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<br />A. NOTICE OF DEED RESTRICTIONS <br />The undersigned understands that this permit may be subject to udeed restrictions" whicll <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 li censed in accordance ,.lith 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 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 uFlorida'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 SeIlsitive <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 whicll <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 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 />lj)~ ~. <br />SIGNATURE: OWNEJ OR AGENT <br /> <br />-:"") <br />r:?-< ~~t7 ~ <br /> <br />. lJL~ ~ <br />SIGNATURE: C TRACT~R <br /> <br />STA'fE OF' FWRJDA"9 ' <br />COUNTY OF \._._ f;"' "j"u) <br />The foregoing instrwent w s a' <br />Before me tlJi I~ 'i'daY. of <br />by . 'L.. <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />The foregoing <br />Before m thi <br />by <br />, (name of person <br />\t;(who is personally <br /> <br /> <br /> <br />~o <br /> <br /> <br /> <br />Dwho has produced <br />,(type of identification) <br />and who "lIxi. id ~id not take an oa,th <br />. / 'l' ('. // ,1 " <br />'.._~~,-- .:~'/b.9Jd/dPZ#.~ <br /> <br />Signature of person taking acknowledgment <br /> <br />Dwho has produced <br />('(.t"YP,e Of. iden.tificatiOn) <br />and di not)ta_ke an oath. <br />. . J <..... {i rr~1 <br /> <br />Signature of person taking <br /> <br />"'MI.'" Bo~' S l~ <br />Name ~~fb.'1f;~ RM:oo~ffiCli9 as <br />~.~~~ Februory 22, 2004 <br />....:r.P.f:.r.,~'. BONDED THI1U TROY FAIN INSURANCf. INC. <br /> <br />Name t <br /> <br /> <br />. :Mr~10N I:e; ~RES <br />F.bruarv 22, 2004 <br />~QNOfO THtu TROY FAIN 'NSUllAHQ; IHe <br />