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<br />A. NOTICE O~ DEED RESTRICTIONS
<br />The undersigned understands thijt t::U/l perm! t may be subj ect to "deed restrictions" \--Ihi.ch
<br />may be more u:lsLJ:iative than City r-euulations. The undersigned assumes responsibility for
<br />eomplianae \Yi th any appli cable de'"d J:t:/ltrictionl:i.
<br />B. UNIJICENSED 'CON'I'RAC'I'ORS AND CON'I'HACTOR RESPONSIBIJ.I'l'IES
<br />If the: Ol--lner has hired a contractor or contractors to undertake work, they may be required
<br />to be lictlnsed in accordance wlth :>tat.e and 10ea1 regulatlons. If the contractor is !lot
<br />licensed as required by law, both the owner and contractor may be cited for a misdemeallor
<br />vio1ation under state: laH. If the OWner" or inttlnded contractor are uncertain as to vlhat
<br />li censing requirements Inay apply for the intended work, they are advised to contact the
<br />City of Zephyrhill s Building Dl::partment, 813-768-6611.
<br />Flu:therll1ore, 1 t the Ovmer has hin:d a contractor or contractors, he is advised to have the
<br />contracLor(s) sign portions of the "Contractor Sections" of this application for which they
<br />vd!l be rtlsponslble. If you, as the owner signs as the contractor, YQll are indiaati.ng that
<br />you, latlier than the contractor, at-e responsible for the work. If the contractor: wishes
<br />you to siyn CIS contractor that mi:lY be an indication that he i.s not pt'opet'ly licensed and is
<br />Hot elltitled to permitting pr-ivileges i.n the City of Zephyrhi.lls.
<br />C. 'l'RANSl'Ok'!'A'flON IMPAC'l' fEES AND U'l'UI'l'Y CONNECTION FEES
<br />D. CONS'l'RllC'rUlON LIEN LMJ (CIiAP'l'ER '713, FLORIDA STATUTES, AS AMENDED)
<br />1 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 appli.cant is someone other that the "owner", I cerity that I
<br />have obtained a copy of the above described document and promise in good faith to deliveJ:
<br />it to the "owner" prior to COlJunencement.
<br />E. CONTRAC'I'OR' S/OWNER' S AFFIDAVIt!,
<br />I certify that all the information in this application is accurate and t}lat all work will
<br />be done in compliance with all applicable laws ragu} ating constr-uetion, zoning, and land
<br />devf!llopment.
<br />Application is hereby made to obtaln a permit to do \York and installation as indicated. 1
<br />certify that no Hork or installation has conunenced pri.or to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regulating construotion, City
<br />codes, zoning regulations, and land development regulations in the jurisdictJon. I also
<br />certify that I undel'stand 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. Sl~ch agencies include but are not limited to; *Department of
<br />Envirormlental Regula ti on-Cypress Bayheads, Wetland Areas and Environmentally Sens} ti ve
<br />Lands, Water/Wastewater Treatment
<br />*Southwel:Ot jj'lodda Water Management District-Wells, Cypress Bayheads, Wet.1 and Areas,
<br />Altering Watercourses
<br />*Arrny Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*lJepartment of Health & Rehabilitative Services, Environmental Health Unit-WeLls,
<br />Wastewater Treatment, Septic Tanks
<br />*11.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 />undeJ::stood that a drainage plan addressing a "compensating volume" 'will be submitted Ylhich
<br />is prepared by a professional enginel::r registered in tlle State of florida prior to penuit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the \York and not as
<br />authority to violate, cancel, alter, or set aside any provisions of the technical codea,
<br />nOt shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />cor~eotion of errors in plana, oonstruction, or vio~ations of any oode. Every p~'mit
<br />i s/iued shall become invalid unlfi!ss the work authorized by such permi t is cOllunenced within
<br />six months of issuance, or if work authorized by the permit is suspended or abandoqed f~r a
<br />period of six months after the time the work is conunenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be reques~ed
<br />JII writing to the Bui1ding Official. An approved inspection must be logged during each aix
<br />lIlonth period, or the project will be considered abandoned.
<br />WARNING '1'0 OWNERI YOUR ~AILlJRE TO RECORD A No'rrCE OF COMMENCEMENT MAY RESUL'!' IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER'ry. If YOU INTEND TO OBTAIN FINANqH~q, _(::{~N~UL'r
<br />W!'l'H YOUR LENDER OR AN A'l"rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'!'. JOBs UNDER
<br />$2,500 IN VALUE no NO'l' NEED TO RECORD AND POS'!' A "NO'l'ICE OF COMMENCEMEN'r",
<br />
<br />COlHJI'rIONS OF PERMI'f AFb'IDAVIT
<br />
<br />SIGNA'l'URE; CONTRAC'l'OR
<br />
<br />S IGNA'l'lJRE I OWNER OR AGENT
<br />
<br />S'l'ATE Of' fLORIDA
<br />COUN'l'Y OF
<br />The foregoing instrument was
<br />Before me this __ day of
<br />by'
<br />
<br />acknowledged
<br />, 15L-
<br />
<br />STA'1'E OF FLORIDA
<br />COUNTY OF _____
<br />'rhe foregoing instrument W~6 aoknoVlledged
<br />Before me this _~ay of---, 19 _~_
<br />by
<br />(name of person acknowledged)
<br />[1ho is personally known to me, or
<br />
<br />o who has produced _____
<br />(type of identification)
<br />and Hho Ddid D.Hd not take an oath
<br />
<br />(name of person acknowl~dged)
<br />Owho is personally kno\Yn to me, or
<br />
<br />o \Yho has produoed
<br />(type
<br />and whoL] did (]did not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />-~~----_.._~
<br />~1-~-I~;;-ty'p;ZC pdnt-;"d or s l:amped
<br />
<br />Name typed, printed or" stamped
<br />
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