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<br />---,-........................ ......... ...._.,"*'........ ..1I....,;,.w...".J.
<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 intende~ work, they are advised to contact 'the
<br />'City of Zephyrhills Building Department, 813-788-6611.
<br />Furthermore, if the owner has hired a contractor or contractors, h, 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 indication 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 "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 arid 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-Asbe.tos abatement
<br />I also certify that, if fill material i$ 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 />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 unle.. the w9rk 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 $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered ~bandone~.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />~2, 500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />dM4 17J~ J1 '1J~
<br />
<br />SIGN~TURE: O~R OR AGENT SIGNATURE: ~RACTOR
<br />
<br />STATE OF FLORIDA P AS- ' 0
<br />COUNTY OF ' "-
<br />The foregoing instrument was aCknOWledg~
<br />Before me this Zo day of .4P/2tL , 2
<br />by t'1;/Z$ fJeE--rJ"C .
<br />~name of person acknowledged)
<br />~o is personally known to me, or
<br />
<br />STATE OF FLORIDA P
<br />COUNTY OF AS L 0
<br />The foregoing instrument wa~oacknowled~e~l/
<br />Before me this ~ay of ~'/lJ' , L"U QL
<br />by Cl2Er;, 6F~
<br />(name of person acknowledged)
<br />~ is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoO did ~ not take an oath.
<br />
<br />~MU I~, CbM
<br />
<br />~nature of person taking acknowledgement
<br />
<br />Owho has produced
<br />~ype of identification)
<br />and who Ddid [9:fid not take an oath
<br />
<br />~. /:)-~
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Brw0E
<br />
<br />B(2vCE A, 4seG~
<br />~ed, printed or stamped
<br />~J'\. Bruce A Asbel
<br />'''Y': ,; My Commission 0011671C
<br />Of ",'.I' Expires June 22, 2006
<br />
<br />Name
<br />
<br />/j. AsiJEL
<br />
<br />typed, p-rinted or stamped
<br />~~ ~ Bruce A Asbel
<br />
<br />,~ ,; My Commission 00116710
<br />
<br />Of ",'.I' Expires June 22. 2006
<br />
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