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<br />~UUI l I/LUUil JVt Ul:~~ rM ltrtlYKtllL~ ~ILVI~
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<br />'tAX No, 813-780-0021
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<br />p, C02
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<br />A., NOTICE OF DEED REBTRIC'l'IONS I
<br />The undersigned understands that this pe~t may be subject/to "deed reatrlction~" which
<br />,may be more restrictive than City re9.Ulatl0ns. The unde~SJned a8.sumes,re9PO~ibilitY for
<br />c~liance with any app~icablQ dQed rQstrictio~. .
<br />B. UNLICENSED COWl'RAcToas !\NO CONTllACTOa RESPONSIl!ILrUES
<br />If the owner has hired a contractor or contractors to uncie ake WOl;"k:, they may be raquir~
<br />to be licensed in accordance with state. and local regulatio s. If the contractor 1s not
<br />licensed as required by law,. both the owner and contractor ,ay be cited for a misdemeanor
<br />violation under state law. Ir the owner or intended contracptor are. uncertain as to what
<br />licensln<} requirements may apply for the intended work, the:\, are i;ldvised to contact the
<br />City ot Zephyrhills auilding- Deparbuent, 813-180-0020, I
<br />Furthermore, ir the owner has hired a contractor Or contrao ors, he js advised to have the
<br />contractor (a) aign PD!'tions of the "Contractor Sections" of this applicat.ion for which they
<br />will be r"sponsibl... If you, as the owner 'Signs a" the COn ractor,you are indicating that
<br />you, rather than the cont.rac.tor, are respons1ble tor tbe wO.fk. If the contractor wishes
<br />yOU to sign as contractor that may be an indica~ion that he.lis not properly licensed and is
<br />not entitled to pe~tting privileges i~ th$ City o{ ~phyrjillS.
<br />C. TRANSPORTATION IMPACT FEES AND UTILI'l'Y CORNEC'l'IOHFEES
<br />D. CONS'PRUC'l'UION LIEN LAW (CHAPTER 113, F'LORlDA. STATUTES, t AMl:NDED)
<br />I certify that I, the applicant, have been provided with a oPY of ~Florida'8 Construction
<br />~iQn Law - Homeowner's Protection Guide" prepared by the Fl rida Departaent of Aqriculture
<br />and Consumer Affairs. If the applicant 1ssCJaeOne other tjt the ".owner", I cerify that I
<br />have obtained a copy of the abovQ described docmQent andpr mi.~ in good raith to deliver
<br />it to t:he ~owner" prior to COllllllencelllent.
<br />E. CONTRACTOR' SIOHNER' S AFFIDAVIT
<br />r certify that a1.l the intorJllation in tMs application is curate and that all IfOrk w111
<br />be UOne in Compl~ance with a1.1 applicable laws ragulatinq crnstruction. zoning. and l~nd
<br />de"elopment.
<br />Applic;ation is hereby made to obtain a permit to do ,,,ork ] installation as iJldicated. l
<br />certi.fy that no work or installation has ~ed prior to issuance of a pe:rmit: and that
<br />all work will be perfOrmed to meet stanqards ot all la..s r ulat1nq construction, City
<br />codes, zoning rAq1.11ation8, and land'development relJUlations in the jurisdiction. I also. .
<br />certify that. I understand that th~ regulations of other. go~rnmental agencies may apply to
<br />the intended work, and that it is ay responSibility to iden ify what actions I must take.to
<br />be in ClOqIliance. Such agencies include but are not:. liB;it to: *Depart.ent of _
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas an En~ironmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest rlorida Water Manageqent O~strlct-Nells, Cypress Bayheads, Wetland Areas, .
<br />Alterinq Watercourses ,. . _ _. .
<br />*Ax1ay Cot:p" of 2nqin_r"-Seawa~ls, Docu, Nav1gai!lle ~t..:rwars
<br />* Department of Health & Rehabilitative Services, Environmen al Health Unit-Wells,
<br />Wastewater Treataent, Septic Tanks
<br />*U.8. Enviro~nta1. l'rotection AgencY-A8beato8 abatement
<br />1 also certiry that, if rill material 18 to be used in Floc Zone -AN or ~A,etc.~, it is
<br />understood that a drainage plan address1ng a ~CompensatiRg rOlume" will be submitted which
<br />is prepared by a professional engineer registered in the Strte of Florida prior to permit
<br />issuance. .
<br />A peDrlt issued shall be ~n8tl:Ued to be a license to pro~d with tha work and not as
<br />autborityto violate, Cancel, alter, or set aside any prov1 ions of the technical codes,
<br />nor shall issuance af a permit prevent the Building Offici from thereafter requiring a
<br />correction of errors in plans, construction, or viOlatiO~~f ;my code. -Every permit
<br />issU<KI. shall becOllle invalid unl8l!ls the work authorized by s ch peDllit is C<lIIIJIIenced within
<br />six months of is.suanoe, or if work authorized by the permit is suspended or ahandonad for ,.
<br />period of siJr: month~ after th@timethe'fOr.k:iS.COJ\UllenCed.One90dayext!9nsionoftime
<br />maybe allowed :for tne permit with tee Charge of $15.00. e e:xten~ion shall be raqu.st8d
<br />in writing to the Build.1ng Official. An approved inspectio lIIll"t be logged during eaCh au
<br />IIlOllth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A IIDTICE OF CONME
<br />PAUNG TWICE FOR IMPROVEMENTS TO YOUR PROPER!I'Y. IF YOU IN'!'
<br />WITH tOUR LQtDER OR AN AT'l'OlUfEY BEJi'ORIl: RECORDING YOUR NOO'IC
<br />$2, 00 - 1M ~ MOT P TO RECORD !\NO POSf A "NOf OF
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<br />
<br />
<br />FNT1lAC
<br />
<br />STATE OF FLOrIDA Hillsborough
<br />COONTY OF
<br />The foreqoin1J :j.~~t. waSA~OW~edg~
<br />BQror~ thM i ':J . , 20
<br />by lJre~ IVa -
<br />~ (DalIIelOf person acknowledqed)
<br />~ho 1s personally known to me, or
<br />I
<br />rraduced
<br />(type
<br />d ;d n
<br />
<br />STATE OF FLQIUf4. bo h
<br />COUNTY OF tl1. is roug
<br />The foregoing i~t nt was aC!tno"1edqe4.,4
<br />Be:foU ~ tb:i,:l. 'X ~f Au~ . . 2QQ
<br />by nrlageL . 6.eL. _
<br />(name of person acknow~Qdg~d)
<br />lXwho i~ persona~ly k:noWIl to 1Jle, or
<br />
<br />o who has producQd
<br />. (type of identification)
<br />
<br />l!i:Mf tJ(0r~~'
<br />
<br />Signature ot person talcing aclcnowledqement
<br />Carol Van Bebber
<br />
<br />
<br />Name
<br />
<br />printed or
<br />
<br />D. BEGEY
<br />MY COMMISSION # CC 947189
<br />EXPIRES: October 7, 2004
<br />Bonded Thru Notary Public Underwriters
<br />
<br />H_e typed, printed or stamped
<br />
<br />:\","1 Pul.
<br />
<br />*W.
<br />(P~Q~
<br />.lff"F.OFf\.C""
<br />
<br />CAROL R. VAN BEBBER
<br />MY COMMISSION N DD 016596
<br />['XPI~ES: March 23, 2006
<br />l "odod T~ru ~gel Notary services
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