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<br />C()~\'.!JI'r~r.U,\TS Q~' ?~~~.t.\I~~~'.~1 A~:~~~}l\V:~'!"1
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<br />A, NOTICE OF DEED RESTRICTIONS
<br />The undel::slgned understands that Lids permit In3.Y be sJbject to "deed restrictions" which
<br />may. be more restrictive than City regulations. '1']1<= ulldersiqned assumes responsib1U.ty for
<br />compLiance wi th any applicable deed r,=s trictL:>tls.
<br />B, UNIJICE:NSED CON'l'RACTORS AND CONTRACTOR RESPJ~lEiII3IlJI'l'IE:S
<br />If the owner has hired a contractol:: or contractors to undertake Hork, they may be r:equired
<br />to be licensed in accordance Hith state and local reg~lations. If the contractor is not
<br />licensed as required by law, both the owner and contractor may be cited for a misdemeallor
<br />violation under state laH. If the O1.~ner or intended contr:actor are uncertain as to \vhat
<br />licenSIng requirement.s may apply for the intended work, they are advised to contact the
<br />city of Zephyrhills Bui.lding Department, 813-788-6611.
<br />~lrthermore, 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 whicll 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 tile 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 Zephyrhill.s,
<br />C. 'II RAN S POR'l'A.'l' I ON IMPAC'I' FEES AND U'l'ILI'rY CONNEC'rION FEES
<br />D, CONS'1'RUC'l'UION LIEN LAW (CHAPTER 713, FLORIDA S'1'A'l'UTES, AS AMENDED)
<br />I certify that 1, the applicant, Ilave been provided with a copy of "Florida's Construction
<br />1 Jen La\-l - Homeowner's Protection Guide" prepared by the Florida Depar.tment of Agricul ture
<br />and Consllmer Affairs. If the applicant is someone other that the "owner", I cerify that 1
<br />have obtained a copy of the above described document and promlse in good faith to deliver
<br />it \;0 the "oHner" prior' to commencement.
<br />E. CON'1'RAC'l'OR' S/OWNER' S AFFIDAVIT
<br />I certify l;hat all the infor-mation 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 permit: and that
<br />all work wilL be performed to meet standards of all laHs regulating construction, City
<br />codes, zonillg 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 Hor-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 limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensttive
<br />Lands, Water/Wastewater Treatment
<br />*Soutllwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />kAnny Corps of Engineers-SeawaLls, Dock.'3, Navigable Waten.Jays
<br />*Department of Health & Rehabilitative Services, Envlronmenta1 Health Unit-Wells,
<br />Wastewater Treatment, Septlc Tanks
<br />*U.S. Envil::omnental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone "A" or "A,ete,", it is
<br />under'stood that a drainage plan addressing a "compensating volume" 'will be subm.i tted Vlhich
<br />is prepared by a professional engineer registered in the state of Florida prj.or to permit
<br />issuance.
<br />A permit issued sllall 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 tecllnlcal 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 />si.x months of issuance, or if work authorized by the permi.t is suspended or abandoned for a
<br />period of slx months afte.1: the U.me the work is commenced, One 90 day extension of Ume
<br />may be alloHed 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 ped.od, or the proj ect will be considered abandoned.
<br />WARNING TO OWNE',R: YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RESUW' IN YOUR
<br />PAYING 'l'WICE E'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND 'IIO OBTAIN FINANCING, CONSULT
<br />WI'rH YOUR I,E:NDER OR AN A'1''l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ,TOBS UNDER
<br />$2 500 HJ VALUE: DO 1'10'1' NEED '}'O RECORD AND POST A "NOT] CE OF COMMENCEMEN1'1''' ',.-: ~
<br />' ,7 ? 8/,00- '1.7 -.;7 0 -~~O-t::7
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<br />/ - ~--- / ~/
<br />
<br />OWNER OR AGEN'r SIGNA" RE:
<br />
<br />
<br />
<br />STATE OF E'LORIDA
<br />COUNTY OF ----..
<br />'rhe foregoing instrument VIas acknowledged
<br />Before me this ___ day of , 19_
<br />by ____
<br />(name of person acknowledged)
<br />D~lo 1s personally known to me, or
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this __day of
<br />by
<br />
<br />acknowledged
<br />, 19 ~
<br />
<br />(name of person acknowledged)
<br />C1ho is personally known to me, or
<br />
<br />[)who has produced___
<br />( type
<br />and wllo[] did []did not
<br />
<br />II who has produced _____________
<br />(type of ident ificaUon)
<br />and who Ddld Gild not take an oath
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name l~yped, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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