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<br />SiJ:'L) IT:r ONS OF PERI'1 I T AF F I Dr,', i'
<br />
<br />A. NOT I CE OF DEr:J)_J3~f!~iJ~ I c:~U [INS
<br />
<br />The undersigned underst,lTd:; that \hi5 PQfoi t Clay be subjed to 'deed rcstridie,ns' rlhich Ii"Y b~ ~e,r~ res\r,ictive than Ci ty
<br />regulations. The undersignrd ~'oS\1~~5 r~sponsibili~fJor. complianc!:' \lith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CgGTP~~TORS AND CONTRACTOR RESPO~I::08I~~J-LtS
<br />
<br />If the owner has hired a cDntractGI' Dr contractors
<br />state and local regulations. If the contractor Is
<br />cited for a nisdrneanur violJtion under state laa.
<br />requirements aay apply fDI' the inl~nded Hork, they
<br />788-6611.
<br />
<br />to undertake \lork1they /flay be required t~ be ,licensed in acc~rdance Hith
<br />not licensed as required by I"", both tho OMner and cDn\~act~r ~ay be
<br />If the D"ner Dr Intended cuntractDr are uncertain as tu Hhat licensing
<br />are advised to contact the City of Zephyrhills Building Depar\~ent, (813)
<br />
<br />Furtheroore, If the o"ner has hired a contractor or cuntractors, he is advised tu have the contl'~ctor(s) sign pOl'tions of the
<br />'Contractor Sections' of this ~r~lication for "hlch they ~ill be responsible. If you, as the Dwner sign as the cDntractor,
<br />you are indicating that YOII, ruther than th!! contractor, are respc,nsible for the Ij[,rk. If the ((,ntr"de,r \fishes ye,u tc. sign
<br />as contractor that ~ay be an indication that he is nut properly licensed ~nd is not entitled to permitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D.
<br />
<br />CONSTRUCTION LIEN LAW
<br />
<br />(CHAPTER 713, FLORID0 STATUTES, AS AMENDED)
<br />
<br />I certify that I, the applicant, have been provi'ded ~ith a COP)' of 'Fle,rida's Cc,nstructic,n Lien L"H - HC,~eGHn2r'S Prc,tedion
<br />Guide' prepared by the Florida Department of Agriculture and Consu~er Affairs. If the applicant is soee5ne other than the
<br />'uwner', I certify that I have obtained a c~py of the above described document and pl'omise in good f"ith to deliver it to the
<br />'uwner' priur to cui~ence~ent.
<br />
<br />; I, .: ~:~. '. . ; :'
<br />
<br />E. CONTRACTOR'S/OWNFR'S AFFIDAVIT
<br />
<br />I certify that all the information in this application Is accurate and that all Hork Mill be done in conpliance "ith "II
<br />applicable la"s regulating construction, zoning, and land developoent.
<br />
<br />Application is hereby ~ade to obtain a percit to'do Hork and installation as indicated, I certify that no "ork or
<br />installation has co~~enced prior to issuance of a permit and that all Hork will be perfor~ed to meet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develupment regulations in the jurisdiction. I also
<br />certify that I und~rstand that the regulations of other governaental agencies may apply to the intended Hork, and that it is
<br />~y responsibility tc, identify iihat actiuns I must take to be in compliance. Such agerldes include bid ;;1 C Iie,t li,1ited to:
<br />
<br />, ,.
<br />I Deoartsent of EnvirDn~ental Reoulation - Cypress Dayheads, Hetland Areas and EnvirDnmentally Sensi live L~nds,
<br />Hater/HasteMater Treatment
<br />I SDuth~est Florida Yater ~anane~ent District - Hells; Cypress Bayheads, Hetland nreas, Altering Hatercour5~5
<br />I Ar~y Corosof Enqineers - Seai1allsl Ducks, Navigable Hater~ays
<br />I Department e,f Health I, B.0!a!0.Et"tive Services, Environfflental Health Unlt_ - lIells, \Iastewater Treat~E"'~. Septic Tanks
<br />I US Envire,n~ental Prc,tHtie", ~<Enc'L - Asbestos abatement
<br />
<br />also certify that, if fill ~atc:riJl is to be used in Flood Ze,ne 'n' e,r 'n,dc,', it is undc-rstc,[,d \1,31 "drainage plan
<br />addressing a 'cu~pensating volume' Hill be sublltted Hhlch Is prepared by a professional engineer registered in the State uf
<br />Florida prior tu per~it issuance.
<br />
<br />A perllit issued shall be ([,nstrued to be a license to proceed llith the "c,rk .,nil nc,t as allthe,rity te, vic.]"ti', caned ~ltu, Dr
<br />set aside ~ny provisiDns Df the technical CDdes, nor shall issuance of a permit prevent the Building Official fro~ thereafter
<br />requiring a cc,rrectic,n c,[ i',rurs in plans; construction, e,r violations (,f any ce,de. Every p['r~it isslld =t,all becc,(e invalid
<br />unless the wOl'k 2uthc,ri;~d by such permit Is ce'llIlIenced lIithin six lUonths e,f issuance, c,r if \le,d, ~\!II,r" Iled bi the rerlit is
<br />suspended ur abandoned fDr a period Df six lIunths after the ti~e the Murk is COlmencEd. One 90 day c~tc~5jOII of ti!!, ,ay be
<br />alle,Hed fe,r the PCI'",;t (I'j;':, fee charge of $15.00. The extensi(,n shall be requcstC'd in liri\ing te, the 8ui\ding Official, An
<br />approved I nspec t i e,n .~us \, be \ C.ggl'l\ dur i I"Ig each si x lIIUnth per i od, or the pre' jt'd Ii ill Ilc c (,ns i dn fd ~balldc'r,[.d,
<br />
<br />WARNING TO OWNEn: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
<br />RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, IF YOU
<br />INTEND TO OO'rAIN FINANCING, CONSULT WITH YOUR LENDER OR AN Al'TORNEY
<br />BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT, JOGS UNDER $2,500 IN VALUE
<br />DO NOT NEED TO REcorm AND POST A "NOT I CE OF CmW1ENCEf1Ef\lT".
<br />
<br />~,. -}(li~ ~
<br />SIGNATURE SIGNATURE ----------- ---------------
<br />_n - -,iWNER-ii- AGENTP';:;;;;;;;::;-,tAi",^"", -- CONTRAC OR I%:"So'';''= ;.q.kitJ
<br />DATE _____:?d-~.i~~--------------,------- DATE ___~q-?:L~--C" --- ------ - - -- -- - ---
<br />
<br />
<br />~~~~~Y o~s A~~rH __~~r;.~~!~'- (J_fpL"~:~'~-
<br />j:: 117l-11..J.;;:.L tJ Jj-, 3/.? c (, ~ \ ,,,'
<br />MY COMMISSION EXPIRCS______________________
<br />
<br />NOTARY AS TO -<1/ II
<br />CONTR ACTOR ____J:;~rdild'~~_(=-'- -:~*.- ~c,,~~--'
<br />" I<-A71-/i-i_ DAJ ~V J5;e <'"(, i.V
<br />MY COMMISSION EXPIRES__________________
<br />
<br />.~---.
<br />ilf'.
<br />I.. ".. i
<br />~--~
<br />
<br />
<br />
<br />... J, BRoWN
<br />My c,+:,,~ ::"frt~.t 1995
<br />Comm. # c;C ()95017
<br />
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