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<br />[:C;,.ID I T IOt>JS OF F":I'l I T (F'="' ;::,';'v': T
<br />A. NOT I CE OF DEI;:J! F:~J?J :::: I CT I O".I~;
<br />The undersigned understands that this i2rmit may be subject to "deed restrictions' which may be ffiore restrictivr than City
<br />regulations. The undersigned aSSUies 2sponsibility for co~pliance nith any applicihle deed restrictions.
<br />
<br />B. UNL I CENSED CmHRACi DRS P,ND COf\lTRACTfJf~ 13.1~'3FJT~'I~J B l1:::..I T I ~$.
<br />If the OMner has hired a contractor Dr contractors to undertake Mork, they lay be required to be licensed in accordance with
<br />state and local regulations. If the c[ntractor is not licensed as required by law, both the owner and contractor may be
<br />cited for a lisdeleanor violation undei state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirements lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departient, (B131
<br />788-bbll.
<br />
<br />Furthermore, if the owner has hired a .ontractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections", of this applicatiDn for which they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather thin the contractor, are responsible for the work. If the contractor wishes you to sign
<br />as contractor that may be an indicatioL that he is not properly licensed and is not entitled to permitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TF:Al'-JSPORT A T IOt'J H1P( r-:::T FEES AND UT I L I TV Cot~l::!.S!:.IJ CiN__FEE2
<br />
<br />D. CONSTRUCTION LIEN lAW (CHAPTER 713, FLOF:IDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have l'een provided with a copy of "Florida's Construction Lien Law - HOieowner's Protection
<br />GuideD prepared by the Florida Depart~"nt of Agriculture and Consumer Affairs. If the applicant is someone other than the
<br />'owner', I certify that I have obtain~ a copy of the above described document and promise in good faith to deliver it to the
<br />"owner' prior to comftencement.
<br />
<br />E. CONTF:ACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the information in 'his application is accurate and that all wDrk will be done In coapliance with all
<br />applicable laws regulating constructi[,,! zoning, and land development.
<br />
<br />Application is hereby made to obtain a per.it to do work and installation as indicated. I certify that no work Dr
<br />installation has commenced prior to is~uance of a permit and that all work will be performed to meet standards of all laws
<br />regulating construction, City codes, ",'ning regulations, and land development regulations in the jurisdiction. I also
<br />certify that 1 understand that the reg 'lations of other governmental agencies may apply to the intended work, and that it is
<br />.Y responsibility to identify what act'ons I ~ust take to be in compliance. Such agencies include but are not li~ited to:
<br />f Deoarhent of Environlental Requlati'.0.. - Cypress Bayheads, lIetland Areas and Environmentally Sensitive Lands,
<br />Water/llastewater Treatment
<br />f Southwest Florida \later ManaQe~ent D.strict - lIells, Cypress Bayheads, Hetland Areas, Altering Watercourses
<br />t Aray Corps of Enqineers - Seawalls, lDCks, Navigable Waterways
<br />. Department of Health & Rehabilitati'i, Services, Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks
<br />f US Environ.ental Protection AQencv - Asbestos abatement
<br />1 also certify that, if fill material,s to be used in Flood Zone "A" Dr DA,etc.", it is understood that a drainage plan
<br />addressing a "compensating volu~e' wil be subtitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance_
<br />
<br />A perait issued shall be construed to .e a license to proceed with the work and not as authority to violate, cancel alter, Dr
<br />set aside any provisions of the techni al codes, nor shall issuance of a perr,it prevent the Building Official frol thereafter
<br />requiring a correction Df errors in pi Ins, construction, or viDlations of any code. Every perr,it issued shall beco~e invalid
<br />unless the work authorized by such per ,it is commenced within six months of issuance, Dr if Mork authorized by the permit is
<br />suspended Dr abandoned for a period D1 six &onths after the tile the work is commenced. One 90 day extension of ti~e, lay be
<br />allowed for the permit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection must be logged dur;ng each six month period, or the project will tie considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECJRD A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN Flh ';)lCING, CONSULT \lITH YOUR LENDER OR AN ATTORNEY BEFOF:E RECORDING YOUR NOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN Vi .UE DO NOT NEED TO RECORD AND POST A "NOTICE OF COI1MENCEHENT".
<br />
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<br />SIGNATURE: 0 R OR AGENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA ~ STATE OF FLORIDA
<br />COUNTY OF ~ COU!!11 OF
<br />The fOl-egoing instl-ument"w~ cc. ackno\11edged /)1'l"e foregc,ing in~,trurnent
<br />before me th is! 'iZ;::-- by ./ befol-e me th is.
<br />
<br />, /
<br />" /
<br />kno\-rn to me o~o has
<br />
<br />,')2S ackno,.Jledged
<br />! 19 by
<br />
<br />known to me or who has
<br />
<br />who is personally
<br />produced
<br />as identification
<br />take an oath.
<br />
<br />and who c~/did not
<br />
<br />who is persDnally
<br />pl-oduced
<br />as identification
<br />,,~_ake an oath.
<br />
<br />and who did/did not
<br />
<br />
<br />( si ~!~:ln~ )
<br />
<br />(f\lame T~,:;~~~I' i nted C'-I' Stamped)
<br />t~QT AF:,LE,W~{J=I.~~
<br />
<br />(Signature)
<br />
<br />-',
<br />
<br />'..
<br />
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