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<br />Cm-!I'I T -: '
<br />.~. . r~L'JT I;:E.,J..~;':'- j-..E::;.~'\). RESJ...3}~~-"- }J7.~_'~0.
<br />The undel signed undersbnds ~hat thi!> p~r.itl;} bE ,ubir-d
<br />regulations. Th~ undf:rsigned assules H.!spOrF":::!it', ',. ."'!fi!
<br />
<br />::.'c'1IT M.F::'u{WIT
<br />
<br />:Jjp'~rj restriction~. ;.h;ch lIlay be lore restrictive than C'i,ty
<br />~.,[, ~~th any appl~:able deed restrictions.
<br />
<br />B. UNL I CENSED CQNTRACTOF:S ';~XL~d.r":;;f,;,CTOR RESF'ONS 13 I LIT I ES
<br />If the DlIner hilS hired a contractor 0- r;:.ntrad.'ls ;~ '~r;_iLl! t1ork, they lay be requirl;!d to be iicensed in accordance with
<br />state and local regulations. If the contractor i~ n~~ llcensed as required by law, both the owner and contractor lay be
<br />cited for a lis~eleanor violation under sute 1.,w. If tl.;. ,'loIl1I!r or intel~dec contr;;ctor are uncertain as to what licensing
<br />requirelents lay aprly for the int~n!je!l "rln:, i:li~y are ad'!ise~' to contact thE" City of Zephyrhills Building Deparhent, (8131
<br />79B-bbl!.
<br />
<br />Furtherlore, if the owner has hired a contractor or contr~ctDi!, he is advised to have the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for which they ~,~l be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contrQ~tor, are fPsponsible for the work. If the contractor wishes you to sign
<br />as contractor that lay be an indication that he is not prcp~rI: licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrhills.
<br />
<br />c. TRANSPORTATION IMPACT FEES AND UIILITY CONNECTION FEE~
<br />
<br />D. CONSTRUCTION LIEN LAW ~CHAP~:.R 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been prc~;ded WIth a copy of 'FIorida's Construction Lien La" - HOleowner's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture aad ~Dnsuler Affairs. If ~he applicant is sOleone other than the
<br />'owner', I certify that I have obtained a ropy Dr ~he ahove described doculent and prolise in good faith to deliver it to the
<br />.owner' prior to cOllencelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in complianCE with all
<br />applicable laMS regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby lade to obtain a per~it ~o do Bork and \:~t31Iation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of. a perli~ ~nd ~hat all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning re~uIations, and lJnd developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulation~ of other gov~r'iJentdl agencies lay apply to the intended ~ork, and that it is
<br />IY responsibility to identify what action5 I ~ust ~ake to b~ '1 CDlpliance. Such agencies include but are not liaited to:
<br />f Departlent of Environlental ReQulation - Cypress aa~~E?~s. ,~,land Areas and Environ.entally Sensitive Lands,
<br />Water IlIast;:uater "I r~.: ~;;,!ilt
<br />t Southwest Florida Water "anaQp.lent District, - WeJls; Cypre~5 D~yheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of EnQineers - Seawalls, Docks, ~~vipa~i~ ~dtpr~~vs '
<br />t Department of Health l. Rehabilitative Servi.t!~'_'.!lviror",e!l' .'- Health Unit - Wells, Wastewater Treah~~t, Septic Tanks
<br />f US Environ.ental Protection AQ:'ncy - Asbest:s ,I ;'tl:c, ~nt
<br />I also certify that, if fill laterial is to be '..~~ ;1' Flood Zone 'A' Dr 'A,etc.', it is understood thai a drainage plan
<br />addres~iilg a 'rolpensating volule" Mill be 3ubliiv'j whlch is preDared by a professional engineer regist~ed in the State of
<br />Florida prior to perlit issuance.
<br />
<br />~ perlit issued shall be construed to be a Jicense to ~I or~e~ with the Mork and not as authority to violate, cancel alter, or
<br />set aside any provisions of the terhniral codes, r0 5hal! ir:,ildnce of a perlit prevent the Building Official frot thereafter
<br />requiring a correction of errors in plans\ construction, ~r .iolations of any code. Every perlit issued shall becote invalid
<br />~nless the work authorized by such pertit ~s c~lt.~nced within six ~onths of issuanre, or if work authorized by the perlit is
<br />5uspended Dr abandoned for a period of sl^ ionth: -f"cr thE til2 the work is cOI.enred. One 90 day extension of ti~e, lay be
<br />illowed for the perlit with fee charge of $15.00. Tn~ exten5inn shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six lonth per '~l ~r the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOrICE nF COHK=~,;CK~~r KAV RESULT IN YOUR PAYING TWICE FOR IMPROVE~ENTS TO YOUR
<br />PROPERTY. IF YOl, INTEND TO OBTAIN FINANCING, CONSULT tHlH f;tlR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TL RECORD AND POST A 'NOTICE OF COMMENCEMENT'.
<br />
<br />
<br />If2Q~
<br />
<br />SIGNATURE: C TRACTOR
<br />
<br />
<br />STATE OF flORIDA ~r
<br />~OCNTY OF. ~~J ~~
<br />The f~egoing instrument was a~nowledged
<br />before me this"A-N. :;~ 19-12. by
<br />
<br />_l....o\s 5. Q,R~~
<br />who is personally kno to me or
<br />produced
<br />as identification and
<br />
<br />~h7.
<br />
<br />(-. gnat'.!n,,)
<br />~g.J."l.st:Ji. YJ1 '
<br />(Name Typed, P.inted
<br />NOTAF,,: PUBLIC
<br />
<br />
<br />Notary Public, Statu of Florida at i..ar&"
<br />t.~ eommissicn Expire$ Aug. 28. 1~
<br />~. .1l:-cc,0430\ol:J
<br />
<br />STATE OF FlORIDA '];)
<br />COUNTY OF ~~ ~
<br />fhe foregoing instrument l>Ja~ acknDLoiledged
<br />befol-e me this J~' ~ ~ , 19~ by
<br />
<br />..Jd., ,4, f\j eu.j~
<br />who is per~Dnally kno n to me Dr who has
<br />produced
<br />as identification and did/did not
<br />
<br />~hr_ ~
<br />;:)).g tu',-e)
<br />. Lr;, fV'']jt;..---+h Yh, '7<,v..J'J ~ t... L
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />NoIaIy Publi~, State of Florida at Large
<br />U)' Commission Expllea Aug. 28. ,.
<br />~ . ':f:f:- CC{) V 3 0 '\c-~
<br />
<br />
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