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<br />Jul 20 04 OS:39a
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<br />R & R GARAGE DOORS
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<br />(352)754-1246
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<br />p.2
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<br />oJ., I:"
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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 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 />Furthermore, 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. 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 and promise in good faith to deliver
<br />it to the "owner" prior to conunencement.
<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-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 />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 unless the work authorized 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 abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESlJl.T IN YOUR
<br />PAYING TWrCE ~~R IMPROV NTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN fINANCING, CONSULT
<br />WITH YOUR E DER OR AT ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2, O/IN VA UE DO OT N D TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />/
<br />/'
<br />!
<br />
<br />subject to "deed restrictions" which
<br />undersigned assumes responsibility for
<br />
<br />
<br />'~1:~~
<br />SIGNATUR: CONTRACTOR
<br />
<br />ORIDA '. J:}fV! /7~ cL-ZJ
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing ~r~ent w~&knOwledge~( ~
<br />~;fore me this {(\day of . J() -, 20r..L::1
<br />
<br />c- ~name of person acknowledged)
<br />~o is personally known to me, or
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<br />WL2At~tiJ)
<br />
<br />o who has produced
<br />~pe of identification)
<br />and ~ did {).d1O, n n~o/1 S taakkee ~ iln oath.
<br />\~~~~yL/
<br />
<br />Signature of person taking acknOWledgement
<br />
<br />~ Alva MAIIIOn
<br />. 1 ~3'"
<br />Name typed, pr;i,t: !cj t&~p206e
<br />'.... Of...' ElqIIN' JIiIy 01.
<br />
<br />o who has produced
<br />\ (~of identification)
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<br />a~~YlL~h r
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name tyPe@~='MtBMd
<br />, Ellp/r8a Nt 08, 2008
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