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<br />OCT/04/2004/~ON 04:08 PM ZEPHYRHILLS BUILDING
<br />
<br />FAX No, 813-780-0021
<br />
<br />p, 002
<br />
<br />A. NOTICE OF Di:ED RESTRICTIONS
<br />The undersigned understanda tha.t this permit llUly be subject to "deed restriction,," which
<br />may be mOre restrictive than City requlations. The undersigned 8s8umes respon8~bility for
<br />cOMpliance with any applicable deed restrictions.
<br />B. 'UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITItS
<br />It the ownar has hired a contractor or contraotors to undertake work, 'they may be required
<br />to be licensed in accordance with state and local requlation". If the contractor is not
<br />lioensed as required by law, both the owner and oontractor may be cited for a misdemeanor
<br />violation under state law. If the.owner or intended contractor are uncerta1n as to what
<br />licensing requirements may apply for the intended work, they are advised to contsct the
<br />City of Zephyrhills Building Department, 813-780-0020.
<br />Furthermore, if the owner has hired a cOntractor or contractors, he is advised to have the
<br />contractor(s) sign po~tions of the "Contractor SeotionsN of this application for which they
<br />will be responsible. It you. as the owner siqns a8 the contractor, you are indicating thet
<br />you, rather than the contractor, are responsible tor the work. .It the contractor wishee
<br />you to sign as contractor that may bean indio.~ion that' he is not properly licensed and is
<br />not entitled to permitt1ng privileges in the C1ty or Zephyrhills.
<br />C. TRANSPORTATION IKPACT FiiS AND UTILITY CONNECTION FEES
<br />D. CONSTROCTUION LIEN LAN (CliAP'l'tR 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, thQ applicant, haye be.n provided with a copy.of .Flor1da's Construction
<br />lien taw - Homeowner'a.Protection Guide" propared by the rloriCla Department of Aqriculturll
<br />and Consuraer Affain. If the applicant is eOlll8one other that the "owner", I cerify that I
<br />have obtained a copy or the above deeoribed document and promise in qood taith to deliver
<br />it to the .owner" prior to cOll\lllencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that .11 the infor~tion in this application is accurate and that all work will
<br />be done 1n compliance with all applicable laws regulating construction, zoninq, and land
<br />developnent.
<br />Appli~ation is hereby made to obtain a permit to do work and instaliation as 1ndicated. I
<br />certify that no work or installation has oommenced prior to issuahoe ot a permit and that
<br />all work w1ll be PQr!orm9d to m..t standards of all laws requlating construction, City
<br />codes, zoninQ re<;/ulations, and land. developlllerit regulations in the juriSdiotion. I also
<br />certify that Iunder~tand that the requlat10ns of other governnental aqencie. may apply to
<br />the intended work, and that it is my re8ponsibility to ident1ty wn.t actions I must take to
<br />be in compliance. Such agencies include but are not limited to: .Department ot
<br />EnVironmental Regulation-CyprQSc Sayheads. Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />"Southwest Florida Water Management District-Wella, Cypress Bayheads, Wetland Areas,
<br />Alterinq Watercourses
<br />.Army Corps of Engineers-Seawalls. Docks, Naviqable Waterways
<br />*Department or Kealth , Rehabilitative Services, Invironmental Health Cnit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill IIlAterial ia to be used in Flood Zone "AN or ~A,etc.H, it is
<br />understood that a drainage plan address1ng a .oompensating volumeH will be submitted which
<br />is prepared by a protessional engineer registered in the State ot Florida prior to permit
<br />issuance.
<br />A permit issued sball.be construed to be a 11cense to proceed with the work and not as
<br />authority to violate, cancel, a,lter, or set aside any provision:!! ot the technical codes,
<br />nor shall issuance ot a permit prevent the Buildinq Offioial from thereafter requiring a
<br />correct10n of errors in plans, construction, or violations ot any code. Ivery permit
<br />issued shall became invalid unless the work author1zed by such permit is commenced within
<br />six ~nths ot issuance. or if work authorized by the permit i8 suspended or abandoned tor 'a
<br />period of six months after the t~e.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 writinq to 'the Building Official. An approved 1nspection must be log<;/ed durinq each six
<br />month per10d, or the project will be COnsidered abandoned.
<br />~ING TO OWN&R: YOOR rAILOR! TO AECOaO A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE R!;COROING YOUR NOTICE OF COMMZ;NCUitNT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF QOHHENCENENTN.
<br />
<br />
<br />Sfd~';;;,J1:: V SIGNAroRE, ",,,...,ro.
<br />
<br />STATE OF FLOR
<br />COONTl" Of"
<br />The !oreqoinq
<br />Sefo me this
<br />by
<br />~ (name. of person acknOWledged)
<br />ho 1s personally known to me, or
<br />
<br />who has produced
<br />
<br />
<br />
<br />STATE OF FLORIDA
<br />COUNTY or
<br />The toregoing instrument was acknowledged
<br />Before me this ---Pay of , 20_
<br />by
<br />(name of person aOknowledged)
<br />~ho is personally known to me, or
<br />
<br />Owho has produced
<br />(type ot identification)
<br />and who Odid D:1id not take an oath
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name
<br />
<br />typgd, pr~~C'A ['5NAf~ON
<br />NOTARY PUBLIC. STATE OF FLORIDA
<br />COMMISSION # 00044518
<br />EXPIRES 9/1712005
<br />BONDEDTHRU 1-888-NOTARYt
<br />
<br />Name typed, printed or 8~amp.d
<br />
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