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<br />_""...................>.J..,oJ v.. .........""...J.,J. ~J.Jr,.:.LJ..I.(I,.v.l.J.
<br />
<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 intende~ work, they are advised to contact the
<br />City of Zephyrhills Building Department, 613-766-6611.
<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 permdtting 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 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 permdt to do work and installation as indicated. I
<br />certify that no work or installation has commenced prior to issuanc. 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 agenci~s include but are n9t,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 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 con8tru~d to be a license to proceed with the work and not as
<br />authority to violate, cancel, alter, or .et 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 w9rk author1~.d by such permit is commenced within
<br />six months of issuance, or if work author1~ea!!by",th.p.rmit is suspended .or abandoned for a
<br />period of six months after the time the work lsPcommenced. 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 ~bandoned.
<br />WARNING TO OWNER: YOUR !'AILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' 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 />}::{1~ z?~pp~
<br />
<br />SIdNATURE: WNER OR AGENT
<br />
<br />subject to ~d~edrestrictions" which
<br />undersigned assumes responsibi~ity for
<br />
<br />SId:!xf10NT~~
<br />
<br />STATE OF FLORIDA T)~r
<br />COUNTY OF . , Ih:> ('0
<br />The foregoing instrument was acknowledg~~
<br />Befor_e me this tif/t- day of flf1l-.L L , 20~
<br />by C;;IlJ~C (? F~- - .
<br />~name of person acknowledged)
<br />~who is personally known to me, or
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument w~acknowled~e~1
<br />Before me thilS ~ay of f.f111 ( , lU ~
<br />by &zF(;; R -
<br />~~(name of person acknowledged)
<br />UMbo is personally known to me, or
<br />
<br />T ASc CJ
<br />
<br />Owho has produced
<br />(type
<br />and whoD did Ddid not
<br />
<br />~ ~ A- ~ floJ2u.2
<br />
<br />Signature of person taking acknowledgement
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Dwho has produced
<br />(type of identification)
<br />and who Ddid [):lid not take an oath
<br />
<br />&~ tJ, tU~
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name
<br />
<br />'R/ZllCF J1. ff5 (3~,-
<br />typed, Printedi~v~r:~~~Ae..abel
<br />. ~ ~ My Commission 00116710
<br />~ClI",df Expires June 22. 2006
<br />
<br />Name
<br />
<br />1?(2(/G~ if. AsafL
<br />typed, printed or stamped
<br />~'~ Bruce A Asbel
<br />!~ ~ My Commission 00116710
<br />~o.",df Expires June 22. 2006
<br />
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