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<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be
<br />may be more restrictive than City regulations. The
<br />compliance with any applicable deed restrictions.
<br />B, UNLICENSED COlnRACTORS 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 v>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 lal'J, If the OI-mer or intended contractor are uncertain as to vJhat
<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 />Furtherwore, if the owner has hired a contractor or contractors, he is advised to Ilave 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 licerrsed and is
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C. TRANSPORTATION H1PACT FEES AND UTILITY CONNECTION FEES
<br />D, CONSTRUCTUION I,IEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Constructi.orr
<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", 1 cerify that 1
<br />have obtained a copy of the above described documerrt and promise In good faith to deliver
<br />it to the "Ol'iller" prior to corrunencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the information in this application is accurate and that all I-Iork I'Jil]
<br />be done in compliance with all applicable laws regulating construction, zoning, aIrd land
<br />development.
<br />Application is hereby made to obtain a permit to do vlOrk and installation as indicated. J
<br />certify that no vJOrk 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, r also
<br />certify that I understand that the regulations of other governmental agencies may apply La
<br />the intended Hork, and that it is my responsibility to identi fy what acUons 1 mIlS r La ke to
<br />be in compliance, Such agencies include but are not limited to: *Departmenl of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sellsitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetlarld 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" OJ: "A,et.c.", it. is
<br />understood that a drainage plan addressing a "compensating volume" will be submitted Ii/hich
<br />is prepared by a professional engineer registered in the State of Florida prior to perlnit
<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 trre 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 cOIllmenced vlithin
<br />six months of issuance, or if work authorized by the permit is suspended or ahandoned for a
<br />period of six months after the time the work is commenced. One 90 day exterrsion of time
<br />may be allol-Ied for the permit IJith 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 />
<br />, ~~~-
<br />
<br />SIGNATURE: OWNER R AGENT
<br />
<br />subject to "deed restricL.i ()[)s" villi cll
<br />undersigned assumes respon~ihility for
<br />
<br />SIGNATURE:
<br />
<br />CONTRACTOR
<br />
<br />STATE OF FL~IDA
<br />COUNTY OF _r!LS(..O
<br />The foregoing instrument was acknowledged
<br />Before me this ~ day of t)lU\"'" ,2QQl
<br />by ~I~~~
<br />(name of person acknowledged)
<br />l!1'1^lho is personally knOl'1n to me, or
<br />
<br />STATE OF FLClRIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _day oi-
<br />by
<br />
<br />acknov,.1 edged
<br />-, 2 (J
<br />
<br />(name of person acknowledged)
<br />Cliho is personally known to me, or
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o who lias prOd\ICed_______________
<br />(type oficleIltifical:ion)
<br />and I'Jho Odid Ojid not: take an Odtll
<br />
<br />
<br />ac knol^lledgemen t
<br />
<br />Signalure of person taking acknol'lledglllelll:
<br />
<br />Name
<br />
<br />name typed, printed or stamped
<br />
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