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<br />A. NOTICE OF UEED RESTRICTIONS
<br />The unrlersigned understands that this permit may be subject to "deed restrictions" whidh
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance l'iitll any applicable deed restrictions,
<br />B. UNLICENSED CONTRACTORS Ail!) CONTRACTOR RESPONSIBILITIE,S
<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 tinder state law. If the own~r or intended contractor are uncertain as to what
<br />licensillg requirements may apply for the intended work, they are advised to contact the
<br />City of ZephyrhiJls Building Department, 813-780-0020,
<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 Sections" of this application for which they
<br />will be responsible. If you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the contractor, at'e responsible for the \'1ork. If the contractor wishes
<br />you to sign as contractor that may be an indicat;ion that he is not properly licensed and is
<br />not 811titled to permitting privileges in the City of Zephyrhills,
<br />C, TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTlJION 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 Uepartment of Agriculture
<br />and Consumer Affairs, If the applicant is someone other that: the "owner", I eerify that I
<br />have obtained a copy of tile above described document and promise in good faith to deliver
<br />it to the "owner" prior to commencement,
<br />E. CONTRACTOR' S/OWNER' S AFFlDAVI'I'
<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 110 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 tllat I understand that the regulations of other governmental agencies may apply to
<br />the intended work, and that it is my responsibility to idelltify 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 Environmentaily Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Welis, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rellabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone ".l1," or "A,ete,", it is
<br />understood that a drainage plan addressing a "compensating volume" w.i 11 be submit tfld which
<br />is prepared by a professional engineer registered in the State of Florida prle)r to permLt
<br />issuance,
<br />A permit issued shall be construed to be a license to proceed \<lith the work and not as
<br />authority to violate, canoel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter req\liring 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 cd_thin
<br />six montllS of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of six months after the time the \'lark is commenced. One 90 day extension of Lime
<br />Illay 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 OWllER: YOUR FAILURE TO RECORU A nOTICE OF COMl'1ENCE['1ENT t/1AY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITll YOUR LENUER OR AN ATTORNEY BEEDRE RECORDING YOUR NOTICE OF COMMENCEMENT, JOBS UNDER
<br />$2,500 IN A lEZ;":O TO FECORO AND POST ~ZN'I~gil
<br />
<br />
<br />
<br />SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
<br />
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by
<br />
<br />acknovJledged
<br />2CL-
<br />
<br />STATE OE' FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this .__day of
<br />by
<br />
<br />acknowledged
<br />, 20
<br />
<br />(name of person acknowledged)
<br />0\'1110 is personally knOl-m to me, or
<br />
<br />(name of person acknowledged)
<br />Olho is personally known to me, or
<br />
<br />Dwho has produced
<br />(type
<br />and l'ihoO dl d 0 did not
<br />
<br />of identification)
<br />take an oath,
<br />
<br />o who has produced
<br />(type of identification)
<br />and ",ho Odid Oiid not take an oath
<br />
<br />Signature of person taking acknol'iledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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