City ot Zephyrh.ill. Buildinq Department, 813-780-0020.
<br />runhemore.. if the owner has hired a I:Ontraotor or contractort, he 18 .dviaed to have the
<br />contrector(s) slqn pOft1on.:l ot th.. "CQt\trac.tor lleotion." of thh Iippl.l.oat1on tOi; whiCh they
<br />will be rnponsib.le. It you, .88 the owner .iqna II thl oontraotor, ydu an ind10atinq that
<br />you, rather tll.n the conu'actor, arl reeponsible tor the work. ,If the oontraCltor willhell
<br />you to a1qn AI contractor th"t -t be 'an ind1'O.~ion that' he ill not proper.ly actin.ed and 1e
<br />not entitled to ~nlttinq privil.ges in the Clty ot Zep'hy~hill.,
<br />C. Tl\AllSl'OR'l'MION Il-lI1AC'l' ritES AijQ CTILITr COlOltCTION .nzs .
<br />D. COllsraOCTUIOH LIOl LAW ICIiAP'l't!\ 713, I'LOIUDA S'l'ATUTES, M AMENDED)
<br />I oertity that I, the applicant, hay. be.n prOvided with a copy 'of ~rlorld.'. Conlltruction
<br />lien 1;.10' - HOlleowner''', Protection Quide" pro~~ed' by the rlod~ ~pllrtlllent ot IIqr10ulture
<br />and ConllUlacr "'Ueirs, If the applicant 111 'OIUIone oth.r th4t tile "ownlr", I. cldtytllat I
<br />heve obtainea .. oopY ot the aboY.!' deeOr1bed doo\llllent and prollliae in oood tdth to deliver
<br />it to the .owner" 1>1: ior to OOIl1llI.nOllll8nt,
<br />E. COWTAACTOR' S/OWIi~R' S Ai"FIo.o.VIT
<br />I certify th.t all the infor:mation in thi, application ia accurate and'that all work w111
<br />be done J..n cOll\pliance with all appliOable law. regu18ti09 con.tr\1ot1orl, zonino, aM land
<br />develoPRent,
<br />AppUo:;ation is heraby 1Md8 co obtain II p.nalt to do work lIJld in.tll.lilltion lIS 1n<1J.oated. I
<br />cert1ty that no wo;ok or inHlIllation hu oOllllllmcod pdor to J....u.hc. ot a plmit and that
<br />all WQrK w1U b. perror:mlid to l1le.t .ta~rd.of all law. reiiulatlnq construction, Clty
<br />codes, zoninQ regUlations, and land' d.veloPlUnt re9Ulations in the jur18'd.iotion. I also
<br />certity that I,under.:ltllnd that tho reOUlation. or Other qovernJ\ental aoenole, ~y apply to
<br />the intended work, and that it i& illY r,.pon.ibiHty ~o idlnt1ty wtw.t aotion. I lIlust take to
<br />be in complianc.. SuchaqencJ.... include but arl not lillited to: *Pepartm.nt ot
<br />Enviro~ntill Re9J.lhtJ.on-CyprQ$s Bayneact., WetlAnd IIr... and Envirorvaentelly 5en$it1ve
<br />Landa, Water/Waetewater Treatment
<br />.Southwut Florida Watllr lolan.1geaent District-Welle, Cyprus 84yheads, lietlan~ ~eu,
<br />AHerin9 Watercoulohs
<br />.Arlly Corp. of !;ngiJleen-5eawal.1e, DockJ, Nav10'abJ.I Waterways
<br />.Departl1lent ot Klalth , P.ehi.l:>il.l.htivlI lIIen-1c.., Envirollllllntal Health Dnit-Wells,
<br />Wastewater Tr.atment, S.ptic Tank.
<br />.0, S. i:nvirolUllllntal "rotectio,,; AgenCly-Asbestos abetellen1;
<br />I also certify. tha.t, if fill lllateria.l ls,to be u..d in Flood Zone -A" or "A,etc,", it 18
<br />undernood that a dr.ina90 plan adclre"1nO' a -OolllPenn.t1nq yolUlllo" w1l1b. submitted which
<br />1. prepared by a proteuiond IIn9ine"r r"911tor.d in th, State ot rlorida. prior to ~mit
<br />18l1ual1ce.
<br />,., p.~t iS5U.d shall.be con.:ltru.dto be a llcln.1 to proceed with the work and not a.s
<br />autl\ority to vio.la.te, ca.nce.1, a,lter, or ..t aside. any proYi.s10n3 or the technical COdes,
<br />nor ahan i5suance ot II permit pr.vent the 8\11lcu.nq <ilttJ.oial trOll thereatter r9quJ..ring 8
<br />correct10n or error. in Plans, COMt1:1;lOtJ..Qal,or. violatiQn. ot an.y cod.. Every penait
<br />1..uld ahdl becClll8 inva.lid unh.. the work authorlZed by suoh perl!lit 11 cOIU\lnoed within
<br />8J.;x Mnth. ot 1Uuance, or it wOl;'k authoriuQ by the pemit 11 'lfsp.nded or LbandOned for 'a
<br />p.r1od of sh /lonths a.fter tlle tUll. .,the worle h COIllll.nced. One 90.'day extension of tillle
<br />m.ay be llllow..d tor tile permit with fee charlie ot $15.00. The ext.nsion snail b. requut.d
<br />1n writJ..n9 to 'the Bul.ldinq Ott1oid. An approved in,plction 'lIIU.t be 10;;ld dUr.l.nqeach dx
<br />1Il0nth p.ri.od, or the.pi:ol~ct will be c<mll1dnecj abandOn.d. .
<br />lfAANING'I'() OWNER: YOOR rAILORE TOJ\.ECO~l)AWOTIClor C06QolENC!:HJINT HA't DSULT ni 'tOUII
<br />PAYING TWICE FOR IHl!ROVEKENTSTO' YOUR PIlOPERT't. IF YOU INTEHDTO OB'l'lUN rIN~ ,NO, CONSUL'!'
<br />!IITH '(OUR LENDER OR~ ~TTORNEY iu:FOJU: ~"CQUING YOCR NOTICE OF. COMKENC N'l'. 08'S l1NOI:R
<br />". SO, IN ""'"' 00 "'" ''"' '0 ......,... J..'m or """"'''.'''''..
<br />
<br />
<br />
<br />SIGNATURE i OWNER OR AGENT SIGNi\'I'UREh
<br />
<br />STA'!'E or FI.OIUDA
<br />COUNT\, or
<br />'1'hl fo~.qoing i~t ~SOWledq
<br />8eto~ th1s\ . 0 '. , ZO
<br />by Ty\ A .'
<br />..J. In_ ot penoll .oknowledllld)
<br />~ 11 Personally known to lie, or
<br />
<br />o who nn produoed
<br />(type
<br />d
<br />
<br />
<br />STATE or FLORrDA
<br />COOH7Y or
<br />The tor~qoin9 J..n'trunent was acknowledged
<br />Before m.a thb _ day of '2L
<br />by
<br />(nAm.' ot pereon acknowledged)
<br />o who 1. ~r.on..lly known to lIe, 'or
<br />
<br />Owho ha3 prOduced
<br />(type of identifiCation)
<br />and wlioO did O<li<l not t~kIl an oath.
<br />
<br />Sign.ture ot person taking scknowledge~ent
<br />
<br />
<br />lllllU ~J~~: gVP~~d~~~Itl,~
<br />:':W:--- an ra . 0221
<br />~ ~}~on:unjssion # DD61S374
<br />""'" "", ExplIes: Nay. 16 2010
<br />BO!\'DED THRU ATIh"'TIC BONDING CO" INC.
<br />
<br />W""", typlld, print.d or "tamped
<br />
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