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<br />cmm I T IONS m.- PE.l (1'1 I T (-iFF I DAV I T
<br />A. . NOT I CE OF DEED RESTF: I CT IONS
<br />The undersigned understands that this perlit aay be subject to 'Jee~ restrictions. which lay be lore restrictive than eit;
<br />regulations. The undersigned assules responsibility for rOlpliunca ~ith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTQFS AND CONTRACTOR RESPONSIBILITIES
<br />If the OMner has hired a contractor or c0ntractors to undertake work, they lay be required to be licensed in accordance with
<br />state and local regulations. If thec~ontractor is npt licensed as required by law, both the owner and contractor lay be
<br />cited for a lisdeleanor violation under state law. If the ONner or intended contractor are, uncertain as to what licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, IB13)
<br />7BB-6611.
<br />
<br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor!s} sign portions of the
<br />.Contractor Sections. of this application for which they Mill be respo~~ible. If you, as,the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
<br />as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTIONFEE~
<br />
<br />D. CONSTRUCTION LIEN Lr,y- (CHAPTER 713, FLORIDA STATUTES~ AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of .Florida's Construction Lien Law - HOleowner's Protection
<br />Guide. prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
<br />.owner., I certify that 1 have obtained a copy of the above described doculent and prolise in good faith to deliver it to the
<br />.owner. prior to cOllencelent.
<br />
<br />E. CONTRACTOR"S/OWNER'~ AFFIDAVIT
<br />I certify that all the inforlation in this application is accur~te and that all work will be done in co.pliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby lade to obtain a perlit to do Mork and installation as indicated. I certify that nc Mork or
<br />installation has cOllenced prior to issuance of a perlit and th~t all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />Water/Wastewater Treataent
<br />f Southwest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />f Depar tlent of Health 1. Rehab i Ii tati ve Services, Environlental Health Uni t - We 11 s, Wastewater Treataent, Sept i c Tanks
<br />f US Environlental Protection AQency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood Zone .A. or "A,etc,', it is understood that a drainage plan
<br />addressing a .colpensating volule. will he sublit~ed which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A per.it 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 perlit prevent the Building Official frol thereafter
<br />requiring a correLtion of errors in plans, construction, or violations of any code, Every perlit issued shall becole invalid
<br />unless the work authorized by such perlit is cO.lenced within six months of issuance, or if work authorized by the per.it is
<br />suspended or abandoned for a period of six lonths after the tile the work is com.enced. One 90 day extension of tile, lay be
<br />allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six lonth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IMPROVEKENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,. CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COKKENCEKENT, JOBS UNDER $2,500 IN VALUE DO NOT NEED TO ~ECORD AND POST A .NOTICE OF COMHENCEKENT..
<br />
<br />~ r'rJ~
<br />SIG ATURE: OWNER OR AGENT
<br />
<br />~.,-= o-,/p~~~
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />--.
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF Pasco
<br />The foregoing instrument
<br />before me this Nov. 19
<br />
<br />was acknowledged
<br />, 19 ~ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF Pasco
<br />The foregoing instrument
<br />before me this Nov. 19
<br />
<br />was acknowledged
<br />~ 1 9....92.- by
<br />
<br />Kevin T. Roberts
<br />who is personally known to me or who has
<br />produced N/A
<br />as identification and who did/did not
<br />~ke an oath.
<br />~
<br />
<br />(51 natul-e)
<br />.l;lnpt Rl;lrk-wl'>ll
<br />(Name Typed~ Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />Kevi n 1. Roberts
<br />who is personally known to me or who has
<br />produced N/A
<br />as idantification and who did/did not
<br />taJ.-;.,e an oath.
<br />~'-^~
<br />(Signatwe)
<br />_Jane.t Rhrk-wpll
<br />(Name Typed~ Printed .or Stamped)
<br />NOTARY PUBLI'C
<br />
<br />~~~'"
<br />,\
<br />.1.0(
<br />_>:."~
<br />_!..:.:., ,
<br />
<br />Notary Public. State of Florida
<br />CA .cn BLACKWELL
<br />My Ccmm. Exp. 9.1 8.96
<br />Comm. f-iO. CC 228545
<br />
<br />~~t,
<br />~
<br />
<br />Notary "'ubl\c. State of Florida
<br />.lA 'cEl GLACKWELL
<br />M~'- Comm, Exp. 9.13-96
<br />Comm, 1'10. CC 228545
<br />
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