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<br />Tbe undersigned understands that this perlit lay be subject to "deed restrictions" wbich lay be lOre restrictive than City
<br />regulations. fbe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they JaY be required to be licensed in accordance w:,th
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor JaY be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensin~1
<br />requireJents lily apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the OIner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />RContractor SectionsR 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 wisbes you to si.gn
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to perlitting privileges in tbe
<br />City of Zepbyrbills.
<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, bave been provided with a copy of RFlorida's Construction Lien Law - lIoIeoImer's ProtecUon
<br />GuideR prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is SOJIl!OIle other than the
<br />Rovner., I certify that I bave obtained a copy of the above described docUJent and prolise in good faith to deliver it to the
<br />"ownerR prior to COIIeDCeJent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforJation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developleDt.
<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 bas ~ced prior to issuance of a perli t and that all work will be perforted to Ieet standards of all lawll
<br />regulating construction, City codes, loning regulations, and land develo(llent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIDlleDtal agenCies laY apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lUst take to be in coapliance. Such agencies include but are not lilited to::
<br />t Departlent of Envirolllel1tal Regulation - Cypress Baybeads, Wetland Areas and Bnvirolllel1tally Sensitive Lands,
<br />Water /Wastewater !reablent
<br />t Southwest Florida Water Managl!Jellt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArtY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health & Rebabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater freatlent, Septic fants
<br />t US EnvirODJeDtal Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood Zone "AR or "A,etc.", it is understood that a drainage plan
<br />addressing a RCOJpensating volUJeR will be sublitted wbich 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 sball issuance of a perlit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery pertit issued shall becme invalid
<br />unless the lIOrk authoriled by such perlit is COIIIeIlCed within six JOnths of issuance, or if work authorized by the Perlit is
<br />suspended or abandoned for a period of Sil JODtbs after the tile the work is COII811ced. One 90 day utension of tile, laY be
<br />allowed for the perlit with fee charge of $15.00. fbe utension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each six JODth period, or the project will be considered abandoned.
<br />WARMING '1'0 OIlIER: YOUR FAILURE fO RECORD A NOIlCE OF COHMDCBIIIN'l MAY RESULf IN YOUR PlYING DICE FOR IIIPROVIIImS fO YOUR
<br />PROPBR'IY. IF YOU IIft'BHD fO OBfAIN FINANCING, CONSULf WlfH YOUR LBNDER OR AN AnoRDY BIPORE RECORDING YOUR DICE OF
<br />COHMBNCEMBNf. JOBS UJmER $2,500 IN VALUE DO NOI NBID fO RECORD AND POSf A 'NOIlCE OF CCJOIBIfCBllDf'.
<br />
<br />SIGJIA!URE: OOBR OR AGB1ft'
<br />
<br />.~.....---.e 6'~('1 po~
<br />SIGJlAfURE: COJlfRlCfOR
<br />
<br />SfAfE OF FLORIDA
<br />ccum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />Sf An: OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19_____ by
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an o~th.
<br />
<br />who is personally known to me or who bas
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name. Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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