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<br />i:OND1'l'10NS r.'!;' PEi'.Ml'(' !\FFID.'\',;:~,'
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perini!:. may be sU~Jec': to -"deed r:eslri,:t.lons''- '"l:\.clo
<br />may be more restrictive than City regulali':;>ns. Th~ undersigned asswnes respon:s~_L;.J.i ty for
<br />compliance with any applicable deed rEstrictions,
<br />B. UNLICENSEp CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertak~ work, they may be required
<br />to be licensed in accordance with state and local regulations. If the contracto~ is not
<br />licensed as required by law, both the owner' and contractor may be cited for ,1 rnisdemecliloJ.
<br />violation under state law. If the m-mer or intended contractor a.l:e uncertain '::'s to tJl;:I1:
<br />licensing requirements may apply for t:le intended wor1:. they are ad"i~ed te, contact the
<br />City of Zephyrhills Building Department, 813-78(,-6611.
<br />Furthermore, if the owner has hired a contractor or contractors, he is advised to have t-:be
<br />contractor(s) sign portions of the "Contractor Sections" of this application fo~ which the~
<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 contrDcLor WiS)10S
<br />you to sign as contractor that may be an ir:dication that he is not_ properly licensed c,nd '~E
<br />not entitled to permitting privileges in the City of '!.ephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTII.ITY CONNECTION F'EES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTf~R 713, FLOP-IDA STI...TUTE:S, AS AMBNDED)
<br />I certify that I, the applicant, have been provided with a copy of "Flo~ida's Ccnstructjcll
<br />lien Law - Homeowner's Protection Guide" prepared by the Florida Depa rtment ef l\gricul ture
<br />and Consumer Affairs. If the applicant is someone other that the "owner". r (~eri t',' that I
<br />have obtained a copy of the above described document: and promise in ,;ood f:d. th tn (le.L ver
<br />it to the "owner" prior to co~nencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the information in this application is
<br />be done in compliance with all applic<lble laws .regt:lating
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indicated.
<br />certify that no work or installation has comm.~nced prior to issuance of a p~rmit ar:d l:!Jat
<br />all work will be performed to meet standards of nIl laws regulating construction, C5.ty
<br />codes, zoning regulations, and land development regulations in the jurisdiction, ] ~lso
<br />certify that I understand that the regulat ions of other governmental agencies may appl~/ to
<br />the intended work, and that it is my responsibility to identify what actions I R~st t~ke to
<br />be in compliance. Such agencies include but are not limited to: *Department: Qf
<br />Environmental Regulation-Cypress Bayheads, 'tletland Areas and E!'lvirornnenta.lly Sensi I:i 'I",
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypr:ess Bayheads, ~'ieLla,;d Areas,
<br />Altering Wat.'rcourses
<br />*Army Corps of Engineers-Seawalls, DOCKS, Navigable Waterways
<br />*Department of Health & Rehabilitative Servic~s, 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 b~ used in F'lood Zone "A" or '"'.n..,etc.", :it is
<br />understood that a drainage plan addressing a "'conpensating volume" will be submitted T'lhj ch
<br />is prepared by a prof~ssional engineer regist~red in the State of Florida prior to pe[rr~t
<br />issuance.
<br />A permit issued shall be construed to be a License to pI:oceed \-lith the work c;nd nr:;t as
<br />authori ty to violate, cancel, alter, or set aside ar.y provisions of ;;.he technical cod",s.
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring CI
<br />correction of errors in plans, construction, or violations of ~ny code. Every permll
<br />issued shall become invalid unless the work authorized by such permit is cG~r.enced \o/ithin
<br />six months of issuance, or if work authocized by the perrot is suspended or aba!1deoned tOl: i1.
<br />period of six months after the time the work is commenced. One 90 day exten:=:ion of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall. be requestt'.d
<br />in writing to the Building Official. Jm approved inspection must be logged during each si.:'.
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD .1\ NO'rICE OF COM~tENCCi"!ENT MAY RESULT } N YOUf"
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUF l?ROPE1l.TY, IF YOU INTEND TO OBTAIN E'IlJAN(;ING, CCiNSUl,'!'
<br />WITH YOUR LENDER OR AN ATTORNEY BEFuRE RECORDING YOUR NOTICE O~ COMMENC&~ENT. JOB~ UNDEP
<br />$~O IN VALUE DO NOT NEED TO RECORD AND POST A~TICE OF Crn~ENCEMENT".
<br />
<br />C /L'/, 1. A Gh~ _ L h,.. 07 J
<br />~ x:::/rfflL.{W-- .tbr~______.
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />acc'Jrate and that il.U
<br />c01IstructioI1, 2')ni nq 1
<br />
<br />10W r;; ....' i. ..1
<br />and lauel
<br />
<br />I
<br />
<br />SIGNATURE:
<br />
<br />CONTRACTOR
<br />
<br />S'l'ATE OF FLQRI ~A
<br />. COUNTY OF I--b..S CJ) .
<br />The foregoing instrument was acknowledged
<br />Before me this a,S'00-day of ~ ' ~~t)l{
<br />by DOh /1\ ,^, 1"1'l f) () I"-
<br />~ (name of person acknowledged)
<br />bdwho is personally known to me, or
<br />
<br />STJ.\'J'I~ OF r'LOIU I.lli--
<br />COUNTY OF _L~ S CEO -.----..-
<br />The foregoing instrument was acknowledged
<br />Before,.lQe this ;!S~ay of fYlC<.( , ~ :}LJtJy
<br />by D OV"l KC"-~^-o_
<br />/ (name of person acknowledge-dl
<br />L~O is personally knOlro"I1 to me, or
<br />
<br />o who has produced
<br />(type of identifjcationl
<br />and whoD did Ddid not take an oath.
<br />
<br />~~,-,~
<br />
<br />o \-Jho has pr0dllc;ed___.____.______.__
<br />(type of identjfic~t;on)
<br />and who Ddid [}.:lid nct ti11~e an onth
<br />
<br />~ ~~~~~<1
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of i'.~.cson t'1kinq acknOlo/ledgrne;:t
<br />
<br />~ p'7 I /,'
<br />uS~ H-n It. La-VCL-(/ee
<br />Name typed, printed ar stamped
<br />
<br />r:m'-"";)t~'i"';;"' ..',' ' ---"
<br />; gt~ ,'%, SUSAN ANN LAVALLE:: .
<br />.~ "."Ii<.;" .S Nofcry Pubfc - Stab of F\,,~.dc
<br />1 ~~':'_ rB My Comm. B:p:-c3 Jun 13. ~"U4
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<br />, ~lt1t~' ~0rnlssfon ~.' CCo/"}7~~
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<br />~~sa.^ r+nh. ~<-uJI'.ee
<br />'n 3 me t YJ?S.~f.i H!.~~q., 2s..,,;~t~!l~.d
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