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<br />CONDITION::; (),~' ::'~R"1l'}.' A,~''5'~:;)AV }.':'
<br />
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permi.t may bE~ sub:),::ct 1:0 "deed restrictions" which
<br />may be more restrictive than City requl3ltions. The undersiqned assumes responsibility for
<br />compliance with any applicable deed J=E~stric.tion:~;.
<br />B. UNLICENSED CONTRACTORS AND CONTRll,.CTOR R]~Sj?ONSIBILI'rIE:S
<br />If the owner has hired a contractor or cont:rac,:ors to uudert:ake 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. If the owner or in1tended contractor are uncertain as 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 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, 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 Zephyrhills.
<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 A~fairs. 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 is 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, Wet~and Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative 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 "A" or "A, etc.", it is
<br />understood that a drainage plan addressing a "compensating volume" will be 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 $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 OWNE' UR FAILURE TO RECORD A NOTICE OF COMMENCEMENT
<br />PAYING TWI IMPR VEMENTS TO YOUR PROEERTY. IF YOU I
<br />WITH YO R OR ATTORNEY BEFORE RECORDING YOUR I
<br />$2,5 DO T NEED TO RECORD AND POST A
<br />
<br />/'
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF pAS(~O
<br />The foregoing instrument was acknowledged
<br />Before me this ~ day of ()(!...n:>8c:1?, :a;~3
<br />by J<.. A Y 'D A,J J EL-5
<br />. (name of person acknowledged)
<br />~ho is personally known to me, or
<br />
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF PASc.'D
<br />The foregoing instrument was acknowledged
<br />Before me this ~day of flr7?l.k:::Je, .. ~3
<br />by RAY .~
<br />(name of person acknowledged)
<br />~o is personally known to me, or
<br />
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoD did gdid not take an oath.
<br />
<br />.-1{; f;tjJ--e ~~. ~~ .
<br />
<br />Signature of per n taklng acknowledgement
<br />
<br />o who has produced
<br />(type of identification)
<br />~id not take an oath
<br />
<br />
<br />j(An.ILEtEA.) V :.B~iJvV,J
<br />
<br />Name typed, p V.L ~ ~
<br />~.".~p~ KATHLEEN J. BROWN
<br />~~ ~ MY COMMISSION # DD20n41
<br />"'I't'OFt\.~$ EXPIRES: Aprtl3O. 2007
<br />l-E!lX}3-NOTAAY FL Nolaly Discount Assoc. Co,
<br />
<br />KA 77-1 LE:l:..7V \. r. y; R () IN Ai
<br />Name typed, . ed
<br />.to KATHLEEN J. BROWN
<br />~..1 MY COMMISSION # DO 2On41
<br />~ OF t\.~ EXPIRES: April 30. 2007
<br />l-EllJO.3-NOTARY FL Notary ~ Assoc. Co.
<br />
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