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<br />CONL:; i . "NS OF '-.::r(I' '. I r;y,- I D(:)'''' I T
<br />A. NOTICE OF DEED F:.t::STRICi ,. ,~
<br />The undersigned understands thit this per.its'a) .;-;-;ubjed tll "iJeed rwstrictitns" which IllY be lore rntrictive than City
<br />regulations. The undersign~d assules responsibility for cOlplianc! with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contracto~s to untieTta~~ Ilork, lhey ~ay be required tc be licensed i~ acr.ordance with
<br />state and local regulations. If the. cont'ractor is rloi....l~c~r:s~~ ,,:; 12quired ~y law, both the owner. and contractor lay be
<br />cited for a lisdeleanor violation under state laM. If the OMner or int~nded contractor are uncertain as to what licensing
<br />requirelents lay apply for the intended work, they are advised to con'act the City of lr:~hyrhills Building Departlent, (813)
<br />7BR-bb 11.
<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 "ill be responsible. 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 froperly licensed and is not entitled to peraitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "flurida's Construction Lien Law - HOleowner': Protection
<br />Suidea prepared by the Florida Departlent of Agriculture and C:onsuler Affairs. If the applicant is sOleone other than the
<br />"owner", I' certify that I have obtained a copy of the above described document ~nd promise 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 Nork Hill be done in cotpliance with .all
<br />applicable laMS regulating constructi~n, zoning,and land developtent.
<br />
<br />Ap~lication 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 perlit and that all work will be perforled to leet standards of all laMS
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand tha~ the regulations of other gover~mental agencies lay apply to the intended worK, and that it is
<br />.y responsibility to identify what actions I lust take to be in co.pliance. Such agencies include hut are not lilited to:
<br />f Departlent of Environlental ReQulation - Cypress Bayheads, W~tland Areas and Environmentally Sensitive lands,
<br />Water/Wastewater Treat.ent
<br />f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways .
<br />f Departlent of Health ~ Rehabilitative Services. Environment,l Health Unit - Wells, Wastewater Treataent, Septic TanKS
<br />f US Environtental Protection AQency - Asbestos abate.ent
<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 />:ld~res:;jnq il 'c!),ap~n;,..LHg fiJlil~~a ;,ili !!!' ":::~;:;: :~~ \.":d:h IS :lr"!1~rI'!U by C!. profPss';(.nal Enqiileel registereo in the State of
<br />Florida prior to pertit issuance.
<br />
<br />A ~j:~rv0Y\~t 'o+k~
<br />SISNATURE: OWNER OR AGENT
<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 froD thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beeoae invalid
<br />unless the work authorized by such pertit is co..enced within six lonths of issuance, or if worK authorized by the pertit is
<br />suspended Dr abandoned for a period of six lonths after the tile the work is cO&ienced. One 90 day extension of tile, lay be
<br />allowed for the perlit with fee charge of $15.00. The exten~ion shall be requested in writing to the Building Official. An
<br />approved'inspection lust be logged during ear.h six lonth pe_riod,_o..r theprojed wi 11 be considered abandoned.
<br />WARNING TO OWNER: YuUR FAILURE TO RECORD A NOTICE OF COHllENCEHENT HAY RESULT IN YOUR PAYING THICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FlNANCINS, CONSULT WITH YOUR ltNDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMHENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />
<br />4!-rJ,~
<br />SISNATURE: ONTRACTOR
<br />
<br />STATE OF FlORI~
<br />COUNTY O{ r.4s f'o
<br />The foregoing instru~~nt was acknowledqed
<br />befc.re me thiS;?If/f7~, 19.:23 by .
<br />
<br />f!Le/!/ICt 0. /lIEH.-t'/(IIfi1 ____
<br />~hn i~ "~r~on~11v known tn mp nr who h~~
<br />produced - d/' J V~Ji'f_ <, L I (' P -.t:LS.e._ -
<br />as id ntification whD did/did not
<br />tak n oath.
<br />
<br />STATE OF FLORIDA i~
<br />COUNTY OF ~~~~()
<br />The foregoing instrument was acknowledged
<br />befc'l-e me th i s c5?1( ~~. , 19 ~ by
<br />
<br />
<br />\',0 is personally
<br />prOduced -
<br />as identificat.
<br />take an oath
<br />
<br />
<br />me or l'lho has
<br />
<br />(Sig~ture) r.1
<br />U/V/I//tE H/P?4N.
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
<br />(SignatLlre~
<br />vt /1/ t'"
<br />(Name Typed, Printed
<br />NOTARY PUBLIC
<br />
<br />d#4/f
<br />01- Stamped)
<br />
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<br />
<br />-fJ
<br />
<br />{~, ! ,,:~;{?~i~IT1:tn,:;:t,
<br />
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