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<br />!:ONDl'l'.LONS f.lIe PE,;).Ml'I' AF/oID.'":i::.'~'
<br />
<br />.~\. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perwit. may be su;:je.:~t. to "'deed .::esl:r:i,::t:.i.,'ns': ,,1:\-::1;
<br />may be more restrictive than City regulations. 'I'h.~ uncersig;led asswnes respOi:sU;;J.i 1'" for
<br />compliance with any ~pplicable deed restr1ctions.
<br />B. UNLICC:NSEp CONTRACTORS AND CONTRl\CTOR RESPONSIBTLI1'IES
<br />If the owner has hired a contractor O.r: contractors to undertak":! "'od~, they may b", n;!q'J.i..red.
<br />Lo be licensed in accordance with state and local regulations. If the contractor is not
<br />licensed as required by law, both the owner and contractor may be cited [or;) misdcmeclilol
<br />violation under state law. If the mvner or intended contractor are uncertain ':'5 to \1/;31:
<br />licensing requirements may apply for the intended '''lOrl:, they are ad,,:i.:~ed tel c0ntact the
<br />City of Zephyrhills Building Department, 813-785-6611.
<br />Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
<br />contractor (s) sign portions of the "Contractor Sect:j.ons'" of this application fG~ Ir:hich Ull'Y_
<br />will be responsible. If you, as the owner 51gn5 as the contr~ctor, you are indicatillg that
<br />you, rather than the contractor, are responsible for t.ne 1tlOrk. I f the contraccor wishes
<br />you to sign as contractor that may be an ir!dicatic.n that he is not. properly licensed rtnd .~~
<br />not entitled to permitting privileges in the City of 'Z.ephyrhills.
<br />C. TRANSPORTATION IM.PACT FEES AND UTIl,ITY CONNECTION E'EES
<br />D. CONSTRUCTUION LIEN LAW (CRAPTf~R 7L~, FLOP.IDA S'I'I-\TOTE:S, AS AMeNDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guide" pre;:>ared by the Florida Depa rtment ct l\gricul ture
<br />and Consumer Affairs. If the applicant i.s someorle othel: that the "owner", 'r '.'eri t.y thi:lL I
<br />have obtained a copy of the above described document and promise in go::>d b i th to (leL~ ve[
<br />it to the "owner" prior to commencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />I certify that all the information in this application is
<br />be done in compliance with all applicdble la1tlS regl:lating
<br />development.
<br />Application is hereby made to obtain a permit to do work and installalion as indicated. I
<br />certify that no work or installation has commenced prior to issuance of a permit al:d that
<br />all work will be performed to meet standards of all laws regulating construction, C).t',:
<br />codes, zoning regulations, and land dev'elopment regulations in the jurisdiction. ] ,1150
<br />certify that I understand that the regulat i.ons at othe.r governmental agencip.s lIlay appl:i to
<br />the intended work, and that it is my responsibility to identify what actions I must take to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, !fletland Areas and E~\vironmenti~.lly Sensi ti -12
<br />Lands, Water/Wastewater Treatmer-t
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, ~ei::la,~d Area.';,
<br />Altering Watii'rcourses
<br />*Army Corps of Engineers-Seawalls, DOCKS, Navigable Waterways
<br />*Department of Health & Rehabilitative Servicl;!s, Enviromr.ental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone "A" or ~A,et~.~, it is
<br />understood that a drainage plan addressing a "'conpensating volume" will be sUDnLi.tted "/hj ch
<br />is prepared by a profr.!ssional engineer registered in the State of Florida prior to per.mit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed \~i th t:he \-lOrl;: i'dl'J. l1':;t as
<br />authority to violate, cancel, alter, or set aside any provisiollS of ~he technical cod~s,
<br />nor shall issuance of a permit prevent the Building Official from thereaftei: requiring <I
<br />correction of errors in plans, construction, or violations of any code. Every permIt
<br />issued shall become invalid unless the \oJ::>.::k authorized by such permit is cOllunenced 1tlitbin
<br />six months of issuance, or if work authocized by the per~t is suspended or abandoned tor ,~
<br />period of six months after the time the work is conunenced. One 90 day exten:~ion of t.ime
<br />lllay be allowed for the permit with fee charge of $15.00. The extension shall be requestf.-d.
<br />in writing to the Building Official. 1m approved inspection must be logged during '~<v:h s1:r
<br />Inonth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD 1\ NOTICE OF COMHENCE,>1ENT MAY RESULT ; N YOUf~
<br />PAYING TWICE FOR IMPROVEMENTS TO YauP. PHOPEll.TY. IF YOU INTEND TO OBTAIN FIfJAN'~ING, C0WW]/!'
<br />WITH YOUR LENDER OR AN ATTORNEY BEEURE RECORDING Y~UR NOTICE O~ CO~~ENCK~ENT. JOtl~ UNDEP
<br />$2:9,00 IN VALUE DO NOT NEED TO RECORD AND POST A "NO'rICE OF COHMEI;J-CEMENT".
<br />
<br />accurate and tha t. <11.1
<br />construction, z')ning,
<br />
<br />.wrk \-,j}.l
<br />and l.alld
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<br />,<;;/' . (:7 ., /--\... -;"'<' ~._-_.C.. "" / _ .. _,' , .' r',
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />....
<br />
<br />) &11 J' \.__/;1,1.....~
<br />_ .,;;//', JL/I/{ ~. /'./W__tL~:________
<br />SIGW\T\JRE: CONTRACTOR
<br />
<br />STATE OF f.L~I ~J:\
<br />- COUNTY OF ,t<.:::> C-lJ
<br />The foregoing instrument wa~ ackno~ledged .
<br />Before me this ! I ~ day of ND \fe..r\r\. i?f;'.Y'Jt!J~L/
<br />'{" .
<br />by ,,(:) ~'\ tA.A, VV'1 fJ 0 "'--
<br />./(name of person acknowledged)
<br />Gf~ho is personally known to me, or
<br />
<br />STATE OF ["LORi D,1\-I'
<br />COUl,JTY OF _ i'-'Cf..S ~8 .---.-
<br />The forego1nCj inst~ent was ,ackno}'J1edged
<br />Befor~ me this ~day of 1ILt'tN!/'Yll:Jev, ~ f?t7t!J'f
<br />by (>01'1Vl.u. f21cOJr-
<br />_ (name of person acknowledgedl
<br />E2(ho is pers0n;:~1.1y known to me., or
<br />
<br />
<br />cknowledgemen i:
<br />
<br />o \-./ho has prvd.,IGed___..._____.________
<br />(type of identjfic~t~onl
<br />and who Odid [)::lid net take an Ooth
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<br />.->.!~f>J.A\ ( t.I'1 ~ . <pi.JvU Id{' _..___.____
<br />~)ign3ba~0Su.iM).Rir1,8'oM1I....1kinq acknO\v' edqHle;:t
<br />o 0 My CommiUkJn 00340488
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<br />-- ilIpiw' ..~ -.----
<br />name typed, pr.inted OJ: '3 tamped
<br />
<br />o who has produced
<br />( type
<br />and whoO did Odid not
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<br />.LA...-2. c;.t...,- ~-'/A
<br />
<br />Signatur~f;erson,ta .
<br />o oMyCommiSilon
<br />'\ ~ r.l Expires July 22, 2008
<br />
<br />Name typed, printed o::>r stamped
<br />
<br />of identification)
<br />take an oath.
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<br />:i.e.R.-
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