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<br />A. NOTJCR OF DEED RESTRICTIONS
<br />The undersigned undersl~ands that this permit may be subjecl' to "deed restrict,Lons" which
<br />may he more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance \'lith any appLicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />[f tile 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. If the owner or intended contractor are uncertain as to wh3t
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills 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 app.1ication for \vhich they
<br />will be responsible. If you, as the owner sign~ 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 indi,c,J.t~ioll 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 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 COMnencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />I certify that all the information in this application is
<br />be done in c:ompliance \'lith all ,applicable laws regulating
<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, zonin'J 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 />tile 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 ane! Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />'Southwest f'lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*l\rmy Corps of Engineers-Seawalls, Docks, Navigable WatenoJays
<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 pe~mit with fee charge of $15.00. The extension shall be requested
<br />in writillg to the Building Official. An approved inspection must be 10'Jged 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 TO 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 "NOTICE OF COMMENCEMENT".
<br />
<br />
<br />t1~4 ~/~
<br />
<br />SIGNATU ,: 0 R OR AGENT
<br />
<br />STATE OF FLORld5A""-j , ~
<br />COUNTY OF /.~~::/ ~0
<br />The fo~eCjoing ins rument was acknowledged
<br />Before me this 1/1 day of It) () vi , 20~ "':3
<br />by F ~ . _roe; .
<br />(name of person acknowledged)
<br />Owho is personally known to me, or
<br />
<br />accurate and that all work will
<br />construction, zoning, and land
<br />
<br />SIGNATURE:
<br />
<br />CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregojng instrument was
<br />Before me this _day of
<br />
<br />acknowledged
<br />, 20
<br />
<br />by
<br />
<br />(name of person acknowledged)
<br />Dvho is personally known to me, or
<br />
<br />~;;~ has produced /0. f)L :7j2.tJO--;Li)t/-'1'1./ff}~-cSJ who has produced
<br />. -- ."..-. . (type of identification)
<br />and,.. .Wh... "C:dic1) ~di~ n9t, I,.~J~" O}t~/
<br />
<br />!, ~~- l{~J 4J<;&!(M. ,
<br />
<br />Signature of person taking acknowledgement
<br />
<br />and 'tlho 0 did
<br />
<br />(type of identification)
<br />O:lid not take an oath
<br />
<br />Signature of person taking acknowledgment
<br />
<br />...\\'S..~''J,'''' I
<br />!':i1' Bobbuo !:w9lland
<br />Name~' i~ ~~G.Qt.1MI5sJOt4ltCC!S~l/?Xl'~S
<br />- '. '1~~.......jj~. February 22, 2004
<br />. !If, ,r,i.. ,JONDED THRU TROY FAIN INSURANC~ INC
<br />
<br />Name typed, printed or stamped
<br />
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