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<br />A. NOTICE OF D_EED RESTRICTIQ1<.J
<br />The undersigned understands that this perlit 'lay be subiect to -deed restrictions" which lay be lore res~rict~ve ~~~n :~~y
<br />regulations. The undenigned assUllS responsibility for cOlpliante with any applicable deed restriction!;. .
<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 ~ccord,lIlce ~ith
<br />stite ilnd local regulations. If the contractor is not licensed as required by law, both the owner and contractor .,11' b!
<br />cited for a lisdeleanor violation under state IaN. If the owner or intended contractor are uncertain as tOlChat lil:ensin,}
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departle,~t, !~13)
<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 />.CoAtrilctor Sections. of this application for which they will be responsible. If you, as the owner sign as the c~ntra,ctor,
<br />you are indicating thilt you, rather than the contractor, are responsible for the work. If the contractor wishes )'O~ to sign
<br />as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privilt'ges in the
<br />City .f Zepbyrhills.
<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 - HOleo.ner'!, Probction
<br />6uide- prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is SOleone other than tbe
<br />-owner", I certify that I have obtained a copy of the above described doculent and prOlise in good faith to delivl!r H t,~1 the
<br />-owner- prior to cOllenteaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforution in this application is accurate and that all .ork lIill be done in cOlpliance IIHhall]
<br />applicable liMS regulatiog cODltruction, zoning, ilnd land developaent.
<br />
<br />Application is hereby lade to obtain a perlit to do IlOrk and installation as indicated. I certify that no work ,~r
<br />installition has cOllenced prior to issuance of a perait ilnd that all 1I0rk IIi 11 be perforled to leet standards of ,tll lallls
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I itlso
<br />certify that I understand that the regulations of other governlental agencies lay apply to the intended 1I0rk, and that it is
<br />IY responsibility to identify what ilctions I lUst take to be in cOlpliance. Such agencies include but are not liaited to:
<br />f Departlent of Environaental Reaulation - Cypress Bayheids, Wetland Areas and Environlentally Sensitive Lands,
<br />Witer/WisteWiater Treitlent
<br />f Southwest Florida Water "anaa..e"t District - Wells, Cypress Bayheids, Wetland Areas, Altering Watercourses
<br />t Aray Corps of EnQineers - Seilills, Docks, Navigable WaterliYs
<br />f DeDirtaent of Health 1 Rebabilititive Services. Environaental Health Unit - Wells, lIastellater Treabent, Sept if: Tanks
<br />f US Environlentil Protection Auency - Asbestos abate..nt
<br />I ilso certify that, if fill lateriil is to be used in Flood Zone "A" or "A,etc,", it is understood that a drairlilge phil
<br />addressing a -colpensating volule- ,ill be sublitted Ilhich is prepared by a professional engineer registered in j~he Stilte of
<br />Floridil prior to perlit issUilnce.
<br />
<br />A perlit issued shall be construed to be a license to proceed Ilith the 1I0rk and not as authority to violate, cal~cel al1;er, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official fru thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perai t issued shall heeole invalid
<br />unless the work authorized by such perlit is cOlaenced Ilithin six lonths of issuance, or if work authorized by~he pemit is
<br />suspended or abandoned for a period of six lonths after the tile the work is COlaenced. One 90 day extension of tile, lay be
<br />allowed for the perlit .ith fee charge of tI5.00. The extension shall be requested in IIriting to the Building I~ffici,;al, An
<br />approved inspection lust be logged during eich six lonth period, or the project lIill be considered abandoned.
<br />WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCEKEMT KAY RESULT IN YOUR PAYING TIIICE FOR IKPROYEKENTS TI~ YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT IIITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />CDKIENC~T. JOBS UNDER t2,5OO 1M VAlUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMKENCEMENT".
<br />
<br />.--
<br />
<br />j' .
<br />516MATURE: IllIIlER OR mT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />was acknowledged
<br />, 19__ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />STATE OF flORIDA
<br />COUIITl OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknol"ledgled
<br />, 19___ by
<br />
<br />known to me or ...,lho helS
<br />
<br />who is personally known to me or who ha~
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />who is personally
<br />produced
<br />as identification
<br />take an oath.
<br />
<br />and who did/did not
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />----
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLI C
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLI C
<br />
<br />..._--~<_.
<br />
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