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<br />LUI-.j!Jl I lLl!,j~, UI' I L.',II.l I III I .lUll" ,l I
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<br />A. NOTICE OF DEED RESTRICTIONS
<br />Jhe undersigned understands that this perlit lay be subject to 'deed restrictions' which lay be lore r~trictive 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 ONner 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 OMner and contractor lay be
<br />cited for a lisdeleanor violation under state law. If the owner Dr intended contractor are uncertain as to "hat 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 contractorls) sign portions of the
<br />'ContratlorSections' of this application forllhich they will be responsible. If you, as the ollner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the 1I0rk. If the contractor IIi shes 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 lephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (~HAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of 'Florida's Construction Lien Lall - HOleowner's Protection
<br />6uide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
<br />"ollner., I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the
<br />.ollner. prior to COllencelent.
<br />
<br />E. CONTRACTOR1S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all 1I0rk will be done in cOlpliance with all
<br />applicable lalls 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 has cOllenced prior to issuance of a perlit and that all lIork will be perforled to leet standards of all lalls
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that 1 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 1 lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />f DeDartlent of Environaental Regulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />I Southwest Florida Water "anagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f ArlY CorDS of Engineers - Seawalls, Docks, Navigable Waterways
<br />I DeDartlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />I US Environlental Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to ~e used in Flood lone .A' or .A,etc.', it is understood that a drainage plan
<br />addressing a "colpensating volule" will be SIIblitted which is prepared by a professional engineer registered in the state of
<br />Florida prior to perait issuance. '
<br />
<br />A perait 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 co~es, not shall issuance of a perlit prevent the Building Official frol thereafter
<br />requiring a correc'ion of errors in plans, cpnstruction, or violations of any code. Every perlit issued shall becole invalid
<br />unless the work au}horized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six lonths after the tile the work is cOllenced. One 90 day extension of tile, lay be
<br />allowed for the perlit with fee charge of tI5.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six lonth period, or the project will be considered abandoned.
<br />WARNIHS TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR I"PROVE"ENTS TO YOUR
<br />PROPERTY. IF YOU >INTEND TO OBTAIN F~NANC1N~, CONSULT WITH YOUR LENDER DR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />CO""ENCE"ENT. JORS UNDER $2,500 IN VALUE DQ NPT NEED TO RECORD AND POST A 'NOTICE OF con"ENC4EnENT":
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<br />/!~~ ~-
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<br />SIGNATURE: OWNE~OR AGENT SIGNATURE: CONTRACTOR
<br />
<br />was ac:knowledged
<br />, 19__ by
<br />
<br />STATE OF FlORIDA~
<br />COUNTY OF ~
<br />The foregoing instrument
<br />befc.re me th i s _ I) - /S
<br />
<br />was ackno\"ledged
<br />, 19 t-J:, by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me th~s
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/~id not
<br />take an oath.
<br />
<br />w
<br />
<br />
<br />kno
<br />
<br />o me or whc. has
<br />
<br />pro
<br />as identification and who did/did not
<br />
<br />take an oath L/14A1--<" 11 J11 _1..
<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 />
<br />....~~.u",,,,,
<br />l~:&'~~ Nancy A. M.,"
<br />~*: :*~ MY COMMISSION # cci. ,: "'>:
<br />~ .~. N.hn_ft. j,
<br />~":l'''''~.;' .--,21, /,.",
<br />'8f,,'n\' BONDED THRUTROY FAfH'lt;~'l!;I\, "~'. '-/,,\"
<br />
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