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<br />The. undeX:S,1.gned understands t.ha.t this pe:nnit ma.y 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. 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 1s not
<br />licensed as required by law, both the owner and contractor may be cited for a misdemeanor
<br />violation under state law. If the owner or intended contractor are uncertain as to what
<br />licen$ing requirements may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />Further.more, if the owner has hired a contractor or contractors, he 1s advised to have the
<br />contractor(s) sign portions of the UContractor SectionsN of this application for which they
<br />will be responsible. If you, as the owner Signs as bhe 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 Zepnyrh11ls.
<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 Uowner" 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 per.mit 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 1$ 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 Engineer$-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U. S. Environmental I'l:'otection Agency-Asbestos abatement
<br />! 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 volumeN will he SUbmitted which
<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 the technical 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 />six months of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of six 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 ~lS.OO. 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 />$2,500 IN VALUE DO NOT NEED '1'0 RECORD AND POST A~'NOTIC~u7Tn~ _
<br />
<br />
<br />(, ~I
<br />SIGNATURE: OWNER OR AGENT SIGNA: URE: CONTRACTO~~
<br />
<br />.-:>
<br />
<br />STNfE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _ day of_
<br />by
<br />
<br />acknowledged
<br />, 20.........
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledibed
<br />Before me this day of '..-:-
<br />by
<br />(name of person acknowledged)
<br />C4ho is personally known to me, or
<br />
<br />Owho has produced
<br />(type of identification)
<br />and who Odid []:iid not take an oath
<br />
<br />(name of person acknOWledged)
<br />Dwho is pe~$onally known to me, or
<br />
<br />o who haa produced
<br />(type of identification)
<br />and whoO did Ddid not take an oath.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or s~ed
<br />
<br />Name typed, printed or stamped
<br />
<br />Z 'd
<br />
<br />SOU'ON.
<br />
<br />Sl!IH~^Hd3Z jO Al!J
<br />
<br />~d82:? SOC! '8?' fe~
<br />
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