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<br />A. NOTICE OF DEED RESTRICTIONS <br />The undersigned understands that this permit may be subject to "deed restrictions" which <br />may be more restrictive than City regulations. The undersigned assumes responsibility for <br />compliahce with any applicable deed restrictions. <br />B. UNL[CENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES <br />If the pwner 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 />license~ as required by law, both the owner and contractor may be cited for a misdemeanor <br />violatipn under state law. If the o~ner or intended contractor are uncertain as to what <br />licensipg requirem~nts may arply for the intended work, they are advised to contact the <br />City ofl Zephyrhills Building Depart:Il\ent, 813-780-0020. <br />Further~ore, if the owner has hired a contractor or contractors, he is advised to have the <br />contrac~or(s) sign po~t{ons 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, ra~her 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 ent~tled to permitting privileges in the City of Zephyrhills. <br />C. TRA~SPORTATION IMPACT FEES AND UTILITY CONNECTION FEES <br />I <br />D. CONpTRUCTUION 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 La~ - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture <br />and Con~umer 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 certi~y 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 />develop~ent. <br />Appli~ation is hereby made to obtain a permit to do work and install~tion as indicated. I <br />certifyl that no work or installation has commenced prior to issuance of a permit and that <br />all wor~ will be performed to meet standards of all laws regulating construction, City <br />codes, Izoning regulations, and land development regulations in the jurisdiction. I also <br />certif~ that I understand that the regulations of other governmental agencies may apply to <br />the int~nded work, and that it is my responsibility to identify what actions I must take to <br />be in cbmpliance. Such agencies include but are not limited to: *Department of <br />I <br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive <br />Lands, Water/Wastewater Treatment <br />*Southw~st Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, <br />Alterin:g Watercourses <br />*Army Cbrps bf Engineers-Seawalls, Docks, Navigable Waterways <br />*Depart~ent of Health & Rehabilitative Services, Environmental Health Unit-Wells, <br />Wastewa:ter Treatment, Septic Tanks <br />*U.S. ~nvironmental Protection Agency-Asbestos abatement <br />I also ~ertify that, if fill material is to be used in Flood Zone "A" or "A, etc.", it is <br />undersbood 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 perm~t issued shall be construed to be a license to proceed with the work and not as <br />author~ty 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 />correc~ion of errors in plans, construction, or violations of any code. Every permit <br />I <br />issued ishall become invalid unless the work authorized by such permit is commenced within <br />six mo~ths of issuance, or if work authorized by the permit is suspended or abandoned for 'a <br />period lof six months after the time the work is commenced. One 90 day extension of time <br />may be fallowed for the permit with fee charge of $15.00. The extension shall be requested <br />in wri~ing 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 RESULT IN YOUR <br />PAYING iTWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT <br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF MMENCEMENT. JOBS UNDER <br />$2,500:IN VALUE NOT NEED TO RECORD AND POST A "NOT OF COMM CEMENT". <br /> <br /> <br /> <br />STATE dF FLORID~ <br />COUNTY!OF <br />The fo~egoing ins ument waS~~ledge~,/ <br />Before !me th's y of , 2~ <br />by <br /> <br />STATE OF FLORIDA ~ ~ <br />COUNTY OF ~ <br />The foregoing inst6ement wa~ledged_,~ <br />Before me thi-s ~,.ctlL~f ~, 20 t:!f:" <br />by rcA~tA~ <br />(name of person acknowledged) <br />~is personally known to me, or <br /> <br /> <br />a knowledged) <br />known to me, or <br /> <br />J <br /> <br /> <br />of identification) <br />take an oath. <br /> <br />o who has produced <br />(type of identification) <br />and who ~ not t oath <br /> <br />Owho1has produced <br />(type <br />(iJ..d1"'"d t <br /> <br />Si <br /> <br />Signa <br /> <br /> <br /> <br />bllctaking ackn~wledgement <br />t, ' <br />U ~~ <br /> <br />Ru~o.kSfa1!J at. ledgment <br />Elq:jes 0cI25,2OO1 <br />ommisslon # 00243970 <br /> <br />Name t*,p'ed.,. p.,.,ri.nteq, of.~ <br /> <br />:1), <br /> <br />Name <br /> <br /> <br />.; <br />