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<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" Ivtdeh
<br />may be more restrictive ttlan City regulations. The undersigned assumes responsibility for
<br />campI iance vii th any applicable deed restrictions.
<br />B. UNLICENSED COl~TRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accordance \vith state and local regulations. If the contractor is riot
<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 what
<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 />Furthennore, 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 wtdeh 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 wistles
<br />you to sign as contractor that may be an indica~ion that he is not properly licerlsed and is
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C. TRAt\lSPORTATION H1PACT 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 Constructi.on
<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 obtained a copy of the ~bove described document and promise in good faith to deliver
<br />it to the "mmer" prior to cOlrunencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />I certify that all the information in this application is accurate and that aU \-Iork I'd.l]
<br />be done in compliance with all applicable laws regulating construction, zoning, alld land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as irldicated. I
<br />certify that no vlork 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 work, and that it is my responsibility to identify what actions 1 mllst lake to
<br />be in compliance. Such agencies include but are not limited to: *Departmenl of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Baytleads, 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 vvhich
<br />is prepared by a professional engineer registered in the State of Florida prior Lo permit
<br />issuance.
<br />A permit issued stlall 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 ttle 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 pennit
<br />issued shall become invalid unless the work authorized by such permit is cOlwnenced within
<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 with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspection must be logged durirlg 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 />LJJ~ ~~ [,jJ
<br />
<br />SIGNATURE: OWNER OR AJ . SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUl~TY OF
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by
<br />
<br />acknovlledged
<br />20_
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument \vas
<br />Before me this _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 />Olho is personally known to me, or
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o who has produced_________
<br />(type oficleIltificaUon)
<br />and Ivho 0 did Diid not ta ke all oa Ul
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknov,ledglllenl:
<br />
<br />Name typed, printed or stamped
<br />
<br />llame typed, printed or stamped
<br />
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