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<br />A. NOT:CE or DEEC RESTRICTIONS
<br />'Ir.1l unc:l9:CSignllQ und.a5tar:;de 'C:r.at "his pam.it Il'.ay be subje:::t to -.'d.".d re.9trictions" wh1ch
<br />~ay be more restrict~ve than ~ity regulations. The uncie~~ign..d assurr,es r~~ponS~bility for
<br />complia"ce with any ~pplicable deed restrictiona.
<br />E. ~NL:CLN8ED CONTRACTORS ~jlD CONTRACTOR RESPONSIB:LITIES
<br />If the .~l'lner has hired a cont:r_ctor or contractors to undert..l:e wOrk, they lr.ay be required
<br />to be licensed in acoo~Qance with stef:., ilnd local rsgulo.t1cns. It thQ cont~actor i8 not
<br />licensE<d ..s required by 1....., both the owner and contr;octor may be ei.ad for a misd......eIU\Or
<br />violation under sta.", law. If the "'.:r.er Or intend..c1 cont:::actor arQ uncertai" "s to what
<br />licensin~ requirements may apply tor ~ha ir.tanded work. they are advised to contact ch~
<br />~ity ot Zephyrhills Build~ng Department, 813-780-00<0,
<br />Furthermore, it the owner h~e h1red a contractor ~r ccntractors, he is advised t., have the
<br />contract",r(s) sign po,ticns of the ~~ontractor Sections4 ~f this application for which they
<br />>>ill be responsiJ:>le. If you, as 'the Owner signa aEo the c:mtractor, ~'ou are ind1(~e.ting that
<br />you, rather than the con'tractor, are responsible for the work. If the contractor wishes
<br />~ou tc 9i9n as contraotor that may be an ir.dicatior. that he is not properly licensed and is
<br />not en'titled to permitting privileges in the City of Zephyrhills.
<br />~. TRAl1SFORTATION IMPACT fEES AND UTILITy CONNEC'IION FE~S
<br />D. CONSTRQCTUION LIEN LAW (CEAPIER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify chat 1, tll.. applicant, h..ve been previcl"d ,,1'i:h a copy 0: "Florida'll Construction
<br />lien Law - Eom",owner'" Protection Guide" pr"pared by the Florida Departm..nt of Agricu:ctur..
<br />and COr,SLLT(,er ."ffairs, If the applica"t is someone othOlr that the "owner", I o.,r;, f}. 1:hat !
<br />hav.. cbtained a copy of t:he abov.. dascribed doc'.>:nent ar.d ];:romi.... in goed faith ':<> deliv..r
<br />it to the \\owner'''' prior to cornmencemt!!r.t.
<br />E. CONTRACTOR'S!OI1NER'S AFFIDAVIT
<br />I certify ~hat all :he ir.formatlon in this application is accurate and that all "~rk will
<br />Cll done in complianoe \1i th all applicable ':a>ls regUlating conS':ruotion, zoning, and land
<br />cte-,;elopment.
<br />Application is hereby made to obtain a permit to do work and installation as indicated. _
<br />certify that no work or inst~ll..tion h&s co~enced prior to iSBuance of a ];:e:emit and that
<br />all work will be performed to meet standards of all taws regulating con8truotion, City
<br />cedes, zoning rQgulat~on~. and IGnd ~evelopment regulatione in the jurisdiction. I also
<br />oertify that I under8tand that the regulations of other governmental agencies may apply to
<br />the in, ended WOrk, and that it is my re9pon~iDility to identify whet ao.ions I ffi~5t take to
<br />be ~n compliance. Such agencies inolude but are not limited to: ~Deparcment of
<br />Environmental Regulation-Cypre~s Bayheads, Wetland Areas and Environrnen"~lly Sensitive
<br />tands, W"ter!WaSte>later Treatment
<br />'Southwest Florida Water Management District-Wells, Cypres~ Eayheads, Wetla~c1 Areas.
<br />Altering Watercourses
<br />*~<ny Corps of Engineers-Seawalls, Dooks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmgntal Health wnit-Wells,
<br />Waetewater Trea~ment, Sllptic Tanks
<br />'u.S. Environmental Protection Agency-A9ce~tos aba1:ement
<br />I ~lsc certify ~hat, if fill m~tezial is to bQ u$ed in Flood Zone "An or "A,etc.H, it 1e
<br />underst:ood t"..t a drainage pl.an addressing 6. "compensat:..ng velume" will be .!lubmitted I.hich
<br />is prepar,;.d by " professional engineer regist..red 1:>. the State of Florid.. prior t" permit
<br />iSSuance.
<br />A per:ni t lss'~e:i shall :0", const:ru.,d to be a lice"s.. to proceed with 1:1l.. work an::! not as
<br />au~hority to v10lat... ~ancel, alter, or set aside any pro?isions o~ the technioal cOde9,
<br />ncx shall issuano~ ot a permi" prevent the Building Official from thereaft.,r requiring a
<br />correotion of errors in plans. constructicr" cx vio:ations of a~y code. E~ery permi~
<br />issuad shall b..come invalid unLess the work authorized by such permit is co~menoed within
<br />six months of issuance, cr if wo:::~ authorized by the permit ~9 s~sp..nded or abandoned fer a
<br />periOd of six months after tll.. time the work is Oornnenced. One 90 day extension ()f eime
<br />may be allcwed for the permit with fee chllrge of $15,00. The e><ten"icn shall be "equested
<br />in writing 1:0 the Building Offi.,=ial. lL... apprcved inspaction must b.. logged d..lrinsr each six
<br />mcnth period, er the project will be considered ..candcned.
<br />WJ..f\NING ':0 OWl-lI;;R: YOUR FAILURE TO RECORD A NOTICE OF COM~.IEnCEI.lENT MAY RESrJ,--T n, YOUR
<br />PAYI~G TWICE fOR IMP~OVE~~NTS 70 YOJR PROPERTY. IF YOU INTEND TO OETAIN FI~~~CING, CONSULT
<br />WITH YOUR LLNDER OR AN ATTORNEY 8EFORL RECORC!NG YOUR NOrICE OF CCMMENCEM~N'I. J03S ONDER
<br />$2,500 HI VALUE DO NO? NEED 'IO RECORD 1>.ND POST A "nOTICE OF COMMENCEMENT".
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<br />Lt. ~ ~/
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<br />SIGNATURE: CONI?ACTOR
<br />
<br />
<br />STATE OE' FLORIDl>_
<br />COONTY OF
<br />~he foregoing instrument was
<br />B..tore me this _ day of
<br />oy
<br />
<br />aCkncwleclqed
<br />, 2'L-
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />7he for..going 1nstrument WaS ac~nowledged
<br />Sefore Ir,e this -----""ay cf _, 20
<br />by
<br />(r.~me of person acknow19dg6dl
<br />Ckho i~ person511y kn~wn to me, or
<br />
<br />(n~ne of person aoknowledged)
<br />Owno is pers~nally known to me, or
<br />
<br />o Wilo !",,s.s produced
<br />(~YP& of ide~tifi=atoon)
<br />andwhoO did octid not t..k.. an oath,
<br />
<br />owh:> has produced
<br />(type of .identi:rlcation;,
<br />anc. who 0 did []did not ta'r", an oath
<br />
<br />Signature of ~er~on ~aking ~cknowledgement
<br />
<br />SiQr..ature of. person taking acknowledgment
<br />
<br />Name type", p~'inted or star.l"QQ
<br />
<br />Name t~ped, prin~ed Or stampsd
<br />
<br />'d
<br />
<br />dOg'DN
<br />
<br />SlllHdAHd3Z JC All~
<br />
<br />V\~Zt:Oi tOr)? 'gz' 2V,
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