|
<br />L;lJIW1'1'lONS DE' PERl'1I'f AFlrIIlAVI'f
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands th~t this p~rmit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNI,ICENSED CONTRAC'l'ORS AND CON'l'RACTOR RESPONSIBII,I'l'IES
<br />I f the o\"mer has hired a contractor or contractors to undertake work, they Hlay be required
<br />to be licensed in accordance with state and local reglllations. If the contractor is not
<br />lioensed as required by law, both the o\"mer and contractor may be cited for a mil:ldemeanor
<br />violation under 6tate laH. If the owner or intended cuntractor are uncertain as to Vlhat
<br />licensing requirements may apply for the intended work, they are advi.sed to contact the
<br />City of Zephyrhi.lls Building Department, 813-788-6611.
<br />Furtherlnol:e, 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 />Hill be r'esponsi.ble. If you, as the owner signs as the contractor, YOl! are indicating that
<br />you, loathe!: than the contractor, are responsible for the work. I f the contractor wishes
<br />you to sign as contractor that may be an indication that he is not properly licensed alld is
<br />not entitled to permitting privil~ges in the City of Zephyrhi.lls.
<br />c. 'I'RANSPOR'l'ATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONS'I'RlIC'I'UION LIEN LAvJ (CHAP'I'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the appli.cant, have been provided with a copy of "Florida's Construction
<br />1i.en Law - Homeowner's Protection Guide" prepared by the Flori.da Department of Agriculture
<br />and Consumer Affairs. It the applicant is someone other that the "owner", I cerity that I
<br />have obti:iined a copy of the above described document and promise in good faith to deliver
<br />it to the \\owner" prior to conunencement.
<br />E. CONTRAC'l'OR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the informati.on in this application is accurate and tllat all work will
<br />be done in compliance with all appli.cable 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 />certi fy that no \"wrk or installation has commenced prior to issuance of a penni t 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 jllrisdiction. I also
<br />certify that I understand that the regulations of other governmental agenci.es lnay 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 i.nclude but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environment.ally Bens~tive
<br />Lands, Water/Wasteh'ater Treatment
<br />.Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*AC1UY Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*LJepartment of Health & Rehabi.l.itative Services, Environmental Health \Jnit-WeLls,
<br />Wastewater Treatment, Septic Tanks
<br />*lI.S. Environmental Protection AgencY-A~bestos 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 suumi tted vlhich
<br />is prepared by a professional engineer registered in the State of Florida prior to permit
<br />issuance.
<br />A permit issued shall 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 tbe technical codes,
<br />nor sllall issuance of a permit prevent the Building Of~icial from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any oode. Every pe1:mlt
<br />issued ahall become invalid unless the work authorized by such permit is cOlJuuenced within
<br />six months of issuance, or if work authorized by the permit is suspended or abandoqed for a
<br />period of Sill months after the time the work i6 commenced. One gO day extension of tillle
<br />may be allowed for tbe permit with fee charge of $15.00. The extensi.on shall be requested
<br />in writing to the Building Official. An approved inspection must be logged during eacb'six
<br />month period, or the project Hill be considered abandoned.
<br />WARNING TO OWNER; YOUR FAILURE '1'0 RECORD A NO'I'ICE OF COMMENCEMEN'I' MAY RESUL'I' IN YOUR
<br />PAYING 'l'WICE fOR IMPROVEMENTS TO YOUR PROPER'fY. If' YOU INTEND TO OB'I'AIN li'INANC;IN~, ~qNftlUL'I'
<br />WI'l'H YOUR LENDER OR AN A'f'rORNEY BEfORE RECORDING YOUR NOTICE OF COMMENCEMEN'!'. JOBS UNDER
<br />$~2,'/~.U " no NOT NEEl> "0 RECORD AND POS" A "NonCE OF COMMENCEMENT".
<br />
<br />y~~~
<br />
<br />SIGNA'l'l1RE: OWNER OR AGEN'l' SIGNA'I'URE: CONTRACTOR
<br />
<br />of identi.ficationl
<br />take an oath.
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument w~s acknowledged
<br />Before me this ------siay of----, 19
<br />by
<br />(name of person aoknowledged)
<br />[1ho is personally known to me, or
<br />
<br />o VlilO has produced
<br />(type of ident.ifioation)
<br />and VJho Ddid DUd not take an oath
<br />
<br />S'fA'rE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />Before me this __ day of ___., 19_
<br />by.
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and who[] did Ddid not
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or st.amped
<br />
<br />Hame typed, printed or stamp.,;c.l
<br />
|