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<br />""'........,...4.....V........., VJ.; L'LJ..U..l,J....l ri.J.:J:..L.Li.L""1.V.l...1.
<br />
<br />A. NOTICE OF DEED RESTRICTIONS .
<br />Tbe'pndersigned understands that this perJit lay be subject to "deed restricti6nsll IIbicb lay be,iliQre restrictive than City
<br />regulations. Tbe undersigned assUles responsibility for cOlpliance lIith any applidable deed restrictions.
<br />
<br />B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake lIork, they lay be required to be licensed in accordance lIitb
<br />state and local regulations. If the contractor is not license4 as required by lall, both the owner and contractor lay be
<br />cited for a lisdeaeanor violation under state lall. If the owner or intended contractor are uncertain as to what licensing
<br />requireaents aay apply for the. intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />Furthermore, it the owner has hired a contractor or contractors, be is advised to hav.e 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 lIork. If the contractor lIishes you to sign
<br />as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting 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 - Haaeowner's Protection
<br />Guidell p~epared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
<br />.ownerll, I certify that I have obtained a copy of the above described docUlent and prolise in good faith to deliver it to the
<br />DownerD prior to cOlleOceaent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT .
<br />I certify that all the inforlation in tbis application is accurate and that all work will be done in coapliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby lade to obtain a per.it to do work and installation as indicated. I certify that no work or
<br />installation has COIIenced prior to issuance of a perlit and that all 1I0rk lIill be perforJed to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governlental agencies lay apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are notlilited to:
<br />t DepartJent of Environaental Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Water Hanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t Arly Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />t US EnvirODlental Protection Agency - Asbestos abatBlent .
<br />I also certify that, if fill laterial is to be used in Flood ZOne IIA' or "A,etc.", it is understood tbat a drainage plan
<br />addressing a DCOIpensating volUleD will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued sball be construed to be a license to proceed with the 1I0rk and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued shall becoae invalid
<br />unless the work authorized by such perlit is cOllBOced within six IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of slxlOnths after the tile the work is couenced. One 90 day extension of tile, Jay be
<br />allowed for the perJit with fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned.
<br />WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO~NCEHENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVKKKNTS TO YOUR
<br />PROPERTY. IF YOU Ilft'BND TO OBTAIN FIHANCING, CONSULT WITH YOUR-LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COHHENCEHElft'. JOBS UNDER $2,500 IN VALUE 00 NOT NEED TO RECORD AND POST A IINOTICE OF COHHBNCEHENT".
<br />
<br />~~ ~:: ~--
<br />
<br />SIGNATURE: OWNER OR A SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA 1]
<br />COrnftYOF ur~
<br />The foregoing inst~t was acknowledged
<br />before ,me this J S""hl'J' 19~ by
<br />
<br />/ nJ
<br />'who is personally known to or who has
<br />produce
<br />as identification and who did/did not
<br />take ~ath. < jJ jI' _
<br />A~~<~
<br />(Signature)
<br />
<br />
<br />STATE OF FLORIDA 1')
<br />COUNTY OF fL:.... Q,.~o
<br />The foregoing instrument was acknowledged
<br />before me this ISh c7'}y;d' ' 19~ by
<br />
<br />~-_. ~f) / IV ~_ Y n /I rtJ
<br />who is personally own to meJor who has
<br />produced
<br />as identification and who did did not
<br />take an oq. 7~
<br />
<br />(Signature)
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Nam~ Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~..y ~
<br />.^ DONNAM SINCLAIR
<br />* * My Commission CC382619
<br />Expires Jun. 14,1998
<br />~IJFA.~'"
<br />
<br />~..y ~
<br />*ii.
<br />
<br />~IJFA.~'"
<br />
<br />DONNA M SINCLAIR
<br />My Commlsalon CC3826111
<br />Expires Jun. 14. 1998
<br />
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