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<br />MaY. 7, 2004 12:44PM CITY OF ZEPHYRHILLS N0.5343 P,2
<br />n. ~v~~~~ vt u~~u RESl~Lv!~vN~
<br />The undersigned understands that this pe~it 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. UNLICENS&D 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 />Furthe~ore, if the owner has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign po~tions of the "Contractor Sections" of this application for which they
<br />will be responsible. !f 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 siqn as contractor that may be an indication that he is not properly licensed and is
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C. TRANSFORTATION IIoiPAC'r FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, lIS 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 a owner" , I cerify that!
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the aowner" 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 lawB regulating construction, zoning, and land
<br />development.
<br />Appli~ation is hereby made to obtain a pe~it 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 Bayheade, 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 in the State of Florida prior to permit
<br />issuance.
<br />~ 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 ~nless the work authori~ed 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 logqed during each six
<br />month period, or the project will be considered abandoned.
<br />~ING TO OKNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RtSULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEroRE RECORDING YOUR NOTICE OF COMMENC NT. J B UNDER
<br />$2,500 IN VALUE DO NOT NEE TO RECORD AND POST A aNOTICE OF C ENCEMEN'
<br />
<br />
<br />
<br />ST E OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />Before me this-ll day of ~rer.( 2fJ./Yf
<br />by It( ICIf-~/. 7i I*'
<br />(name of person acknowledged)
<br />~WhO is personally known to ~e~.r
<br />
<br />o who has produced ~ '/}-
<br />(type of ide tification)
<br />and wlio 0 take an oath.
<br />
<br />STATE OF
<br />COUNTY OF
<br />The foregoing inst~ent was a~Owledged
<br />Before me this -1..2sJ.ay of 1'$i;.;-ft JJ!t
<br />by J(.,f. (~~Itf7L. r -
<br />(name of person acknowledged)
<br />~o is personally known to me, or
<br />
<br />D who hu produced N'/ A-
<br />(type of identification)
<br />not take an 0 h
<br />
<br />
<br />
<br />m' inted~WMbNoE
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<br />~ 7if:i MyConTriliDn~May19.znc;
<br />..~ OF ...'f.".~- Comnission t CC IlXlOO31
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