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<br />---- --"--"~---"'--"-'-r--- -.. -_.,--~--- - .-___ -_______ ...,__ _..~_,.__....____._,;_ _._"
<br />regulations. fbe unclersigned asSOles responsibility for COIpliance litb any applicable deed restrictions.. : .
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake lad, tJJer .y be required to be liClDSed in acc:ordance lith
<br />state and local regu1atiOJ1ll. If tbe contractor is not licensed as required by lu, both the 0IIIIer and contractor .y be
<br />cited for a lisdl!leanor violation under state law. If the 0ID8I or intended contractor are uncertain as to what liClDSing
<br />'requirelleDu .1 apply for the intended IOrt, they are advised to contact tbe City of Zepbyrhil1s Building Departlent, (813)
<br />788-6611. '
<br />
<br />Furtbenore, 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 Ibieb tbey will be responsible. If JGU".18 the OIrIler iip 18 the c:ootractor,
<br />you are indicating that you, rather than the contractor, are responsible for the IfOrk. If the contractor wi8hes fOIl to sign
<br />as contractor that .y be an indication that he is not properly liClDSed and is not entiUed to pmitting 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 AMEHDED)
<br />I certify that I, tbe applicant, have been provided litb a copy of 'Plorida's COnstruction Lien LaI ~ lIcNoImer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUll8l' Affairs. If the applicant ia 8OIl!ODI other than the
<br />'OlDer', I certify that I have obtained a copy of tbe above described docuIent and prolise in good faith, to deliver it to the
<br />'owner' prior to COIHDCl!leDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all tbe inforaatlon in this application is accurate and that all IOrt lill be done in COIpliance with all
<br />applicable 1_ regulating construction, loning, and land develOplellt.
<br />
<br />Application Is hereby ule to obtain. a perlit to do IfOrk and installation as indicated. I certify that DO lIIOft or
<br />installation lias CDIeJ1ced prior to issuance of a pmit and that all'lOrl lill be perfOl'led to _t staDdard8 of all Ius
<br />regulating construction, City codes, loning regulations, and liIDd developlll!llt regulations in the jurisdictilll. .1 also
<br />certify that I understand that the regulations of other goveruental agencies .y apply to the intended lIIOf1, and that it ia
<br />IY responsibility to identify lbat actions I lust take to be in COIpliance. Sueb agencies include but are not lilited to:
<br />t Departlent of Invirouental Regulation - Cypress Bayheads, lIeUand Areas and InvirODlentally Sensitive Lands,
<br />lIater/llasteltater freatlent
<br />t SoUthlest Florida lIater HanagelleDt District - lIells, Cypress Bayhea4s, lIetland Areas, Altering lIatercourses
<br />t AllY Corps of Engineers - Sealalla, Docks, lIavigable lIatenays
<br />t DePaItlent of Health' Rehabilitative Services, InvirODlelltal Health Unit - lIells, lIasteuter lreatlent, Septic lants
<br />t US InvirODlental Protection Agency - Asbestos abatl!ll!llt .
<br />I also certify that, if fill uterial is to be used in Flood loDe 'I' or 'I,etc.', it ia understood that a drainage plan
<br />addrl!8Bing a Icmpensating vol_' will be sublitted which is prepared by a profl!8Bional engineer registered in the State of
<br />Florida prior to perait issuance. '
<br />
<br />A perlit issued shall be construed to be a license to proceed lith the 'IOrt and not as authority to violate, canc:e.l alter, or
<br />Set aside any provisions of the technical codes, nor shall issuance of a penit prevent the Bulldint Official fa tbereafter
<br />relJUiring a correcUOJ1 of errors in plana, constructlOJ1, or vlolatioua of any code. Ivery pera1t Issued aIIall becme invalid
<br />unless the worl authoriledby such perlit is co.enced WiWD aillODths of issuance, or if.work authodud hI the pmit is
<br />suspended or abandoned for a period of sillODths after the tile the lIIOflls ~ced. ODe 90 day UtensiCll of tile, .y be
<br />allGled for the perlit lith fee charge of $15.00. fhe utension shall be requested in lriUng to the, BuiWDg Qf~lcial. An
<br />approved inspection .ust be logged during eaeb sil IODth period, or the project will be considered aNQI1oned.
<br />IfUJfIIfG ro 0IfDR: YOUR FAILURE ro RICORD 1lf00lCE OP alllllJlCIIIIIIf lilY RlSULr 111 YOUR P1YIJIG IllICE PCIlDlPlOVlllllS ro YOUR
<br />PROPIRIY. IF YOU II'fDD fO OBfW FIDIICDG, COISDLI IUD YOUR LIIIDIR 01 II AIfOBIIY BIFOJII DmBDIIG YOUR JOIlCE OF
<br />aJlKDCEIIIIfI. JOBS UlIDIR. '2,500 III VALUE DO IIOt 11110 10 RICORD .IIID POSf A. 'IfOtICl OF CCIIIDCIIIIIf'.
<br />
<br />m. ~./l)~
<br />
<br />SIGIIA!URI: ~ IGDI
<br />
<br />SIGllAfURI: COIWCIOR
<br />
<br />SIArE OF FLORIDA
<br />coum OF
<br />The foregoing instru.ent was acknowledged
<br />before me this , 19_ by
<br />
<br />Sf AD OP FLORIDA
<br />coum OP
<br />The foregoing instrullent was acknowledged
<br />before me this. , 19 ' ' by
<br />
<br />who is personally known to lie or who, bas
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />who is personally known to _ or who bas
<br />produced
<br />as identification and.whodid/did not
<br />take an oQ.th. ' .
<br />
<br />(Signature)
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />. (Signature)
<br />
<br />(Name Typed, Printed or Staped)'
<br />NOTARY PUBLIC '
<br />
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