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<br />COND 1: (' ''J1'4~: C ,::- pi:::: '." I T '-iFF I D{~'v I T
<br />A. NOT I CE OF DEE;) RESTR I C- .. ;]l'Jf:i
<br />The und~rsigned understa~ds that this penit--;';:.: be sUJject tr. '~e!d restrictions" which Day be ~o;,e re~trictive than City
<br />regulatIons. The underSIgned assules responsibility for co.p1i3nce ~itjl any applicable de~d r~stricti~ns.
<br />
<br />B . UNLICENSED CONTRACTORS0tND COI'HRACTDR F:ESPONS I B I LIT I E:~
<br />If the ollner has hired a contractor or contraci:ors t,,-;j~':!:'ft;~~ lIork, they ma,' be required to be {'icensed in accordance IIi th
<br />state and local regulations. If the contracttr i~not iicens~j a~ required by law, b6th the ollner and contractor lav be
<br />cited for a lisdeleanor violation under state laH. If the ONr;~r or intended contractor are uncertain as to what lic~nsing
<br />requirelents lay apply for the intended work, they are advised t& contact the City of Zephyrhills Building Depart.ent, (813)
<br />788-6611.
<br />
<br />Furtherlore, if the ollner has hired a contractor or cDntractofs, he is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for which thlY 1I~11 be responsible. If you, as the ONner sign as the contractor,
<br />you are indicating that you, rather than the contr~ctor, are responsible for the work. If the contractor lIishes you to sign
<br />as contractor that lay be an indication that he is not properly jicensed and is not entitled to perlitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES,
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a c~': of "Florida's Construction Lien Lall - HOleollner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
<br />"ollner., I certify that I have obtained a copy of the above d' :crihed doculent and promise in good faith to deliver it to the
<br />"owner" prior to cOllencelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIl
<br />I certify that all the inforlation in this application is accurat2 u~d that all work will be done in cOlpliance Nith all
<br />applicable laws regulating construction, zoning, and jand development.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of. a pertit and that all work will be performed 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 governmental agencies tay apply to the intended work, and that it is
<br />IY responsibility to identify ~hat actions I .ust take to be in rOlpliance. Surh agencies include but are not limited to:
<br />I Departlent of Environeental ReQulation - r.ypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
<br />Water/Wastewater Treatment
<br />I Southllest Florida Water ManaQelent District - ~p.lls, Cypress Barheads, Wetland Areas, Altering Watercourses
<br />f ArlY Corps of EnQineers - Seawalls, Docks, Navigilble Waterways .
<br />I Departeent of Health L Rehabilitative Services, Environlen~~l Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />I US Environlental Protection AQenry - Asbestos abate.ent
<br />I also certify that, if fill .aterial is to be used in ~lood Zone "A" or "A,etc.', it is understood that a drainage plan
<br />addressing a "coepensating volule" lIill be subeitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to pereit issuance. ~
<br />
<br />A permit issued shall be construed to be a licens~ 1L proceed with the lIork and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor 5h~ll i5s~~:,~~ of a perlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, constri:ltion, or violations of any code. Every pertit issued shall becole invalid
<br />unless the Nork authorized by such perlit is cOJl2nc?d withiB siy Booths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six lonths ~~ter {h~ tile the 1I0rk is comienred. One 90 day extension of tile, lay be
<br />allolled for the pertit with fee charge of $15.00. :he ~xtension shall be requested in IIriting to the Building Official. An
<br />approved inspection,lust be logged during each six tonth periorl. or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCr.MtNT MAY RESULT IN YOUR PAYING THICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CiJ~SULT mTH YIJuH LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COM"~~ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT'.
<br />
<br />~'xY~ . :rM:J; (t-ie..
<br />
<br />;)..;t~~ if &!!.~_ ~ p ~~
<br />SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF flA<; C 0
<br />The foregoing instrument was acknowledged
<br />befol-e me th i s ..li.:.L..i.!i.-" 19.1l by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF hJ 5NJ
<br />The foregoing instrument
<br />befcq-e me th is Feh 161
<br />
<br />was acknowledged
<br />, 19~ by
<br />
<br />{!{lJ 1)?f}./lfi2-____
<br />or Starop~c:
<br />
<br />/?/,/n,J\/' ~ IJ'A,--T/>>o/le 01' .7/llJ .:LAK',
<br />who ili F/Ql-=b:n:all'/ I:nc\.'n to .lIe or ~ojho has
<br />produced Fl,M.//JA J)/UIA'?r:" LiceNSe
<br />as identification and who did/~d net
<br />
<br />take&~th~~LJ
<br />
<br />(SisLnature)
<br />.i)AiJAi ~,t.iv,rlw,;n~ (!C:#tJ7tJO'fZ__",_
<br />(Name Typed, Printed or St2mped)
<br />NOTARY PUBLIC
<br />-'-\1 ' . -'~E OF FLORIDA.
<br />MY\:~Ml'H""i"l" ;';XI'mES: Jan. 2~~~&s.
<br />aONDED TlIRU NOTARY PUBLIC UNDER......u
<br />
<br />ROSemR6.J! b-, /)/JtJ/J RNd F/zP'/i?L'~1c. (. hkcL-
<br />who ~ personall y known to me "':- "':~.,~ h.:t~
<br />Aile..
<br />p..reElu"::cJ
<br />as identification and who did/~~d r~t
<br />
<br />take.l~~th r:/ ~
<br />
<br />(SignatLwe)
<br />.2>AMJ./ r= UoO~/;/.I1LJ
<br />(Name Typed, Printed
<br />NOTARY PUBLIC
<br />
<br />.-lOTARY PUBLIC, STATE OF FLORIDA.
<br />~ MY COMMISSION EXPIRES: Jan. 25. 1995.
<br />80NllED THRU NOTARY PUBLIC \JNDEaWlUTBU.
<br />
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