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<br />em.l]) I T lCJj\lS or.::- FER!'1l T ('~Fi-l D('~'v IT,
<br />A. NOTICE OF DEED RESTGICTION~
<br />The undersigned understands that this perait .ay be subject to 'deed restrictions' which ~ay be aore restrictive than City
<br />regulations. The undersigned aSSUle5 re;ponsibility for cOlpliance Kith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or c~ntractors to undertak~ Nork, they may be req'Jired to be licensed in accordance Nith
<br />state and local regulations. If the .'tontrktor is not I icensed as requirell by law, both the owner and contractor uy be
<br />cited for a .isdeleanor violation under state law. If the owner or intended cnntractor are uR,ertain as to what licensing
<br />requireaents aay apply for the intended :lOrl:, they are advised to contact the City of 2ephyrhills Building Deparhent, [8131
<br />788-6611 .
<br />
<br />Furthertore, if the OHner has hired a contractor or contractors, he is advised to have the eontractorlsi sign portions of the
<br />.ContractoT Sections. of this application for which they Nill be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, Tather than the contractor, are responsible for the wOik. If the contractor wishes you to sign
<br />. as contractor that may be an indication that he is not pr~perly licensed and is not entitled to per.itting privileges in. the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES ANp UTILlTY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEi~ ~A~ (CH~PTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provid~d Hith a copy of 'Florida's Construction Lien Law - Ho.~oHner's Protection
<br />Guide. prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is SOteone other than the
<br />.owner., 1 certify that 1 have obtained a copy of the above described doculent and promise in gc~d faith to deliver it to the
<br />.owner. prior to cOllencelent.
<br />
<br />E. CONTRACTOR'S/OWNER'e AFFIDAVIT
<br />I certify that all the infortation in this application is accurate and that all Hork Hill be done in coapliance Nith all
<br />applicable laNS regulating construction, zoning, and land developtent.
<br />
<br />Application is hereby tade to obtain a per.it to do work and installation as indicated. ! certify that no NorK or
<br />installation has cOI.eneed prior to issu3nce of a per.it and that all worK will be perforted to teet standards of all iaNS
<br />regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governaental agencies aay apply to the intended work, and that it is
<br />IY responsibility to identify Nhat actioj)s I lust take 10 be in cOlpliance. Such agencies include but are not Iitited to:
<br />f Departtent of Environ.ental ReQulation - Cypress 9ayheads, Wetland Areas and Environlentally Sensitivp Lands,
<br />Water/Wastewater Treataent
<br />f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f Arty Corps of EnQineers - SeaHalls, Docls, Navigable Waterways
<br />f Departaent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f US Environaental Protection AQency - A:bestos abatelent
<br />I also certify that, if fill .aterial is to be us~d in Flood 20ne 'A' or 'A,etc.', ;t is understood that a drainage plan
<br />addressing a 'compensating volule. Hill ue submitteo which is prepared by a professional engineer registered in the State of
<br />Florida prior ~o perait issuance.
<br />
<br />A pertit issued shall be construed to be a license to proceed with the Hork and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of aperlit prevent the Building Official frot thereafter
<br />requiring a correction of errors in plao:, constructlon, or violations of any code. Every per.it issued shall beco.e invalid
<br />unless the Nork authorized by such perlit is cOI.enced within six r.~nths of issuance, or if HorK authorized by the perait is
<br />suspended or abandoned for a period of SIX lonths after the 'tile the HorK is commenced. . One 90 day extension of tite, aay be
<br />alloNed for the perlit Hith fee charge of $15.00. The extension shall be requested in writing to the Building Official, An
<br />approved inspection must be logged durin~ each six Bonth period, or the project will be considered abandoned.
<br />YARNING TO Ol/NER:, YOUR FAILURE TO RECORll A NOTICE OF COIIIlENCEMEHT tlAY,RESULT IN YOUR PAYING TWICE FOR ItlPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FlNAlh:1I16, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR HOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 1" VALUl: DO HOT NEED TO RECORD AND POST A 'NOTICE Or COMnEHCEIIENT..
<br />
<br />~~A:t fJ1~
<br />SIGN I : OWNER OR AGENT
<br />
<br />
<br />. ,
<br />
<br />c ~ u-..
<br />
<br />--
<br />
<br />,
<br />STATE OF FLOP.IDA /C)
<br />COUNTY OF Ii ~,
<br />The foregoing illstr_u~ent \'Ias ac:lm~.Wledged
<br />befc.\""e me this~ /7 , 19-Z.L by
<br />
<br />J lL'Y7€-1 ~ I tU:fi we.L L
<br />who is personally known to me Dr who has
<br />produced
<br />as identification and who did/did not
<br />take an oath 11 ,/""' (''In, ' ~
<br />~~HQ.~ (..t~ g~~
<br />(S' un~) ,
<br />Barbara Allison
<br />(Name Typed, Printed or Stamped)
<br />NOTARY -PUBLIC
<br />
<br />STATE OF FLORIDA .A
<br />COUNTY OF ~
<br />The foregoing iT1ft~ent. \'Ias acknowledged
<br />befc.n:: me thh, ~J( , it;LL uy
<br />
<br />J a t'\. 'e.. I .B.la.L Klt..>e I I
<br />who is persDnally known to me Dr wh~ has
<br />produced
<br />as identification and ~jho did/did not
<br />take~ ~~
<br />
<br />"'"fsrgnature>
<br />Barbara Allison
<br />. (Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />BARBARA A. ALLISON
<br />Notary Public. State of Florida
<br />My Comm. Exp. 03-26.9B
<br />Comm. No. CC 358940
<br />
<br />~,r
<br />
<br />BARBARA A. ALLISON
<br />Nota ry Public, State of Florida
<br />My Comm. Exp. 03.26.98
<br />Comm. No. CC 358940
<br />
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