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<br />The undersigned understandstbat tbis per.it .ay be subject to mdeed restrictions" which .ay be lore restrictive than City
<br />regulations. The undersigned assUles re;ponsibility for cDlpliante witb any applicable. deed restrictions.
<br />
<br />B. UNL I CENSED CONTRACT(~RS AND CONTRACTOR RESPONS I B I LIT I ES "
<br />If the owner has hired a contractor or c~ntrattors to undertahe Mork, ~hey aay be required to be licensed in accordance with
<br />state and local regulations. If tbe'''Coniractor is ".!l~icensed as required bv law,bot~ the;,owner and contractor uy be
<br />cited for a _isde_eanoT violation under ~tate la.. If the owner or intended contractor are uncertain as to wbat licensing
<br />require_ents lay apply for tbe intended :lork, tbey are advised to contact the City of 2ephyrhills Building Depart_ent, (8131
<br />788-6611.
<br />
<br />Furtherlore, if the owner has hired a co,ltractor or contractors, ~e is advised to have the contractor(s) sign portions of the
<br />.Contractor Sections" of tbis applicatio~ for which tbey will be respo~sible. If you, as the ONner sign as the contractor,
<br />you are indicating that you, rather tban tb~ contractor, are responsible fer the work. If the contractDr Nisbes you to sign
<br />as contractor that lay be an indication that he is not properly lic,nsed and is not entitled tD perlitting privileges in the
<br />City of 2epbyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN Lf.W (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applican~, have be~n provided with a copy of .FloTida's Construction, Lien laM - HOleoNner's Protection
<br />Guide. prepaTed by the Florida Depart.ent of Agriculture and ConsUAer Affairs. If the appljcant is SOleDne other than the
<br />.owner., I certify tbat I have obtained a copy of the above described docu.ent and prolise in good ,faith to deliver it to the
<br />.oNner. prior to cOlaencelent.
<br />
<br />E. CONTRACTOR I S/OWNER' $ AFFIDAVIT .
<br />I certify that all the inforlation in th:s application is accurate and that all work "ill,be done in compliance with all
<br />applicable laws regulating construction, zoning, and land developaent.
<br />
<br />Application is hereby .ade to obtain a p~r.it to do work and installation as indicated~ r certify that no work or
<br />installation has cOllenced prior to issuince of a per.it and that all Mork will be perfor.ed to leet standards of all laws
<br />regulating construction, City codes, zonIng regulations, and land developlent regulations 'i~ the jurisdiction. I also
<br />certify that I understand that tbe regulJtions of other governaental agencies aay apply..to the intended Mork, and that it is
<br />IY responsibility to identify what acti~,ls I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />t Depart.ent of Environ.ental Reaulation - Cypress Bayheads, Yetland Areas and Environaentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Water "anaaa.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY CorDS of Enaineers - Seawalls, Docks, Navigable Waterways .
<br />t Departlent of Health l Rehabilitative Services. Environ.entalRealth Unit - Wells, Wastewater Treatlent, ~eptic Tanks
<br />t US Environaental Protection Aqencv - A~bestos abate.ent
<br />I also certify that, if fill .aterial is to be vsed in Flood Zone "A. or .A,etc.., it is' understood that a drainage plan
<br />addressing a .coapensating voluae. will be sub.itted which is prepared by a professional engineer registered in the State of
<br />Florida prior to per_it issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perait prevent the Building Official fro. thereafter
<br />requiring a correction of errors in plan~, construction, or violations of any code. Everyperlit issued shall becoae invalid
<br />unless the work authorized by sucb per.i~ is cOlaenced within six aontbs of issuance, or if MOrk authorized by the per.it is
<br />suspended or abandoned for a period of six tonths after the ti.e the work is cOlaeneed.Dne 90 day extension of ti.e, lay be
<br />allowed for the perait with fee charge of $15.00. The extension shall be requested in writing to tbe Building Official. An
<br />approved inspection lust be logged durin) each six .onth period, or the project Mill be ton~idered abandoned.
<br />WARNINS TO OWNER: YOUR FAILURE TO RECOR~ A NOTICE OF CO"~NCE"ENT HAY RESULT IN YOUR PAYIN6 TWICEFDR I"PROVE"ENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINAll;~It~G, CONSULT IIlTH YOUR LENDER OR AM ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COlIIlEltCEKEHT. JOBS UIIOEll $2,500 I~U' 00" !I'D TlI RECORIl ~
<br />
<br />
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />
<br />STATE OF FlO~
<br />COUNTY OF \') (' (')
<br />The foregoing instrument was acknowledged
<br />before me this ~"e Q I' 19-2,2 by ,
<br />
<br />
<br />
<br />o
<br />
<br />(Name Typed, Printed or
<br />NOTARY PUBLIC
<br />
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<br />inc.
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