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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 than City regulations, The undersigned assumes responsibility for <br />compliance with any applicable deed restrictions, <br />B. UNLICENSED CONTRACTORS 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 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 co'r}j:;ractor'\,are ~n~tain as to what <br />~" "li.~en~rr"~eq~r~ents may apply for tne i~nrL..rlt"o.rk, 'they a~~'act\f..is~d.'t.o contact the <br />........ '.,.- ",l '. l.,.., ~. ::I .., '. ~...... . "" <br />" ciLY or Zephyr i.1 s Building Depattment~ 81, -7ilO-002o.. ._ " .....-' c::. <br />Furthermore, if the owner has h!rejJjC#)~r;..~cttJ#'\d~nJ:~acfc.~rs;-:tre'.i'f31dVised 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 work. If the contractor wishes <br />you to sign as contractor that may be an indica~ion that he is not properly licensed arid 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 commencement. <br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT <br />I certify that all the information in this application is accurate and that all work will <br />be done in compliance vJit{i all applicable law,S regulij.t).ng,construction, zoning, and land <br />. 'Nt..' "~J' / <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, zoning 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 />the intended work, and that it is my responsibility to identify what actions I mllst 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 Waterw1ityti.. el"~ \. <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 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 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 IMPROVE~T! TO YOUR PROPERTY. IF' YOU INTEND TO OBTAIN ~lNANCIl~G, CONSULT <br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING, Y9UR NO;~ICEl' OF COI-1MENCEtlEt\~, ,JOBS UNDER <br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A'~GTJC;:E.OF..OOMMENtEMBN'F'J..' <br />, . \ <br /> <br />SIGNATURE: OWNER OR AGENT <br /> <br />SIGNATURE: CONTRACTOR <br /> <br />acknowledged <br />20_ <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />The foregoing instrument was <br />Before me this _day of <br />by <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />The foregoing instrument was <br />Before me this _ day of <br />by <br /> <br />acknc)V1Jedged <br />20 <br /> <br />(name of person acknowledged) <br />Owho is personally known to me, or <br /> <br />(name of person acknowledged) <br />[l,ho is personally known to me, or <br /> <br />of identification) <br />take an oat.h, <br /> <br />Owho has produced <br />(type of identificat.ion) <br />and who Odid OEd not take all oath <br /> <br />Owho has produced <br />(type <br />and whoO did Odid not <br /> <br />Signature of person taking acknowledgement <br /> <br />Signature of person taking acknowledgment <br /> <br />Name typed~ 'pr'rnted ~r statri~ed <br />f ~" ... ~ . If . ..~, _~""". '._. <br />'. \ ,,-" ,.. . <br /> <br />Name typed, printed or stamped <br />