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<br />CUii!)) T.LU;,I~ OJ:' i.'L';I'J1,~,T 1\J:'I:'J.!JAV 1';:
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The unde~signed understands that this permit may b," subject to ~deed restrictions" which
<br />may b~"I1l9~e J;es~rict,i ve ,than Ci ty .rf!qula tions . 'Thf! undersigned assumes responsibi,lity for
<br />compliance, "ith, any applicable deed restrictimlS.
<br />B.'-'UNLICENSED' CONTRACTORS AND CON'rnAc'rOR RESI?ONSrUILI'l'IES
<br />If the owner has hired a contractOJ= or I::ontractors to undertake work, they may be required
<br />to be licensed in accordance wiLh sLaLe and loci'll regulations. If the contractor is not
<br />licensed as'required by law, both the owner and contractor may be cit~dfor a misdemeanor
<br />violation' under state law. If the c,wneJ= 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 />co~~~a~tOr(8) 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,_ r..ther 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 li~,ensed and is
<br />not entitled to,' permitting privileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D~:,.,CON,sT,RUCTUION 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 />lie~ 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.
<br />E. CONTRACTOR'S/OWNER'S AFFI0AVIT
<br />I ce~tify that all the information in this application is accurate and that all work will
<br />be done in compl~ance with all applicable laws regulating construction, zoning, and land
<br />development. '
<br />Application is hereby made to obtain a perlnit to do work and installation as in41cated. ,I~
<br />certify that no work or installation has commenced prior to iss,uance of a permit and that I
<br />all work will be performed to meet standards of all laws regulating construction, City ~
<br />codes, zoning'" regu];ations, 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 ~ctions 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 En~ironmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Axeas,
<br />, ,Altering WaterccSurses:.
<br />*Axmy Corps 'of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmental Health Unit-WeltS,
<br />Wastewater Treatment, Sep~ic 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 "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 pe~t issued shall be construed to be a licens~ 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 />corr~c~ion ,of errors in plans, construction, or violations of any code. Everypermit
<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 abandonedfor~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 requeste~
<br />in writing to'the Building Official. An approved inspection must be logged during each sfx
<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 F NANCING, CONSULT
<br />WITIl YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO'rICE OF COMM CT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE O~ OOMM~C ENT"
<br />
<br />
<br />
<br />, /
<br />
<br />,
<br />S~~RE: OWNER OR AGENT
<br />". ,"-,'\."~.-:',~~i/:J.:,~~',.:;;".r.,t~ _ .', ..~ '...v
<br />,'S'1'A'1'B q~ '~RIDJ\
<br />..".COUHTY)o'r,{~""-"'~:..l'" ""1".";.,",:
<br />
<br />The"'''foregoing inst.t=umentwas' acknowledged
<br />Before me this day of , 1~
<br />b '
<br />Y .,
<br />~'" "~~(name-of'person acknowledged)
<br />Owhois-,personally known t,ome, or
<br />
<br />. ".\.... i,'-ni",,'-i':;~'.""." '-. ~
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<br />o wb~ h~~.p~~uced
<br />, ." (type of identification)
<br />and whoOdidOdid not take an oath.
<br />
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<br />':~ ;~;"~.l :.'; ;.: .r
<br />
<br />GNATURE: CONTRACTOR
<br />~JF~!jt\~I,~" ..:,~'.,
<br />STATE OF FLORIDA [)r:-..c~
<br />COUNTY OF ~:2
<br />The foregoing i~~~ent w owled~~d (
<br />Before me \this (, ay f . : " .,~~tJ
<br />by ~ '
<br />~ (name of person acknowledged)
<br />~llO is personally known to me, or' I.
<br />
<br />o who has produced
<br />(type of identification)
<br />id not take. an 'oath~"~'~'~"
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<br />'siinatu'l:eof person taking acknowledgement
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<br />,~~~~~ printed or stamped
<br />
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<br />AUG OJ 200lS
<br />IlOIaD MOlJOH '
<br />R111NSU1lANa CXlMIllNr
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