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<br />The imde.t:s.1.gned understandS t.hat thi.s pe.tlrLit may be suhject to "deE!d restrictions" which
<br />may b. more restrictive than City regulations. The undersigned assumes responsibility for
<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. It the owner or intended contractor are uncertain a8 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 SectionsH of this application for which they
<br />will be responsible. If you, as the owner signs as ~he 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 Zephyrhllls.
<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 promise 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 1s 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 />Landa, Water/Wastewat~r Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engin@ers-Seawalls, Docks, NaVigable Waterways
<br />*Department of Health & Rehabilitative Se~v1ces, Environmental Health Unit-Wellst
<br />Wastewater Treatment, Septic Tanks
<br />*U.5. Environmental Protection Agency-Asbestos abatement
<br />I a150 certify that, if fill material is to be u'sed in Flood Zone "A" or "A, etc.", it is
<br />understood that a drainage plan addressing a "compensating volumeN will be submitted which
<br />is prepared by a professional engineer registerea 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 the technical codes,
<br />nor shall issuance of a permit prevent the Building Offic1al from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any code. Every per,mit
<br />issued shall become invalid unless the work author1zeQ by such permit is commenced within
<br />six months ot issuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of sig months after the time the work is commenced. One 90 day extension of time
<br />may be allowed 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 period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS '1'0 YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NO~CE OF C CEMENT".
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />
<br />OR
<br />
<br />STNfE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by
<br />
<br />acknowledged
<br />, 20,--
<br />
<br />STATE OF FLORIDA I ) " /? J.
<br />COUN'1'Y OF /f~rD ;t/4tJd J
<br />The foregoing instrument was acknowledibed
<br />Before me. this di? day of 111 ~ ' () 3
<br />by )-(1'\ (Jt11.01i/,~ ..e. re.e6tAi.~,v
<br />~~ (name of person acknowledged)
<br />~o 1. personally known to me, or
<br />
<br />(name of person acknowledged)
<br />Dwho is pe~$onally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoO did Ddid not take an oath.
<br />
<br />and~ho Odid
<br />'\ h'
<br />( !Ct.~{.
<br />
<br />o who has produced
<br />(type of identification)
<br />I ~ld not take an oath
<br />
<br />GUts j-
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Si91lature of person taking acknowledgment
<br />
<br />/:JA w /J t{)~ ~ /
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or S~l!l!d
<br />
<br />Z 'd
<br />
<br />so~s' O~j
<br />
<br />Sll[HdAHdjZ jO AIrJ
<br />
<br />INdS8:Z '?DrJ7 '~?'i.el~j
<br />
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