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<br />a. NUTICE OF DEED RESTRICTIONS
<br />The"undersigned understands that this permit may be subject to "deed restrictions" which
<br />may be more restrictive than Clty regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESfONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accordance with st~te 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. It the owner or intended contractor are uncertain as to what
<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 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 contraptor that may be an indication that he is not properly licensed and is
<br />not entitleq to permitting privileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT nEB AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION 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
<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 commencement. J
<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 commenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regulating construotion, 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 aotions I must take to
<br />be in compliance. Such agencies inolude 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 i 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 "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 Offic!al from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any code. Every pe~t
<br />issued shall become invalid unless the work authorized by such permit is oommenoed 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 each six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMHENCEMENTMAY RESULT IN YOUR
<br />I?AYING TWICE FOR IMPROVEMENTS TO YOUR PROI?ERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR .AN ATTORNEY BEFORE RECORDING YOUR NOTICE OJ!' COMMENcItMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND fOST A "NOTICE OF COMMENCEMENTH.
<br />
<br />.~
<br />
<br />SIGNATURE: OWNER OR AGENT' SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORI~~ STATE OF FLORIDA ~
<br />COUNTY OF ' ~~..,..W COUNTY OF _ ~~""if1,.o
<br />The foregoing instrument wa~cknowledged , The foregoing instrument was ackno~ledged
<br />Before me this ~~ day o~ff/J , ~tJ,~ Before me this ~ay of _-rr/ LJ ,1ilI o:i...
<br />by 'iI-JOI11/J,< A. ;1 ~ It /L , by t'1 j../ I? I~ /'!..er:~ Ei.~1'9-
<br />(name of person ackno~ledged) (name of person acknowledged)
<br />'0 who is personally known to me.! or ,1/.L [1ho is personally known to me, or
<br />J1 S-:l V- ~;J {-~7- :L'Y'- 0
<br />~ who has produced ,P/..-'7.>J2IV. )11._ ~ who has produced FL VI? ).,t!...e;I/trt>j3-..3
<br />". (type of identification) . ~~~::~ Of, identi,f, ica1::io!1b
<br />
<br />a~dit:;g~' an,~Jp. ~~ath1i)
<br />
<br />Signature of person taking acknowledgement Signature of person taking acknowledgment .
<br />
<br />.i-:;r.~:'fjt Bobbie Swetland
<br />~z .. .... MY mMl4''>'>1ON it CC8~mg"XPlREg
<br />Na - . '. ' . d, pi~2.<U04stamped
<br />'. ..w"ili.' IlONliED THRU TROY FAIN IN$UiAIq.IHC. ,
<br />
<br />~~
<br />
<br />
<br />Name ~ ;~ p1UCiMtaIOlttC~S
<br />:';'. ~1i February 22, 2004
<br />".:r.Rf.,i~~" BONDED THRU TROY FAIN INSURANC~ INC
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