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<br />.n. .NVLll.~ Vi<' Ut.;t.;U H~S'l'RIC1'IONS
<br />~he undersigned understands that-thIS' pel:.lt ]lay besubject to "deed restrictions" which lay be lOre restrictive than City
<br />regulations. The undersigned assllles 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 nol licensed as required by law, both the owner and contractor lay be
<br />cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requireaents lIay apply for the inlended work, they are advised to contact the Cily of Zephyrhills Building Depart.ent, (813)
<br />788-6611.
<br />
<br />FurtherJlore, 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, ratfler than the contractor, are responsible for the work. If the contractor wishes 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 (ClffiPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeowner's Protection
<br />Guide" prepared by the Florida Departlent of Agricultur~ and Consuler Affairs. If the applicant is sOleone other than the
<br />"owner", I certify that I bave obtained a copy of the above described docUllent and prolise in good faith to deliver it to the
<br />"owner" prior to couence.ent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in compliance 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 has cOllenced prior to issuance of a per.it and that all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land deveIopJlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDlental agencies lay apply to tbe intended work, and that it is
<br />IY responsiQility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />* DepartJent of EnviroDJIental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Nater/Nastewater Treat.ent
<br />t Southwest Florida Water Hanageaent District - NeIls, Cypress Bayheads, Netland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Depart.ent of Health & Rehabilitative Services, EnviroDlental H~alth Unit - NeIls, Nastewater TreatJent, Septic Tanks
<br />t US EnviroDlental Protection Agency - Asbestos abatement
<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 volllle" will be subJlitted 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 frOl tbereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid
<br />unless the work authorized by such perlit is cOllenced within Sil lonths of issuance, or if work authorized by tbe per.it is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day eltension of tite, tal be
<br />allowed for the per.it with fee charge of $15.00. The eltension shall 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 />NARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEMENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT NITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COHHENCEHENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COHHENCEHKNT".
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<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 />was acknowledged
<br />, 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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