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<br />OCT/04/2004/MON 04:08 PM ZEPHYRHILLS BUILDING
<br />
<br />FAX No. 813-780-0021
<br />
<br />P. 002
<br />
<br />A. N@TI~E O~ DEED RESTRICTIONS
<br />The undersigned understan~ th.t this permit may be subject to "deed restrictions" which
<br />m.y be more restrictive than City regulations. The undersigned aesumes responsfbility for
<br />conpliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTIlACTORS /\NO CONTRACTOR RESPONSIBILITItS
<br />It the owner has hired a contractor or contractors to undertake work, 'they may be required
<br />to b~ licensed in accordance with state and local reoulations. If the contractor 1s not
<br />licensed as required by law, both the owner and contractor may be cited for a ~sdemeanor
<br />violation under state law. If the'owner or intended contractor are uncertain 8S 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 hils hi1:ed a cOntraotor or conr.ractOl:.s, he is advised to have the
<br />contractor(s) sign po~tions of the "Contractor Seotions" of this application for whiCh they
<br />will be responsible. If you, .as the owner signs as the contr~ctor, 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 bean ind1oa~ion that' he is not properly lioensed and is
<br />not entitled to permitting privileges in the City or Zephyrhills.
<br />C. TRANSPORTATION IMPACT Fli:ES AND UTILITY CONNECTiON FEES
<br />D. CONSTROCTUION LIEN LAW (ClIAPTl!:R 713, FLORIDA STATUTES, AS NlENDED)
<br />I certify that I, the applicant, haye been provided with a copy 'of ~Florida'. Construction
<br />lien Law - Homeowner's.Protection Guide" prepared by the Florida Department ot Aqr10ulture
<br />and Consumer Affairs. If the applicant is eomeone otker that the ~ownerh, I,cerify that I
<br />hilve obtained a copy of the above described document and promise in oood faith to deliver
<br />it to the ~oimer" prior to comencement.
<br />E. CON'l'RACTOR'S/OWNEIl'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 construotion, zonino, and land
<br />developnent. ,
<br />Appll~ation is hereby made to obtain a permit to do work and installation as iDdioated. I
<br />certify that no work or installation has oommenced prior to iasuahoe of a permit and that
<br />all work will be performed to meet standards of all laws requlating construction, City
<br />oodes, zoninq regulations, and land development regulations in the jurisdiotion. I also
<br />certify that I ,understand that the regulation8 of other governmental aoenciea may apply to
<br />the intended work, and tnat it 18 my responsibility to identify what aotions I must take to
<br />be in oompliance. Such agencies include but are not limited to: *Oepartment of
<br />Environmental aequlation-Cypr~ss Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater ~reatment
<br />*Southwest Florida Water Management District-Welle, Cypress Bayheads, Wetland AZeas,
<br />Alterino Watercourses
<br />*Army Corps of Engineers-Seawalls, DOCks, Navioable Waterways
<br />*Department or Health , Rehabilitative Services, Environmental Health Unit-WellS,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environaental Protectiori Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone ~AH or ~A,etc.", it is
<br />understood that a drainage plan addreseino a ~compensating volume" will be submitted which
<br />is prepared by a professional enginee1: registered in the State of Florida prior to permit
<br />issuance.
<br />A permit iss~ed sball be construed to be a license to proceed with the work and not as
<br />authority to violate, cancel, a~ter, or set aside any provisions of the teohnical oodes,
<br />nor shall iasuanoe of a permit prevent the Buildino Offloial from thereafter r~iring a
<br />correction of errors in plans, oonstruotion, or violations of any code. Every permit
<br />iss~ed shall became invalid unless the work author1zed' by suoh permdt is commenced within
<br />six I1lOnthe or issuance, or it work authorized by the permit is suspended or abandoned for'B
<br />period of six months after the time,the work is commenced. One 90 day extension of time
<br />may be allowed tor the permit with fee charge Of $15.00. The extension shall be requested
<br />in w1:itinq to 'the Building Offioial. An approved in8pection'must be logged during each six
<br />month period, or the project will be considered abandoned.
<br />WNlNING TO OWNER: YOOR FAILURE TO 1\ECORD A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOOR PROPERTY. IF YOU INTEND TO OMAIN 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 ~NOTrCE OF COHHENCENENT".
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />SIGNATURE I CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foreqoing instrument was acknowledged
<br />Before me this _ day of , 2L
<br />by
<br />(name- or person acknowledqed)
<br />o who is personally known to IDe, or
<br />
<br />o who ha" produced
<br />(type of identification)
<br />and wlioD did Ddid not take an oath.
<br />
<br />STATE OF FI.OIUDA
<br />COUNT~ OF
<br />The toregoing instrument wae
<br />Before me. this --1iay of
<br />by
<br />
<br />acknowledged
<br />,20_
<br />
<br />(name of parson aoknowledged)
<br />~ho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and who Ddid Oiid not take an oath
<br />
<br />Signature of person taking aeknowledoement
<br />
<br />Signature of person taking aoknowledoment
<br />
<br />Name typed, printed or stamped
<br />
<br />Nama typed, printed or stsmped
<br />
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