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<br />cmll) I T IONS OF PERI'll T (~FF 1 D{~'.j I T \
<br />'A . NOT l' c: E: err: bl!E:t) 'REst Fn C T ION S?
<br />The undell5Igned urideishndi th~t this per.i t 'uay be sublect to "deed restricHons" I/hich r.ay be lore restrictive th~n City
<br />regulations. The undersIgned ~SSUle!l reiponsibilityfor cOlpliance with any applicahle deed restrictilins.
<br />
<br />B. UNLICENSED CONTRACTClRSAND CONTRACTOr, RESPONSI8ILITIES
<br />If t~e owner h~s hired a contractor or c;ntractors to undertake work, they may b~ required to be licensed in lccordancl with
<br />state and local reguhtions. If the .'t'ont'rktor i!i not licensed as required by law, both the !lwner and contractor lilY be
<br />cited for ~ .lsdeleancr violation under state ia~. If tne owner or intended contr~ctor are uncertain as to what licensing
<br />requirelents lay apply for the intended "ork, they are advised to contact the Ci~y of Zephyrhills Building Departlent, 18131
<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' rf'this application for which they will be respofisible. 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 wishes you to sign
<br />. as contractor that eay be an indication that he is not pr~perly licensed and is not entitled to perlitting privileges in, the
<br />City of 2ephyrhills.
<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 - HOleowner'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 document and pro~i5e' in good faith to deliver It to the
<br />"owner' prior to cOllencelent.
<br />
<br />, E. CONTRACTPR'S/OWNER'S AFFIDAVIT
<br />I certify that all t~e inforlation in this application is accurate and that all Hork Hill be done in coapliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby lade to obtain a perlitto do work and 'installation as indicated. I certify that nD work or
<br />installation has cOllenced prior to issuance Df a perlit and that all work will be perforaed 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 governaental 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 lilited to:
<br />t DeDartlent of Environ.ental ReQulation .. Cypress Bayheads, Wetland Areas and Environlentally Sensitive lands,
<br />Yater/Yastewater Treataent
<br />t Southwest Florida ~ater ManaQeaen! District.. Wells, Cypress Bayheads, Hetland Areas, Altering Hatercourses
<br />t ArlY CorDS of EnQineers - Seawalls, Do~ks, Navigable Waterways .
<br />t DeDartlent of Health ~ Rehabilitative Services, Environlental Health Unit .. ~e115f HasteHater Treatlent, Septic Tanks
<br />t US Environaental Protection AQency .. A:bestos abateAent
<br />I also certify that, if fill laterial 15 to be used in Flood Zone "A' or "A,etc.', it is understood that a drainage plan
<br />addressing a 'coepensating volule' Mill be subBitted 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 Hork 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 thereafter
<br />requiring a correction of errors in plan;, construction, or violations of any code, Every perlit issued shall becole invalid
<br />unless the work authorized by such permit is cOleenced Hithln six Donths of issuance,' or if Hork authorized by the peralt is
<br />suspended Dr abandoned for a period of SIX lonths after the'tiee the work is cOaDenced. . One 90 day extension of tile, lilY be
<br />allowed for the perdt Hith fee charge of 115.00. The extension shall be requested in Hriting to the Building Official. An
<br />approved inspection ~ust be logged durin~ each six tonth period, or the prolect Hill be considered abandoned.
<br />~ARHING TO OWNER: YOUR FAILURE TO RECORll A NOTICE OF COKIIEIlCEIlEIH tlAY RESULT III YOUR PAYING TWICE FOR ItlPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU lHTEND TO OBTAIN FINAllt:llIG, CONSULT WITH YOUR LElIDER OR AN ATTORHEY BEFORE RECORDU-IG YOUR NOTICE OF
<br />COIlIlENCEIIENT. JOBS UNDER $2,500 IN VALUl: DO NOT NEED TO RECORD AlID POST A "HOTICE OF COJiIlEllCEIlEHT'.
<br />
<br />
<br />~
<br />OUNER DR AGENT
<br />
<br />~ '
<br />\" K~&~
<br />51 NATURE: COHTRACTOR
<br />
<br />...~. ..)
<br />
<br />STATE OF FLORIDA f)
<br />COUNTY OF LCLS c_ 0 _
<br />The foregoing instrument was acknowledged
<br />befcore me this ..)\"0<.) .L, ,19.:J:L... by
<br />
<br />Jl.L VIP T- k"6 ia.-G~LL)e.L ~_
<br />~ho is personally known to me or ~ho has
<br />produced
<br />as identification and who did/did hot
<br />I
<br />take all1~~ iu ~
<br />
<br />(Signatul-e)
<br />B a..~ '" a rCl A. 4\ \; $0"'--
<br />(Name Typed, Printed or starn ed)
<br />NOTARY 'PUBLIC .ri.:J~~----"
<br />..vi' ".U' "'", flAR8ARA A. ALLISON
<br />(,)~','" Notary Public, st.-1~e,.Cf Florida
<br />t' .' My Comm. Exp. (, 5-26.98
<br />1"'1:0,','1 Comm. No. CC 3""940
<br />,-'-.-.",..: . '....-. . ,....,
<br />
<br />STATE OF FLPRIDA B
<br />COUNTY OF _~)
<br />The foregoing instrument wa~ ~cknowledged
<br />before me this Y\u,. L, ,11J..!LL by
<br />
<br />t Ia..h.<e.t- t-<. t3 /Q.-G k L/Je- tL.-
<br />who is personally known to me or who haa
<br />produced '.~
<br />as identification and I'lho did/did no\;.
<br />take/~n_ ~"t_h',
<br />~(i.~
<br />(Sign~ture) . .
<br />~Y'OO:r(i,. II. Al/'~_
<br />,(Name Typed, Printed or Stamped)
<br />NOTARY PUBLI C :' -,__n. ----."
<br />~.. "bt.1' BAR8ARA A. ALLISON
<br />o-..'~ NO~:~~~b'::~'E~~:!3~C._~~~~~da
<br />,,,_..~:b . __C:~:~: CC 358940
<br />
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