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A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this permit may be subject to "deed restrictions" which may be more restrictive than City regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations, If the contractor is not licensed as required by lawt both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended workt they are advised to contact the City of Zephyrhills Building Departmentt 813-780-0020. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign po~tions of the "Contractor Sections" of this application for which they will be responsible. If yout as the owner signs as the contractor, you are indicating that yout rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that may be an indica~ion that he is not properly licensed and is not entitled to permitting privileges in the City of Zephyrhills, C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTUION LIEN LAW (CHAPTER 713t FLORIDA STATUTESt AS AMENDED) I certify that It the applicantt have been provided with a copy of "Florida's Construction lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I have obtained a copy of the above described document and promise in good faith to deliver it to the "owner" prior to commencement. E, CONTRACTORtS/OWNER'S AFFIDAVIT I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning, and land development. Appli~ation is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating constructiont City codes, zoning regulationst and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other governmental agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: *Department of Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Landst Water/Wastewater Treatment *Southwest Florida Water Management District-Wellst Cypress Bayheads, Wetland Areast Altering Watercourses *Army Corps of Engineers-Seawallst Dockst Navigable Waterways *Department of Health & Rehabilitative Services, Environmental Health Unit-Wellst Wastewater Treatmentt Septic Tanks *U.S. Environmental Protection Agency-Asbestos abatement I also certify that, if fill material is to be used in Flood Zone "A" or "Atetc."t it is understood that a drainage plan addressing a "compensating volume" will be submitted which is prepared by a professional engineer registered in the State of Florida prior to permit issuance. A permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, altert or set aside any provisions of the technical codest nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, constructiont or violations of any code. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of issuancet or if work authorized by the permit is suspended or abandoned for 'a period of six months after the time the work is commenced. One 90 day extension of time may be allowed for the permit with fee charge of $15,00, The extension shall be requested in writing to the Building Official. An approved inspection must be logged during each six month periodt or the project will be considered abandoned. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCINGt CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR acknowledged ,20_ STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____day of by STATE OF FLORIDA COUNTY OF The foregoing instrument was Before me this _____ day of by acknowledged 20 (name of person acknowledged) [1ho is personally known to me, or (name of person acknowledged) Dwho is personally known to met or D who has produced (type and whoD did D did not of identification) take an oath. Dwho has produced (type of identification) and who Ddid [}:iid not take an oath Signature of person taking acknowledgment Signature of person taking acknowledgement Name typedt printed or stamped Name typed, printed or stamped