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<br />A F' R'- :2 1 - '3 4- T H U
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<br />9:05 GENERAL HOME DEVELQPMENT P.0:2
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<br />COt'!I)! T;[ OI'lS OF PERI''ll T AFF 1: D{W I T \
<br />A. ~OTIC~ OF DEED R~ST~ICTIONa ' ,
<br />The underslgnt'd und~rstand$ that this p~;:;a IA~Y lit 5ubhd to "dtl!d n$tdction~~ tihlch uy bI lor. ~c~trictlvf than City
<br />'regulations. Tht undrrslgned assU~r~ rr,po~5ibility for co.pliant' Mlth any appl'c~hl& deed rcslr\t\lons.
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<br />9. UNL I CENSED CONTRACTC,lr,S AND CONTRACTOI:': REse..9N~L~I LIT I E:!2,
<br />If the o~nQr his hlr~d I contractor or c~ntractcr' to undQrt~kQ ~brk, they Day b~ required lo be lltensed In iccordancl with
<br />s\~tl! and local regulations. If the'{ontractor l~ not liccn~cd as required by laM, both the OMner and contractor lay bt
<br />cited for I .!sde.canor violation under $tate law. If t~~ owner or intended con~ractor are uncertain as to what licensing
<br />require_lnts .~y apply for the intended ;Jcrk, they art advised to contact the Ci~y of Zcphyrhills BUilding Departaent, tB131
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<br />7SB-Ul1.
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<br />FurtherlDre 11 the o"n~r has hired a t~otractor or contractors, he is advised to have th~ contractor Is) sign portions of the
<br />'contr~ctor'Se(tions' of this ~pplicaticn for Mhlch they Mill be responsible. If you, as the owner sign as the contractor,
<br />you Ire indicating that you, rather th~n the contractor, art responsible for th~ Mort. If the contractor _ish!s you to S\9n
<br />. as contractor that Day be an indication that he is not pr~perly licensed and is not entitled to per.ittin; privileges in. the
<br />City of Zephyrhills.
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<br />C. YRANSPORTATION IMPACT ~EeS AND UTILITY CONNECTION FEES
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<br />D. CONSTRUCTION LIEN LAW (CHAPTER 718~ FLORIDA STATUT~S, AS AMENDED)
<br />r certify that I, the applicant. have b~;;provided with a tOpy of ~Florida'5 Construction Lien La~ - H~.eoNner'l Protection
<br />Guide' prepared by the Florida Depart.ent of Agriculture and Consuler Affairs. If the,applicant Is SOleone other than \ht
<br />'oNner', I certify tho~ I have ~btain~d 0 copy of the above described docu~ent and promise in qood faith to deliver It to the
<br />'o~ner' prior.!o COI.eneelant.
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<br />, E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infor.ation in thiS application is accurate and that all work "ill be don~ in cOlpliance Ni\h all
<br />applicable laMS re9ulatin9 tDnstruction, ~ohin9, and land developlent.
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<br />Application is hereby I.de to obtain a p~r.it to do Nork and lns~a}lation as indicated. I certify that no .ork or
<br />In~tallatlon has cOII~nced prior to issuJnc! ~f a p~rlit and that all work will be per(or.ed to .eel standards of all J~w~
<br />regulating const~uctlon. City codcs, ton~ng regulations, and land develDplent regulations in th. jurisdiction. 1 .150
<br />certify that I understand that the r~9ulation5 of other govern.ental agencies lay apply to the intended Mork, and that it is
<br />IY responsibility to identify IIhat adi~I\5 I lust take to be in cOlpliant!. Such agencies lntludr but are not nalted to:
<br />. Deoarllent of Environ.ental RQqulJticln - Cyprc55 Bayheads, Wetland Areus and Environ.entally S~nsitlve Lands,
<br />, Water/Mastewater Trcdt~rnt
<br />t Southwest Florida ~ater M~n~ge5cnt District - ~~lls, Cypress Bayhcads, W~tland Areas, Alterin9 Watercourses
<br />t AT'Y Corps of EnQineers . Seawalls, D~c.5, Navi~;ble U.terNays .
<br />t DeDart.ent of Health , Reh~bilitative S~rvire51 Environ.ental Health Unj~ - Wells, Wastewater Treat.ent, Septic Tanks
<br />t US EnvirDnlental Protection AQcncy ~ A;bestos abatement
<br />I also certify that, if fill .aterial is to be used in Flood Zone 'A' or 'A,etc.~, it is understood that a drainage plan
<br />addressing a 'colpensating volulc' Kill ~e sublitled which is prepared by a professional en~ineer registered in the Stale or
<br />Florida prior t~ perait issuance.
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<br />A per.it issued shall be con5trued to he a licenge to proteed Mith the work and not as authority to violate. clnt~l alter, or
<br />set asid. any provisiDns of the tethnitdl codes, hor shall issuance of a perlit prevent the B~ilding Official frOI thereafter
<br />requiring. correction of errors in pla~,;, construction, or violations of any code. Every pertit issued shall beeo.e invalid
<br />unless the Nork authori:ed by such perDi~ is co.i~nced ~ithi,n six Bonths of issuant!,' Dr if Mort authQrized by the per.it is
<br />suspended or abandoned for a period of 51~ Dontht after the tile the Hork is co..anced.' One 90 day extension of ti.e, lay be
<br />allo~td for the per.it with fee char9c or ~15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection ~ust be logged durin) each sit tonth p!riod, Dr the projett lIill be considered abandoned.
<br />WARNING TO O~tlERI YOUR fAILURE 10 RECOflil ~ NOTICe OF COH~ENCEHENT MY RESULT HI YOUR PAYING TWICE FOR IHPROYEHEllTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FIHAI~I~WG, conSULT WITH YOUR LENDER OR AN ATTORNEY DEFORE RECORDING YOUR 1I0nCE OF
<br />COHKEHCE"EHT. J08S UNDER $2,500 IN V~LUi: 00 HOT HEED TO RECORD AHD POST A 'NOTICE OF COMHENCE~EHT".
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<br />SIGNATUREs OWNER OR AGENT
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<br />- '. -'. _*'llII....-J L ....-,.,
<br />SIGNATURE, CONT~ACTOR
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<br />was ~cknowledged
<br />, l\J_ by
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<br />STATE OF FLORIDA
<br />COUNTY OF .
<br />The foreg~ing instrument
<br />befc.,"e me this
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me \pis
<br />
<br />was acknowledged
<br />1 19_ by
<br />
<br />who is personally known to m~ or who h~~
<br />produced
<br />as identification and who did/did not
<br />take a.n oath.
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<br />~ho is p~r$Dn~lly known to me or who has
<br />produced
<br />as id~ntification and who did/did not
<br />tal{e an oath.
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<br />(Signature)
<br />
<br />(Signature)
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<br />(Name Typed, Printed or Stamped)
<br />NOTARY 'pUBLIC
<br />
<br />,(Name Typed, Pr inted to 1- StMfled)
<br />NOTARY PUBLIC
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