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<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" which
<br />may be more restrictive thal1 City regulations. The undersigned assumes responsibility for
<br />compliance \\lith any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AIJD CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake \\lork, they may be required
<br />to be lj censed in accordance \-lith state and local regulations. If the contractor is not
<br />licensed as required by la\'I, 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 />licensillg requirements may apply for the intended work, they are advised to contact the
<br />Ci ty of Zephyrhil1 s Building Department, 813-780-0020.
<br />Furtllermore, 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 \'iOrk. If the contractor wishes
<br />you to sign as contractor that may be an indica~ion 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 STA'rUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lierl 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 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 AFFIDAVIT
<br />J 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 loJork 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 tile 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, Wetland 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 ZOlle "A" or "A,etc.", it: is
<br />understood that a drainage plan addressing a "compensating volume" will be submil~ted \~hich
<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 liceHse to proceed with tile 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 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 vJJthin
<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 l'lork 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 tIle Building Official. An approved inspection must be logged during eacll six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOIJR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCIllG, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR tJOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT t~EED TO ,RECORD AND POS1' A "nOTICE OF Cm1~1ENCElvjE[\JT".
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />
<br />tJ~
<br />
<br />acknowledged
<br />20_
<br />
<br />STATE OF' FLORIDA
<br />COUNTY OF
<br />The foregoing instrument \oJas a~pwledged?
<br />Before me this ,~/I't'1J.a'l 9f r, 20 ~
<br />by c'/frRf~ h"lFLt7H
<br />(name of person acknowledged)
<br />Dlho is personally known to me, or
<br />
<br />'fi'who has produced F2 lJ. L . tJ 1j;l-;13~ 7;1 -
<br />,."'.._~ . (.~ ype of ident.if.ica~&) U
<br />at,d "ho D.3Jd r;l1tJt)C'~' oath ..
<br />
<br />
<br />t king
<br />
<br />'j
<br />~ ~ ,/
<br />.----r" '/YJ.
<br />/ a.5 'C./
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by
<br />
<br />(name of person acknowledged)
<br />[1 Vlho is personally krlO\oIfl to me, or
<br />
<br />DWho has produced
<br />(type
<br />and \oJhoo di d 0 did not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Si9natnre of person taking acknowledgement
<br />
<br />
<br />
<br />Nall\e typed, printed or stamped
<br />
<br />,,"-:r.~'fU"" Bobbie Swetland
<br />Name{~f: ~,MYp:P~~~~~~~8~E6~Da~~~2J
<br />
<br />-:">";"c',(;i'~., iJONDED THRU TROY FAIN INSURANCf, INC
<br />
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