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<br />CD"~ I T I uf-.lS OF PEt~1'1l T AFF I DA'v' I"'"
<br />A . NOT I CE OF DEED RESI . CT IONS
<br />The undersigned understands that this perlit 'lay be sub~2c~ to '6~ej restrictions" which lay be .o~p. restrictive than City
<br />regulations. The undersigned assules responsibility for cOlpli~nce with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor ~r F~~tractors to undertake work, they lay be required to be licensed in accordance with
<br />state and local regulations. If the contractor is ~ot ~icensed as required by law, both the owner and contractor lay be
<br />cited for a lisdeleanor violation under state IaN. If the owner or intended contractor are uncertain as to what licensing
<br />requirelents tay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departtent, (813)
<br />788-6611.
<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 will 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 tay be an indication that he is not properly licensed and is not entitled to pertitting 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 copy of "Florida's Construction Lien Law - HOleowner's Protection
<br />Guide" prepared by the Florida Depart.ent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
<br />"owner", I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it to the
<br />"owner" prior to cot.encelent.
<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 cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby .ade to obtain a perlit to do work and installation as indicated. I 'certify that no work Dr
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perforled to teet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developtent regulatio,ns in the jurisdiction. I also
<br />certify that I understand that the regulations of other governtental agencies may apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lust take to be in cotpliance. Such agencies include but are not litited to:
<br />f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />WaterlWastewater Treataent '
<br />f Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f ArlY Corps of EnQineers - Seawalls, Docks, Navigabl~ Waterways
<br />f Departtent of Health ~ Rehabilitative Services. Environmental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f US Environtental Protection AQency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood lone "A" or "A,etc.", it' is understood that a drainage plan
<br />addressing a "cotpensating volule" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A pertit 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 pertit prevent the Building Official frot thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid
<br />unless the work authorized by such pertit is COI.enced within six tonths of issuance, or if work authorized by the pertit is
<br />susp~nded or abandoned for a period of six lonths after the tile the work is rOllenced. One 9Q day extension of tile, lay be
<br />allowed for the pertit 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 tonth period, or the project will be considered abandoned.
<br />WARKING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO"KENCEKENT "AY RESULT IN YOUR PAYING TWICE FOR IKPROVEKENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />CGKKEIICEKENT. JOBS UNDER $2,500 III VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />
<br />~ue~ {J -II ~~;--
<br />
<br />SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUIITY OF P n A..r-o-
<br />The foregoing instrument was acknowledged
<br />before me this &t~ /1 . 19~ by
<br />
<br />yJ";,,,i- (' H f)RL 'Es ~ , jil?fJClz
<br />who is personally known to me or who has
<br />produced D L :#
<br />as identification and who did/did not
<br />take an oath.. ~ /
<br />?-('J _~-<~ .J'X.Ah><4-
<br />(!Si~nature) ,
<br />,odd J-Iu vi ('") r I<
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF P ,.. ~ L .A--'
<br />The foregoing instrument
<br />befcq-e me th i s ~I /1
<br />
<br />
<br />\.-las ackno\.-Jledged
<br />, 19 -5?1.L by
<br />
<br />who is er~onall or who has
<br />produced
<br />as identification and who~did not
<br />
<br />~a~/~/41~
<br />~~ature) v
<br />"/'odd 1-/11-1.// DC/<:
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />..***-.
<br />.,~IolW~" OFFICIAL SEAL
<br />~_) TODD JOHN HAYl.OCK
<br />' My Comm'tslon Explr..
<br />. July I'. ItCUI
<br />~ClI'~' Comm. No. CC ;110'0
<br />......
<br />
<br />...~*~ OFFICIAL SEAL
<br />I ~\ TODD JOHN HAYLOCK
<br />: ' ! My Commission Expire.
<br />\ ! JUly 27. 1996
<br />"'~~OI'f~*. Comm. No. CC 218090
<br />..........
<br />
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