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<br />SIGNAT~E": ,:-,.2~~R~.R ~
<br />~~~~~Y O~~;~~~~~q~t7 ()
<br />
<br />The foregoing instrument was acknowledged_ _ J
<br />Before me thiS~ day of :l-f;C' , 19.2.J?'
<br />by A ,q /(/1. r:;-, 111 /,(
<br />_ Jname of person acknowledged)
<br />~o is personally known to me, or
<br />
<br />CONIJI'l'JONS OF PERMIT AE'FIIJAVI'l'
<br />A. NOTICE OE' IJEEIJ RESTIUCTIONS
<br />The undersigned understands that this permit may be
<br />may be more restrictive than City regulations. The
<br />complrance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS ANIJ CONTRACTOR HESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accordance witll state and local regulations. If the contractor is not
<br />licensed as required by law, both the owner and contractor may be cited for a misdemeanor
<br />violation under state law. If the owner or intended contractor are uncertain as to what
<br />licensing requiremellts may apply for the intellded work, they are advised to contact the
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application for which they
<br />will be responsible. If you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor wishes
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (ClffiPTER 7J3, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protectioll Guide" prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to cOllunencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no work or installation has cOIlunenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regulating construction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended work, and that it is my responsibility to identify what actions I must take to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic 'ranks
<br />*U.S. Environmental Protection AqencY-Asbesto!'l abatement:
<br />I also certify thaL, if Llll material is to be used in E'lood Zone "A" or "A,etc.", it is
<br />understood that a drainage plan addressing a "compensating volume" will be submitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to permit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />authority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any code. Every permit
<br />issued shall become invalid unless the work authorized by such permit is commenced within
<br />six months of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of six months after the time the work is cOllunenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />
<br />8.~ ht~oA.
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA /J A../)
<br />COUNTY OF ~~~
<br />The foregoing instrument was ,acknowledged ""./
<br />Before me this --J.LI!.!-day of ~F( , 19!2.f/
<br />by
<br />_ ~e of person acknowledged)
<br />~is personally known to me, or
<br />
<br />subject to ~deed restrictions" which
<br />undersigned assumes responsibility for
<br />
<br />o who
<br />
<br />
<br />o who has produced
<br />~~(type of identifi..catiOn)
<br />
<br />G2. did A"t~~th ~.
<br />'.JJf~ "- .' J./dM{~
<br />~;e of perao~ -"king acknowledgment
<br />
<br />8EI.c- a. ..;;; WEr~/9AJD
<br />Name ~~ prilibbllill~mped
<br />,(:[':"'A~.;.. MY COMMISSION II CC534927 <:\, '.,
<br />~...~,~",j February 22. 2000
<br />";';rOF~~'" BONDED THRU l'llOV fAIN II!SI)R':< ';
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<br />~.~Of peraon t king aCknoWledgemen. t
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<br />. r:1?~~. 55/.JEDrlPD
<br />Name typed, printed or stamped
<br />~~~~~v::""'"'' Bobble s. SWetland
<br />A....Ji. ~.,;~ MY COMMISSION II CC534927 EXPIRES
<br />. ,.: ~ ~= February 22 2000
<br />':~;'F ..,,?/' BONDED THRU TROY FAiN INSURANCE, INC.
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