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<br />A. NOTICE OF DEED RESTRICTIONS <br />The undersigned understands that this permit may be subject to "deed restrictionsH wllich <br />may be more restrictive than City regulations. The undersigned assumes responsibility for, <br />compliance with any applicable deed restrictions. <br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBII,ITIES <br />If the owner has hired a contractor or contractors to undertake work, they may be required <br />to be licensed in accordance with state and local regulations. If the contractor is Il0t <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 wllat <br />licensing requirements may apply for the intended 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 SectionsH 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 (CHAPTER 713, FI,ORIDA STATUTES, AS /\MENDED) <br />I certify that I, the applicant, have been provided witll a copy of "Florida's Construction <br />lien Law - Homeowner's Protection GuideH prepared by the Florida Department of Agriculture <br />and Consumer Affairs. If the applicant is someone other that the "ownerH, 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 conunencement. <br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT <br />I certify that all the information in tllis 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 commenced 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 regulatiolls 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: 6Department 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 Tanks <br />*U.S. Environmental Protection Agency-Asbestos abatement <br />I also certify that, if fill material is to be used in Flood Zone "AH 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 witll 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 commenced. 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 eacll six <br />month period, or the project will be considered abandoned. <br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COM.MENCEMENT MAY RESlJVr IN YOUR <br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULi <br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMM.ENCEMENT. JOBS UNDER <br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMM.ENCEMENT". <br /> <br />(}c~JJJoC-- <br /> <br />SIGNATURE: OWNER OR AGENT <br /> <br />~~c- <br /> <br />SIGN~rURE: CONTRACTOR <br /> <br />STATE OF FL.QRIDA <br />COUNTY OF ~C\ ~(' 1) <br />The foregoing instrument wa~ acknowledged <br />Before me this ~ day of ~ ' 1:'9..dco I <br />by <br />(name of person acknowledged) <br />ErWho is personally known to me, or <br /> <br />STATE OF FLORIDA ~ <br />COUNTY OF . ')0... c..D <br />The foregoing i~strument was acknowledged <br />Before me this ~day of '-Wr ' ~.T- <br />by ~Odf <br /> <br />~ (name of person acknowledged) <br />~ho is personally known to me, or <br /> <br />o who has produced <br />(type of identification) <br />and whoD did . D. d.. iji1n~t take an oath. <br /> <br />~.~ <br /> <br />Signature of person taking acknowledgement <br /> <br />Dwho has produced <br />(type of identification <br />an~, [}lid not take an oath <br /> <br /> <br />Signature of person taking acknowledgment <br />..,~~ Suzanne Douglas.Allen <br />*~*My Commlsslon CC87<4208 <br />~"..".~~1l~4~.2PflHnted or stamped <br /> <br />Name typed, prin~~dSS'dnn~'t::iol1OQ~~len <br />'li" ~ <br />* *My commission CC874208 <br />'." ",' Expires october 25. 2003 <br />".......' <br />