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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 workt they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, 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. Furthermoret 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 contractort 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 "Floridats 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"t 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 conunencement, 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, zoningt 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 conunenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, City codest 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 workt 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-Wells, Cypress Bayheadst Wetland Areas, Altering Watercourses *Army Corps of Engineers-Seawallst Docks, Navigable Waterways *Department of Health & Rehabilitative Servicest Environmental Health Unit-Wellst Wastewater Treatment, Septic Tanks *U.S. Environmental Protection Agency-Asbestos abatement I also certify thatt 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 violatet cancel, alter, 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 conunenced 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 conunenced. 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 N ICE 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 RECORDIN YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2t500 IN VALUE DO NOT NEED TO RECORD AND POST ~ "NOTICE OF COMMENCEMENT". SIGNATURE: OWNER OR AGENT CONTRACTOR acknowledged , 2CL- 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 t 20_ (name of person acknowledged) Owho is personally known to met or (name of person acknowledged) [1ho is personally known to me, or Owho has produced (type and whoO did 0 did not of identification) take an oath. Owho has produced (type of identification) and who Odid DUd not take an oath Signature of person taking acknowledgement Signature of person taking acknowledgment Name typedt printed or stamped Name typedt printed or stamped