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<br />C~Ttlt(jtuflfQF' rpmMlT' 'f6VmA"VtT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to "deed restrictions" whieb lay be lOre restrictive than City
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lay be
<br />cited for a lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />Furtherlore, 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 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 sign
<br />as contractor that lay be an indication tbat be is not properly licensed and is not entitled to per.itting privileges in the
<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, tbe applicant, bave been provided with a copy of 'Florida's Construction Lien Law - HOJeowDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
<br />"owner", I certify that I have obtained a copy of the above described docUleDt and prolise in good faith to deliver it to the
<br />"owner" prior to couencelent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and tbat all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developlent,
<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 cOllenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIDIeDtal 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 not li.ited to:
<br />t Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDJeDtally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Water Managelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Healtb & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />t US EnviroDlental Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a 'colpensating volUle" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit 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 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 perlit issued sball becOle invalid
<br />unless tbe work autborized by sucb perlit is cOllenced witbin six IOnths of issuance, or if work authorized by the peIlit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day l!Itension of tile, lilY be .
<br />allowed for tbe perlit 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 />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICB OF COMMBNCEMEHT MAY RESULT IN YOUR PAYING !WICE FOR IMPROVEMmS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, COHSULT WITH YOUR LBHDER OR AN ATTORNEY BBFORE RE.CORDIHG YOUR HOTICH OF
<br />COMMENCEMENT. JOBS UNDBR $2,500 IN VALUB DO NOT NEED TO RECORD AND POST A "HOTICB OF COMMENCEllEHT',
<br />
<br />
<br />SIGNATURB: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY 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 oath.
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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