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<br />CO/'ll) I ",uNS OF PERI'l r T ('IFF I D{~'..) I T I
<br />:A.' 'Nm"!r:~:tJ'F t)~ '~'ESTFHCTIClNe. ".
<br />The u,ndiJ)51gned :Unde'fsbndi that this peni t 'uy be ;ubject to 'deed restrictions' Ilhich uy be lore restrictive thill,l'City
<br />regulations. The undersigned iSSUle5 re;ponsibility'for cDlplianco with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If t~, owner has hired a contractor or ,;ntractors to undertake work, they aay be required to be licensed in accordance with
<br />state Ind IDeal regulations. If the ,ton t'l"ktor i 5 not licensed as requi red by law, both the ~llner and contnctor lilY be
<br />cited,for ,i a1sduuncr violation under state hll. If th'e owner or intended contrJctor are uncerhin iIS to llhat 11censing
<br />requirellnts lay apply for the intended llork, they are advised to contact the Ci~y of Zephyrhills Building Departlent. (813)
<br />788-6611.
<br />
<br />Furtherlore. if the ONner 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 responsible. If you, as the owner sign as the contractor,
<br />you are indlciting that you, rather 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 pr~perly licensed and is not entitled to per.itting privileges in, the
<br />City of Zephyrhills. .
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLO~IDA 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 Departaent 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~ise' in good faith to deliver it to the
<br />'owner' prior to cOllenceaent.
<br />
<br />E. CONTRACTOR1S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in th~s application is accurate and that all Hor~ Hill be done in cOlpliance with all
<br />applicable laws regulating construction, zoningl and land developaent.
<br />
<br />Application is hereby lade to obtain a penitto do work and 'installation as indicated. I certify that nD work Dr
<br />installation has coalenced prior to issuance Df a perlit and that all work will be perforaed to leet standards of all laws
<br />regulating construction, 'City codes, 10ning regulations, and land develop lent regulations in the Jurisdiction. I also
<br />certify that I understand that the regulations of other governaental agencies lay apply to the intended Nork, and that it is
<br />IY responsibility to identify what actious I lust take to be in coapliance. Such agencies include but are not lilited to:
<br />f Departaent of Environlental ReQulation - Cypress Bayheads, Uetland Areas and EnvironJentally Sensitive Lands,
<br />, Hater/Hastewater Treataent
<br />t'Southwest Florida Uater KanaQeaent District ~ Hells, Cypress Bayheads, Yetland ^reas, Altering Watercourses
<br />t ArlV Corps of EnQineers - Seawalls, Docks, Navigable Uaterways ,
<br />t Departaent of Health L Rehabilitative Services, Environlental Health Unit - Yells, Hastewater, Treataent, Septic Tanks
<br />t US Environaental Protection AQency - A~bestos abateAent
<br />I also certify that, if fill .aterial is to be used in Flood Zone 'A' Dr 'Aletc.', it is understood that a drainage plan
<br />addressing a 'coApensating volule' will be subaitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance. .
<br />
<br />A perllt 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 provi$ions of the technical codes, nor shall issuance of aperlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plan~, construction, or violations of any code. ~very perait issued shall becole inva~~d
<br />unless the work authorized by such perAit is 'colAenced within six Donths of issuance, or if Hork authorized by the per.it 1S
<br />suspended or abandoned for a period of SlX lonths after the 'time the Hork is cOIDenced. . One 90 day extension of tiae, aay be
<br />allowed for the perlit Hith fee charge of ~15.00. The extension shall be requested in Hriting to the Building Official. An
<br />approved inspection ~ust be logged durin~ each six .onth period, or the project Hill be considered abandoned.
<br />VARNING TO OUNER: YOUR FAILURE TO REeORO A NOTICE OF COHHEHCEHEHT HAY RESULT III YOUR PAYING TWICE FOR IHPROYEHEHTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINAII~IIIB, CONSULT \lITH YOUR LElIDER OR All ATTORHEY BEFORE ,RECORDING YOUR NOTICE OF
<br />COKKENCEHENT. JOBS UNDER $2,500 IN Y.ALUI~ DO NOT HEED TO RECORD A1ID POST A 'NOTICE OF COliHEIlCElIENT'.
<br />
<br />~ . . J
<br />"--- ['>--'LA.t. \< B.o 1'1 A'" ~~ ,
<br />SI ATURE:OUNER OR AGENT
<br />
<br />
<br />'-
<br />
<br />I
<br />
<br />. ~r K'Sxo~/~<--w'
<br />COIHRACTO'R
<br />
<br />,.<f, '.
<br />
<br />STATE OF FUlRIDA
<br />COUNTY OF
<br />The foregc,ing iI")jttrumel1t \'las aclmowledged
<br />before me this C€J:; II{ , )ox> by
<br />., ,
<br />
<br />JCt:,\,\-e. T i31u..G/<We.LL__
<br />~Jho is pel-sclna~lLknown to ,!Jl.t;! or ~Iho has
<br />produced--.-.--.. --.
<br />as.identification and
<br />
<br />take ~~A(l
<br />(Signat -e)
<br />
<br />.
<br />
<br />jJa...sco,
<br />
<br />STATE OF FL!lRIDA V '
<br />COUnTY OF L- Q.S c... 0
<br />The foregoing instr4ment \'las ;acknowledged
<br />before me this F 2 ~ J'f , ~~bO by
<br />
<br /><: \Q 11 e.. t {3 Ja....c l< / v e.LL
<br />who is personal!:L ItT.!.~m to_~ or who has,
<br />produced '.' ,
<br />as identification and who dill/did not,
<br />
<br />taJ(etr~ 5{ a.0!.-. _
<br />
<br />(Signature) .
<br />
<br />who did/d.id hot
<br />~~
<br />
<br />
<br />(Name Typedl Pr.
<br />NOTARY 'PUBU'C
<br />
<br />
<br />S t a'BRAfbt>A A. ALLISON
<br />Notary Public, StItt of florid.
<br />My Comm, Exp. ~r. 28,2002
<br />Comm. No. CC 704878
<br />
<br />. (Name Typed,
<br />NOTARY PUBLI
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