|
<br />C~):"J~)IT:~O;\:S ()~' PF:p.!\1~_r:.' AFF~D_A_.\JJ.r_~
<br />
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that t:his 'permit: may be subject to "deed restrictions" Hhich
<br />may be more restrictive than Ci ty t"t:!!gu'l.at:iolls, 'l'h~= llw:l,=rslgned assumes responsib<l.llty- for
<br />comp.U,ance w~th any applicable deed rest:J:ict.Lms,
<br />B. UNIJICI!;NSED CON'I'RACTORS AND CONl'HACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undert:ake work, they may be required
<br />to bl'! licensed in accordance with state and local regulations, If the contractor is not
<br />licensed as requlred by law, both the owner and contractor may be cited for a mlsdemeanor
<br />violatlon under state law. If the OHner or intended cont.l:actor ar.e uncert.aln as t.o what
<br />licens1n9 J:equi.rement.s may apply for the intended \'1ode, they are advised to contact the
<br />City of Zephyrhills Building Department, 813-788-6611,
<br />F'urthermore, 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 thls 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 Hork. If the contract.or 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 Z~phyrhills.
<br />C, 'I'RANSPOR'J'A'I'ION I MPAC'I' FEES AND UTILITY CONNEC'I'ION FEES
<br />D. CONS'rRUCTUION LIEN LAW (CHAPTER 713, FLORIDA S'J'A'I'UTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided "lith a copy of "Florida's ConstructJon
<br />lien Law - Ilomeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "owner", I r.erlfy that I
<br />have obtaJned a copy of the above descd,bed document and promise in good fal th to deli ver
<br />it to the "owner" prior to corrunencement.
<br />E. CONTRAC'l'OR'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 cm~liance 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 parnd!: and that
<br />all work Hill be performed to meet standards of all laHs regulating construction, City
<br />codes, zonlng regulations, and land development regulations 1n the jurisdiction. I also
<br />certify that I underst.and that the regulations of other governmental agencies may apply to
<br />the intended wOL'k, and that it is my responsibility to identify Hhat actions I must take to
<br />be in compliance. Such agencies include but are not l.imited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sells~tive
<br />Lands, Water/Wastewater 'l'reatment
<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 />*11,5. I!;nvironmental Protection Agency-Asbestos abatement
<br />I also certify that, if fil.l material is to be used in Flood Zone "A" or "A, etc.", it is
<br />understood tllat a drainage plan addressing a "compensating volume" 'will be submitt.ed which
<br />is prepared by a professional engineer registered in the state of Florida prior to permit
<br />issuance.
<br />A permit issued sllall be construed to be a license to proceed with the work and not as
<br />author1ty to vJolate, cancel, alter, or set aside any provisions of the tecllnical codes,
<br />nor.llall 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 cOlTunenced wi thin
<br />aJx months of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of sJx months after the time the work is corrunenced. One 90 day extension of time
<br />lnay be all.owed 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 />n~llth period, or the project will be considered abandoned.
<br />WARNING '1'0 OWNE',R: YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RESU.L'I' IN YOUR
<br />PAYING TWICE E'OR IMPROVEMENTS '1'0 YOUR PROPERTY. IF YOU INTEND '1'0 OBTAIN FINANCING, CONSULT
<br />WITIl YOUR I,ENDER OR AN A'rTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. LJOBS UNDER
<br />$2,500 IN VALUE DO NO'r NEED '1'0 RECORD AND POST A "NOTICE OF COMMENCEMENT",
<br />
<br />----.-.-'-----.--r
<br />SlGNA'1'URE: OWNER OR AGEN'r
<br />
<br />SIGNATURE: CON'I'RACTOR
<br />
<br />STATE OF FLORIDA
<br />COUN'l'Y OF ---
<br />The foiegoing instrument was acknowledged
<br />Before me this _ day of , 19_
<br />by___
<br />(name of person acknowledged)
<br />Owho is personally known to me, or
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this ------1iay of
<br />by
<br />
<br />ackno\1l.edged
<br />19
<br />
<br />(name of person acknowledged)
<br />[),ho Is personally known to me, or
<br />
<br />of identification)
<br />take an oath.
<br />
<br />D who has produced_____._____..__
<br />(tybe of Jdentification)
<br />and who Ddid DJJd not take an oath
<br />
<br />[]who has produced
<br />(type
<br />and whorl did Ddid not.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of peraontaking acknowledgment
<br />
<br />--------.---
<br />}1~~~;~-ty-p'~~-pr1nt~d or stamped
<br />
<br />Name typed, printed or stamped
<br />
|