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<br />A. NOTIC~ OF DEED RESTRICTIONS
<br />The und'erslgned understands t~at this peu:mU: may be tlUbject :to "deed. restriotions;' which
<br />may be more restriotive than City' ~egulat:ions. The umlersigned assumes respoli.ibili~y for
<br />compliance with any applicable deed rustr:ic1::i':lus.
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR IDl:SiE'ONSIBIIJI'IrIES
<br />If the owner has hired a contractor OJ~ contlca"Jt:ors to undertake work., they lIlay b~ required
<br />to be licensed in accordance with stat:e l;lnd local regulations. If the contractor is not
<br />licensed as required by J,aw, both the owner and contrllot:or may be cited for a mt-dellleanor
<br />violation under state law. If the owner; or intended oontractor are uncertain as to what
<br />licensing requirements may apply for the intended work,. they are advised to contact the
<br />City of Zephyr-,ill. Building Depart~ent, 81:1-788-6611..
<br />Furthermore,. if the owner has hired a contralctor or: contractors, he is edvilled to have the
<br />contractor(s) sign portions of the "Contractor BectionsN of this applioation for which they
<br />will be responsible. If you, as the owner signs as the contr~ctor, you are indioating that
<br />you, rather than the contraotor, are responsible for the work. If the contractor wishes
<br />you to sign a. contractor that may be an indication that he is not properly lioensed and i.
<br />not entitled to peDM1tting priyileges in the City of Zephyrhill..
<br />C. TRAH~PORTATION IMPACT FBES AND UTILITY CONNBCTION FBES
<br />D. CONBTRUCTUION LIEN LNf (CHAPTER 713, FLORIDA STATUTE", ASAMBHDBD)
<br />. I certify that I, the applicant, have been p,rovided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guiden 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 "ownern prior to commencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />I certify that all the information in this application 1s accurate and that all work will
<br />be ~one in compliance with allap.plioable laws regUlating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a pe~t to do work and installation as indicated. I
<br />certity that no work or installation has oommenoed prior to issUanoe of a permit and that
<br />all work will be perfocmed to meet standards of all laws regUlating construction, City
<br />codes, zO~in~ regulations, a~d land development regulations in the jurisdiotion. I also
<br />certify that I understand that the regulations of other gover~ental agencies may apply to
<br />the intended work, and that it is my re!lPons.1bility 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 Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment. .
<br />*B.outhwest Florida Water Management Distriot'-Wells, Cyp~ess Bayheadll, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of mngineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health , Rehabilitative Services, EnVironmental Health Unik~Wells!
<br />Wastewater Treatment, Septic Tanks
<br />*u. S. Environmental Protection Agency-AIIbe.tc>s abatement
<br />I also certify that, if till material is to be used in Flood lone ~AN or "A,etc.N, it is
<br />understood that a drainage plan addressing a "compensating volumeN will be submitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to petmit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with' the work .nd 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, o~ violation. of any code. Bvery.peDmit
<br />issued ahall become invalid tinless the work authorized by 8uch pe~t is commenc~d within
<br />six months of issuance, or if' work authorized by thepermlt 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 per~t with fee oharge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspeqtion must be logged during each six
<br />month period, or the project will be considered abandoned. \ .
<br />WARNING TO OWNER: YOUR lrAIWRE TO RE~ORD A NOTICE OF COMMBNc"'NT HAY RESULT IN YOUR
<br />PAYING TWICE FOR IMI?ROVllM&HTS TO YOUR PROPBRTY. IF YOU INTIlND TO OBTAIN FINANCING, CONSULT
<br />W'1TH YOUR LBNDIlR OR AN ATTORNEY BErol\& RBCORDING YOUR NOTICE OJ!' COMMIlNCI!IMBNT. JOBS UNDER
<br />$2,500 IN VALUE DO HOT NI!:E~ TO RICORD AND POST A "NOTICE OF COMMBHCEMBHTN'.
<br />
<br />LV"U~I~~NB OF PERMIT AF.FlDAVIT
<br />
<br />r,l~
<br />
<br />. rY'l/);q/J CI ~ ~~7Ct7
<br />. "'''''MIII'''-! '7"""BR OR ""~ CL.
<br />
<br />STATE 01' F~ORlPA~
<br />COUNTY OF I ~"'2!J(J
<br />The foregoing ins~nt was acknowledged
<br />B.:fOr~ath:\.s~pay.o~~~ ' ~
<br />by . ~~ ~~~~Ltl__ _
<br />6: ( me of person acknolfledged)
<br />'0 who i. personally known to me,.~ .
<br />. G (P.30-5'~lri:,&-'7"I-O
<br />~o has produced H. JJJ(h/r/?5 J...IL..
<br />(type of identification)
<br />
<br />.n~}~~w-~th. .
<br />
<br />Sign~t~~~'Pl.~Pf~~, taking ack~owledgement
<br />~ '3JN\1llI'ISNI N1V~ os.. "!\l:~~~"
<br />~ . -;.
<br />
<br />SIGNATURE I CONTRAcTOR
<br />
<br />STATE or FLORIDA
<br />COUNTY OF .
<br />The foxegoing instrqment Was actnowledged
<br />Before me this ~.y of , 19..:..:....
<br />by
<br />(name of person acknOWledged)
<br />C1ho is personally known to me, or
<br />
<br />o who. has produce~
<br />,. ~ (type ~f',..J~ific.tion)
<br />and who OdJ.d. ~..:.Qi(.d nat~ake an oath
<br />
<br />...
<br />
<br />Signature of person taking a~knowledgment
<br />
<br />Name ~_.olJ~~~l.i1lS1tll..t>>b ^!t*
<br />pUOfl9MS 9fQQOll
<br />
<br />
<br />Name typed, printed or stamped
<br />
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