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<br />A. NOTICE OF DEED RESTRICTIONS
<br />The under~igned understands that this permit may be subject to ~deed restrictions" which
<br />may 'be more restrictive than City regulations. The undersiqned assumes responsibility fpr
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they ~y be required
<br />to be licensed in accordance with 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 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, 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 GuideH prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the UownerH, 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 ~ownerH prior to commencement.
<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 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 ~reas 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 ~A" or ~A,etc.H, it is
<br />understood that a drainage plan addressing a ucompensating 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 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 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 COMMENCEMENTH.
<br />
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<br />SIGNATUREC OWNER OR AGENT
<br />
<br />~ lb.< :r;::e 0 ~ .1..w.&JJ
<br />SIGNATURE CONTRACTOR
<br />
<br />STATE OF FLORIDA R
<br />COUNTY OF 4.~ Lb
<br />The foregoing instrument wa~ac~~OWledged
<br />Before j,e this ~ day of rip't' I \ , ~'-
<br />by t'l1'\ Q. T c..c.1< wet
<br />(name of person acknowledged)
<br />~who is personally known to me, or
<br />
<br />STATE OF FLORIDA 0
<br />COUNTY OF J a. s c. 0
<br />The. foregoing instrument wasAacknowledged
<br />Before me this _day of 1'+ P to;~ ,:t;fl :J...oo,j.
<br />by J a. In. r 1(' e I a...c.kuJ e.. _ _
<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 81did not take an oath.
<br />
<br />8~b CJ- ~
<br />
<br />Signature of person taking acknowledgement
<br />
<br />o who has produced
<br />, (type of identification)
<br />and who 0& DJiid not take an oath
<br />
<br />~ ~LJ 9- (jkJ~
<br />
<br />Signature ~f person taking acknowledgment
<br />
<br />
<br />~n. h4."'4. A 1\ iSo n...
<br />Name t~
<br />..,c~_... _
<br />CamIIL . DO 1
<br />
<br />BARBARA A. ALLISON
<br />State of F!~ .,., '
<br />L:v Cc~,' ,.
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