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<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" 1'Ildch
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compl.iance I-,ith any applicable deed restrictions.
<br />B. UNLICENSED COllTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, tlley may he required
<br />to be licensed in accordance l'Iith 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 la\'1. If the ovmer or intended contractor are uncertain as to I-,hat
<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 llave the
<br />contractor(s) sigrl portions of the "Contractor Sections" of this application for wtdch they
<br />I-lill be responsible. If you, as the owner signs as the contractor, you are incLLcating that
<br />you, rather than tile contractor, are responsible for the work. If the contractor wishes
<br />you to sign as contractor that may be an indicat:;ion that he is not properly licensed and is
<br />not entitled to permitting privileges ~n the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. COllSTRUCTUION LIEU LAltil (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. 1 f the appl icant is someone other that the "owner", 1 ceri fy that 1
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "ollner" prior to commencement.
<br />E. CONTRP,CTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the informatioIl in this application is accurate and tl1at all vlOrk 1'1111
<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 vlOrk and installation as indicated. I
<br />certify that no "Iork or installation has commenced prior to issuance of a permit and that
<br />all work 1'li11 be performed to !lleet standards of all la,'1s regulating construction, Ci ty
<br />codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br />certify that I understand that Lhe regulations of other governmental agencies may apply LeI
<br />the intended work, and that it is my responsibility to identify what actiorls 1 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 Sellsltive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses I
<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" vlil1 be submitted vlhleh
<br />is prepared by a professional engineer registered in the State of Florida pri or' Lo permit
<br />issuance.
<br />A permit issued sllall 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 techrlical 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 permit
<br />issued shall become invalid unless the work authorized by such permit is cOJwnenced within
<br />six months of issuance, or if work authorized by the permit is suspended or ahandorled for a
<br />period of six months after the time the vlOrk is commenced. One 90 day extension of ti me
<br />may be allol'led for the pennit vJith 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 l'Iill be considered aba,rodonf;G.!oi.l. :. ..: ~r
<br />ltJARtnNG TO OVJNER: YOUR FAILURE TO RECORD A [KJTICE OF COlvj[vjENCE~'1ENT MAY RESULT IN YOUR
<br />PAYIUG TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FIUANCING, CONSULT
<br />ltJITH YOUR LENDER OR All ATTORNEY BEFORE RECORDING YOUR IJOTICE OF CO[vj[vjENCE~1ENT. ,JOBS UNDER
<br />$2,500 IN VALUE DO NOT UEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />(9~~ ~~~;t~
<br />
<br />SIGNATURE: m'INER. OR AGEllT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF~IDA
<br />COUWl'Y OF ~c...O
<br />The foregoing instrument was acknowledged
<br />Before me this _ day of 2CL..-
<br />by
<br />~ (name of person acknowledged)
<br />~ho is personally known to me, or
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _day of
<br />by
<br />
<br />acknowledged
<br />, 20
<br />
<br />(name of person acknowledged)
<br />C1ho is personally known t.o me, or
<br />
<br />Dwho has produced
<br />(type
<br />did not
<br />
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o who has produced_______
<br />(type of ideIllificaUon)
<br />and l'Iho 0 did D--Jid not I.a ke all oa 1:11
<br />
<br />Signature of person taking acknol'ileclgment:
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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