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<br />CONDl'l'lONS 01" P~l{MIT AI"I"lDAV1'l' <br />A. N,OTICE OF DEED RESTRICTIONS <br />The unders'lgned understands that this permit may be subject to "deed restrictions" which <br />may be more restrictive than City regulations. The undersigned assumes responsibility fo~ <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 may 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 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 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 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 pronlise in good faith to deliver <br />it to the "owner" 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 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 "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 /> <br />, C!C!ll!:1ln__ <br /> <br />:::Ole 1--' -- 1 Un..:' U lJ", U .C' : '."' 'ci C' I" <br /> <br />1"11 Ll::Hlo:' LI.II~:::. I kUL I 1 U1i l j.~i - <br /> <br />:... ._10. <br /> <br />,4 +,.... <br /> <br />, .' <br /> <br />U.'. InIlIC certified <br />Plltlnum In_..' <br />fl. <br /> <br />.. ______ 1Et rnn.o9ul ==--_..~..~~:... .__..,_~_.._!I :2 <br />--". .. 1.P -r ..... Critled <br />@J Builder 1C1COa221 <br />... CwtnIed <br />MIIE!!~.~~~!!!:~~~l2!!r~lnc. "::.: <br />".... ...~1S <br />1!1811 US Hw)t 301 North. Dade City. Florida 33823 C> RCI FbIt...... <br />352/567-6047 · 800/662-2393 · FAX: 3521567.4464 "ouf ~ fHI14. <br /> <br />e!J/19/12 <br /> <br />Page. <br />,- """, <br />"-' <br />'I <br />I: <br />\i <br />II <br />I. <br />'I <br />I: <br />I <br />,. <br /> <br />;i <br />II <br /> <br />1\ <br />I <br />JOB PHONli II <br />'I <br />__.._.,__.J, <br /> <br />I: <br />ii <br />I' <br />;! <br />I' <br />01 <br />I: <br />ji <br />:1 <br />il <br />I <br />i <br /> <br />/7"- <br /> <br />(( <br />\ <br />I <br />1\ <br /> <br />I <br /> <br />I <br />I P iNZER, FRANC IS <br />'I STIIEET <br />5381 EAST 1315T A~ENUE <br />i, CITY. STm aN ZIP <br />I. TAftPA, fL 33617 <br />, NOIT~ <br />II <br />I', . <br />w. ';';;l:ly ""bft,k IpI<ificlllion.'1nd nlimllll..tor: <br />Ii <br />1\ 9. <br />II <br />l <br />\ 11. <br />II <br />II 11. <br />II <br />!I <br />I. <br />ii <br />.1 <br />T <br />II <br />I, <br /> <br />I, <br /> <br />. \ <br />II <br /> <br />Mem", uf t"- ...,leI. <br />Roonng .ftCI f1llt1l MItII <br />AItOCII1Ion <br /> <br /> <br />OAT!: <br /> <br />PANZER RENTAL DUPLKl <br /> <br />JOlI LOCIITION <br /> <br />~12~-~126 16TH STREEt <br /> <br />~, O~ PLANII <br /> <br />ZEPHYRHtLLS, FLORIDA <br /> <br />-- _._..~.._._,. ,., ,'."--'. <br /> <br />"ilB.~ COQ.tr~atlan, Inc. ta p~QY1de 5-year warranty Qn vork~.n.hipJ .Kal~.1Qn.l <br />stor. da..ge. work done or da.ag~ by others, tree da..;e. and/or .tr~et~r.l d...ae <br />t.o roof deok. <br /> <br />Owner to pr~,,_~d!.,....ct:e'.1!I <br />..t..rial.. <br /> <br />11llln Con.tructi.on,.' Inc;' to provid. o.rutral Lfab1Ilty" andWorkl!r' 8 'cowip.msaUi:in <br />In8\lrBnce ($2,....... Uldt) and r!:r~.1l!1~g p.~n1t.~_ <br />'_.'- . .......~- ..."~~". .. ',. ..., <br /> <br />te reof for delivery truck for loading/unloading for rDofing <br /> <br />.r: <br />. ~ I <br />Ii <br />,I <br />\\ <br />I, <br />I. <br />l' <br />" <br />- 11 <br />I: <br />II <br />.! <br />