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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 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 />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 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 and is
<br />not entitled to permitting privileges in the City of ZephyrhiJls.
<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 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 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 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 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 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 which
<br />is prepared by a professional engineer registered if I the State of Florida prior to penuit
<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 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 />
<br />
<br />$2, SOjIO NO!j:7CORD AND POST A "NOTIL OF COMM7J:t
<br />
<br />SIGNATURE' OWNER OR AGENT SIG~E' CONTRACTOR
<br />
<br />STATE OF FLOD~ STATE OF FLORIDA '~
<br />COUNTY OF T:,~-~<V? COUNTY OF./ a.-5 4J
<br />The foregoing instrument was acknowledged The foregoing instrument wa~cknowledged .1/
<br />Before n~ ,phis -:z.b- djiY) o~ ' 20kl/ Before ~meApis d2.L.z-dB.)1 .o~--- , 2ll~
<br />by r ~d.../J44:t4:11rJL, ~ by ~~IIJ't{ tL.Lrg--
<br />(name of person acknowledged) (name of person acKnowledged)
<br />Dwho is personally known to me, or C1ho is personally known to me, or
<br />
<br />llJ...t:iho has producedr/ j).L ~j,~tJtJ-7RJj-'/'f~.::2,b7-0
<br />(type of identification)
<br />a,f)d/0h0EfdI9 ,~i~ n~,t(! "tak~ aD oa,th,
<br />(,"'~;py~. y~51PMJ"
<br />
<br />Signature of person~aking acknowledgement
<br />
<br />~~ has producedFf. ./)L. tJ5tJt)., ?fl1-7.5)5(-o
<br />"__ (typer'C)f identification)
<br />~nd", W,hODdJ) . ~id n~Veke/~:r
<br />'. ,.,j~~' L/..;/ --(dUd: "
<br />
<br />Signature of person taking acknowledgment
<br />
<br />~"""'"
<br />
<br />Name Gi~IY~' print~b~iW~~~~Qed
<br />N :.~ MY COMMISSION I CC893160 1XPIRES
<br />"4'. ':;:l February 22, 2004
<br />";f.';,9f.,1~~" GONDEO THRU TROY FAIN INSURANC~ INC.
<br />
<br />Nam~= /_ MVroMMlsSlSRl#~93~ fjBli#:l,d
<br />'~i-., ..~ February n 200,l
<br />"P.r.,~~" J' lNDED THRU TP.(lY FAIN INSUR," ",~ .K
<br />
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