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<br />CO/WIT,I UIIS OF' FERMiT AI"F'IDAVI'l'
<br />A.' No'ricE OF DEED HF:STIUC'!'10NS
<br />'I'he undersigned understands that this permit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. The undersigned asswnes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AND CONTHJ\CTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accordance with stale and 10Cil1 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 requirements may apply (or: the intended work, they are advised to contact the
<br />City of Zephyrhills Building Department, 013-780-6611. '
<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 pr,operly 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 (CHAPTER '113, 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 Protection 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 conmlencement.
<br />E. CONTRACTOR' S/OWNER' S AF'FIDAVIT
<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 penult to do work and installation as indicated. I
<br />certify that no work or installation has conunenced 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 Enviromnentally 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 Tanks
<br />"'U.S. Environmental Protection Agency-Asbestos abatement:
<br />I also cer.tify that, if rill milter-lilt .is lo he used In F'lood Zone "A" or "A,etc.", it is
<br />understood that a drainage plan addressing a "compensat.ing 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 Dul1d.lng Official from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any code. Every per.mit
<br />issued shall become invalid unless the work authorized by such permit is conunenced 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 cOlmnenced. 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 TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPE~rY. 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 VALU DO NOT NEED '1'0 RECORD AND POST ^ "NOTI OF CO NCEMENT".
<br />
<br />
<br />
<br />STAT OF FLO);IDA
<br />COUN 0 F t.J(
<br />The oregoing instrument was acknowledged
<br />Before me this t,!1::f- day of J1/:Jruar"l. ' ~Jrro
<br />by JFlC'K K~eAJ ~,Jt',
<br />l1J (name of person acknowledged)
<br />,zTWho is personally known to me, or
<br />
<br />STATE 0 FLORIDA f}
<br />COUNT F ~~
<br />'I'he fo goIng instrument was acknowled9~d ~
<br />Before me this g,1:J:- iay of .~~bnltlr/., t8' of IUt)
<br />by _ JIraK j(FEIi / J. , .
<br />OJ J (name of person acknowledged)
<br />~ is personally known to me, or
<br />
<br />o who has produced
<br />tJ../ (type of identification)
<br />and Wh~id( ~dld not ~ake an oath.
<br />
<br />C;a~Jt:'!Jp dJJ}~
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Jl;141~ j;. A ItltaJ.:;t.:
<br />
<br />Name typed, printed or stamped
<br />
<br />o who has produced
<br />~ (type of identification)
<br />and who ~~/J DiJ.,' d no~ take an oath
<br />
<br />r!o~~/~
<br />
<br />Signature of person taking acknowledgment
<br />
<br />JfJI-J I ~ ;.,. jJp // lj) tV sf,'
<br />
<br />Name typed, printed or stamped
<br />
<br />.' .....\l::!... JAMIE L POPLAWSKI
<br />{.f1~:""f..\ MY COMMISSION II CC 732207
<br />~. : ff EXPIRES: April 8, 2002
<br />""-~iII1o\: l' Bonded Thru Notary PIIbli<: Undenitit8nl
<br />"'i"'III".'
<br />
<br />
<br />~~'f.::.". JAMIE L POPLAWSKI
<br />I-f'J:~:\ MY COMMISSION II CC 7322.07
<br />hi: . . EXPIRES: April 8, 2002
<br />Bonded Thru Notary PuIlIic Underwrilers
<br />
<br />..
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