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<br />A. tlOTICE OF UEED IU;STRICTlONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" wli1,:1I
<br />may be more restrictive than City regulations. The undersigned assumes responsibility tOI
<br />compliance with any applicable deed restrictions.
<br />B. UI'-lLICENSED CONTRACTORS AI-.JD CONTRACTOR RESPONSTBILITlf.S
<br />I f the o\"ner has hired a contractor or contl"actors to llIldertake work, they lIIay be regllil",cl
<br />to be licensed in accordance with state and local regulations. 1 f the contractor is rl()t
<br />Licensed as required by lal-/, both the o\.mer and contractor may be cit.ed for a misdemean(n
<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 tilEC
<br />contractor (s) sign po~tions of the "Contractor Sections" of this appl ication for whi ell tm:)'
<br />\'iill be responsible. If you, as the owner signs as the contractor, you are indicatinq that
<br />you/ rather than the contractor, are responsible for the \"ork. If the contractor I-lislles
<br />you to sign as contractor that may be an indication that he is not properly licensed ani] 15
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C. TRANSPORTATION H1PACT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMEt~DED)
<br />I certify that I, the applicant, have been provided with a copy of "FJ orida' s Constl \lei Ii)!!
<br />lien Law -- Homeowner's Protection Guide" prepared by the Florida Department of Agricull.Ule
<br />arid Consumer Affairs. If the applicant is someone other that t.he "owller", I cerify Lllat
<br />have obtained a copy of the above described document and promise in good faitll to deliver
<br />it to the "owner" prior to commencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />1 certify that all the information in this application is accurate and that all work wi \1
<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.
<br />certify that no work or installation has commenced prior to issuance of a permit and tl!cit
<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 jur.Lsdiction. T also
<br />certify that I understand that the regulations of other governmental agencies may apply tl'
<br />the intended work, and that it is my responsibility to identify what actions I must take 10
<br />be in compliance. Such agencies include but are not limited to: .Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and EnvironlnentalJy Sensitive
<br />Lands, Water/Wastevlater Treatment
<br />.Southwest Florida Wat.er Management District-Wells, Cypress Bayheads, Wetlalld Areas,
<br />Altering Watercourses
<br />k Army Corps of Eng ineer s -Sea\'lall s, Doc ks, Na v igable Wa terwa ys
<br />; Ilepartment of Healt.h & Rehabilitative Services, Environmental Health Unit-v~ells,
<br />Wastewater Treatment, Septic Tanks
<br />^ U.:3. E:nv ironmental Protection Agency-Asbestos aba tement
<br />r also certi.fy that, if f.ill mal:erial is to be used in flood Zone "A" ur "j\,eLc.", it 1S
<br />\IIHlerstood that a draina(Je plan addressi ng a "compensati ng volume" will be submi tted \'Ihicl\
<br />is prepClred by a professional engineer registered in the State of Florida prior to perrnit
<br />lSSUdnce.
<br />l~ 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 carles,
<br />nor shall issuance of a permit prevent the Building Official from tllereafter requiring a
<br />correction of errors in plans, construction, or violations of any code. Every pennit.
<br />issued shall becOIne invalid unless the work authorized by such permit. i.s cOllunenced \liLJl1n
<br />six Inonths of issuance, or if \"ork authorized by the permit is suspended or abandoned rOI a
<br />period of six months after the time the work is commenced. One 90 day extension of til11e
<br />lIIay be aJlovJed for the permit with fee charge of $15.00. The extension shall be requested
<br />in wri.ting to the Building Official. An approved inspection must be logged during each S.?:
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR fAILURE TO RECORD A NOTICE OF' COMMENCE~1ENT MIIY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEI'1ENTS TO YOUR PROPERTY. IF' YOU INTf.ND TO OB'l'l\IN fHIl\NCING, C:UIISU:,l'
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UN[JEk
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE Of COMMENCEMENT".
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />SIGNATUEE:
<br />
<br />CONTRACTOR
<br />
<br />acknowledged
<br />20_
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF'
<br />The foregoing instrumerlt was
<br />Before me tllis _day of
<br />by
<br />
<br />STATE OF FLORIDA
<br />COUNTY Of
<br />The foregoing instrument \",as
<br />Before me this _ day of
<br />by"_
<br />
<br />ackrl()wl ecJ'Jc;d
<br />2U
<br />
<br />(name of person ackno\"ledged)
<br />[] \"IJO is personally known to me, or
<br />
<br />(name of person acknovlledged)
<br />Qho is personally known to me/ or
<br />
<br />[] I-Iho has produced.___________
<br />(type of identification)
<br />and vlhoOdi.d Odic! not take an oath.
<br />
<br />o who has produced_____
<br />(tvpe of jdeIJtificatlC'li)
<br />and who Ddid DUel Ilul take an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknO\"ledqll\t;lll
<br />
<br />l'lam8 typed, pl.illLed ()r stamped
<br />
<br />l'-lame typed, pcinLeJ or stamped
<br />
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