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<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be
<br />may be more restrictive than City regulations. The
<br />compLiance vliLh any applicable deed restrictions.
<br />B. UNLICENSED COITrRACTORS AND CONTRACTOR RESPONSIBIL TTIES
<br />If the owner has hired a contractor or contractors to undertake work, tiley may be required
<br />to be licensed in accordance h'ith state and local regulations. Tf the contractor is /lot
<br />licensed as required by law, both the owner and contractor may be cited for a misdelneanor
<br />violation under state law. If the owner or intended contractor are uncertain as to what
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />City of 2ephyrhills 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 applicatio/l for I"I/dch 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 indica~ion that he is not properly ijcerlsed and is
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C, TRAl'lSPORTATIOl'l H1PACT FEES AND UTILITY COl'lNECTION FEES
<br />D. CONSTRUCTUION J,IEN 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", 1 cerify that I
<br />have obtairled a copy of the above described document and promise in good faith to deliver
<br />it to the "o\'mer" prior to commencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />I certify that all the informatioIl in this application is accurate and that al.l 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 irldicated. 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, 1 also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended l"iOrk, and that it is my responsibility to identify what acLi ons 1 mus t take to
<br />be in compliance. Such agencies include but are not limited to: *Department uf
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmelltally Sensiti.ve
<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, et- c.", it is
<br />understood that a drainage plan addressing a "compensating volume" will be submitted 1'/hicl1
<br />is prepared by a professional engineer registered in the State of Florida pLi or La 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. E:very pennit
<br />issued shall become invalid unless the work authorized by such permit is commenced y,ithin
<br />six months of issuance, or if work authorized by the permit is suspended or abarldoned 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 vlith fee charge of $15.00. The extension shal I be requested
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered abandoned,
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYH1G rvncE FOR Il1PROVElJ1ENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FIllANC [NG, CONSULT
<br />WITH YOUR LI:;tlDjl OR At! ATTORNEY BEFORE RECORDING YOUR IJOTICE OF COtvlMENCEME[,j 1'. JOBS UNDER
<br />$ 2, 50 0 ~~f?? D: ll'_:r~:l'(~_ R~ORD AND POST A "N01'1 CE OF CUl'I>1ENCE""" )'f" .
<br />
<br />
<br />/ ,&/J '>l//
<br />SIGN ~t'UR~J OV '/6~ AGENT
<br />
<br />subject to "deed restricti ons" \',hj eh
<br />undersigned assumes respollsibility for
<br />
<br />SIGNATURE:
<br />
<br />COtJTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument \"Ias
<br />Before me this _ day of
<br />by
<br />
<br />ackno,^Jledged
<br />, 2 CL..
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me thi s _day of-
<br />by
<br />
<br />acknowledged
<br />20
<br />
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />O,ho is personally known to me, or
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Dwho has produced
<br />(type ofidenLifical:ion)
<br />and \"Iho Odid [kEd not take an oath
<br />
<br />Signature of persun taking acknowledgement
<br />
<br />Signature of person taking acknOl-lled<jlllent
<br />
<br />Name typed, printed or stamped
<br />
<br />lJame typed, printed or sl:amped
<br />
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