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� r <br /> �once oF��c R��cno�rs�+d•�bnea unae�smn�.tn�c a,����t rr�v�$����,,,,�,arn <br /> whk��maY be mo��°'�we'�an�0oiii�lati°ns. Tha.undersMnsd.assumes rosPonsibllity.�l�PmP� <br /> �����' . �!►L'TOR:RE8P:ON9�18lL•iT1E8: ..ti:the �awne� ��� � <br /> " �UNI.�cENS�D'CON'�►��� to bs liosr►sed in s000��s�s snd.ioc�i'r�sD�a�On�. If tl�e <br /> ����D����� IaM►,�bdt► ths o�wnsr and oa�b�or maY be dted�a•misdemewnor violatior! <br /> �f i� f10t Ik�1�Ad 8S � � ,��� unce�tain�s�what lio�inp'roq�b''�r�ts malY�PPfY�the <br /> undsr s�s law. .If the a�wr w b�t�r�d�d Dhlislotl--�.10�1t�,1 S��.et 72T$47- <br /> ir►iended work.theY aro sd�s�tO°0^�th°��0 Cout�h�B�IdMp�nspsc�on <br /> g0p9. Furtl�em�ors. if ths otivner hq�hirod:s � a oot�trat�ors� he is sdvbed't� .ht�w#he,contraabcx{s) si�n <br /> far which't�y tNNI b� nNpon��t• tf You.�asi!'is a�wnK'si�n ss the <br /> ����•�trac�or Block" offhis �ptic�bn ��� � rat�titled'to'peRniWr19:P��s �'�0 <br /> contrsct�� ��naY�an indk�on�hat fis i�not properb� <br /> ��RUCTION.LIEN tAW(Chapb�7`13�Flo�ida 8tatub�s�asam�ekl�dl: tf valuatlon of work is 32�300.00 or more� � <br /> with a copy of'the 'Florida Constructlon Lis� Lsw--Homec�s <br /> certlt�, �hat �, the apai��. �e�,D�„nt aF ApFia�s and ca�wmer�• lf the app+icar►t 1s�sorr�eor'�e <br /> protec�ion Guide'Prel�ed �Y��I have obt�in�d ooPY docx�ment and promise in�ood faith to <br /> oti�t'than the'awr�"� �oertNY s af the sboNe destx�ed <br /> deiiv�tt b�the'own�Pr��cortlrt� is acxutate ac�d <br /> _ CONTRACTOR'8JOWNER��'� $�I ppik�bte �� °0����8 �cenifY <br /> that alt woric wqi be done �to obtain a permit to do work and ic�as k�ted <br /> ��i�tsli�t�oorrurNnad prior to�ofi s P�a"d�thst����d <br /> meet starodards of all Iswa r�0�0 a�' � � � ��� �at U'te t+epu� of other <br /> developmeM re�s�ons in the �. 1 si�o c�rtlfY th� i ta�d�stand ������ <br /> . �,emmeM aper►des maY aPP�Y'�ths In�ended wo�lc� and that k is mY�''�P��^�� <br /> must taic�e�b bs in e�mPl�u�c�e• {�to Mfio�'rn the oMrn�of t�Pa'm��Itlons set farth in <br /> tf I am the AGENT FORTHE ONMER. � P��°�� �t s ssPa�a� P�K msy be roqu�d to���' <br /> this aftidavit P�ior�to commendnfl oonstrt�. I ur�d�nd ��q�d In ths a�pi�• A <br /> p�� signs� wetls� Pods, afr oot� �� a ��� �s���u�wrlty�p vit�la0e� c�ncsl�a�. °r <br /> �����,p��strued to be a�oetas�o Pr'oo�d �a the BuNdinD OfAdsl from� <br /> sa#aside anY Pro�ai°n�°�the bec�nioal ood��� ra����uatws P��� ��d sh�l�becane� <br /> a oorr�adion of errors in P�� �or violatlons of a�Y codes. EveN P� <br /> �the wo�1c st�thori�bd bY s�h P�mK�c0mme��sbc mont� of Pe�� <br /> i�. or if wark sufhottr.�d bY <br /> ths perm��s w�pe�a�e'd'°r"d tor'p�'bd d sbi(6)ma�t'�s a�tsr tns eim.the work�oo"'� d�imo�� <br /> itt writ�p.t�tlts 8uldinD OA�M for a p�rbd t�t to e000s�d nin�br( ) � <br /> ���tor the e�• �f w�ork c�s fic�n�tY(�)�'°���°�is coraidsrod�at�d�• <br /> � � M�1Y R�BWLT IN�YOUR <br /> WARNING TO ONMER: YO�lR PA�:�TO �� A'NGTICY�: .�.p F��Q,CON8ULT <br /> PAYM1G TWICE�FOR . TO YOUR PROPE�- <br /> �p�A,lURAT(FS.117.03) <br /> and b <br /> ����om b(or a�rnNd)p�ton m�thi� ����,-�'y • � . <br /> Who Waro P�son�Ny w�o�n b en�a h�Nrw Peod��ad --- as W�iad°"' <br /> as fdM�� <br /> �Y P� <br /> NotrY P� <br /> Conn��� . . • <br /> Cartu�du� <br /> N�nN d Nof�rY bl+�•P��or stamPb <br /> Nan�e d Nola�Y bp�p�or� <br /> "�+�F1tAI�i(,'($�� . <br /> i � ��;Lm�ero1.7017 <br /> �o <br />