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<br />;:ONlJIT10NS r.'!~ pE.;.o.Ml'r A.FF'ID.c-:.j:~ T'
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permi t. may be subjec.t: to '.'deed ;:estril::ti(1n~" ",J~.\.c:h
<br />may be more restrictive than City l:egulalions. 'I'h-= undersigned assumes respoiJs~_Li_..! .U.V for
<br />compliance with any applicable deed restrictions.
<br />B. UNLIC~NSEp CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertak~ "'oJ:k, they may be recpli..red
<br />to be licensed in accordance with state and local regulations. If the contracto~ is not
<br />licensed as required by law, both the o.mer and contractor may be cited for;} misdemeaIlor
<br />violation under state law. If the mmer or intended contractor al:e uncertain ;;5 to HI;3\:
<br />licensing requirements may apply for the intended "'orJ~, they aLe advised to cont<:lct the
<br />City of Zephyrhills Building Department, 813-796-6611.
<br />Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
<br />contractor (s) sign portions of the "Contracto~ Sections'" of this application to;: ".:hich Lhey.
<br />",ill be responsible. If you, as the O\-lI1er signs as the contractor, you are indica:-ing that
<br />you, rather than the contractor, are responsible for the ..lork. 1 f the contract.or wishes
<br />you to sign as contractor that may be an indication that he is not properly licensed and .:.-"
<br />not entitled to permitting privileges in the City of ~ephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION 'E'EES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTf:R IB, FLOP.IDA S'l'j-\TUTE: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" prepared by the Florida Depa rtment ct l\gricul ture
<br />and Consumer Affairs. If the applicant is SOlOeor.<=! other that the "owner", .f cel:ity tbaL I
<br />have obtained a copy of the above described document and promise in ,;ood Ld. tl~ to ;;:!e.L veJ:
<br />it to the "owner" prior to commencement.
<br />E. CONTRACTOR' SImmER' S AFFIDAVIT
<br />1 certify that all the information in this application is aec'.lrate and thc.t elll ,JOrl~ \.,jU
<br />be done in compliance with all applicable laws regl.:lating c(JII~,truction, 2:')nin'1, and land
<br />development.
<br />Application is hereby made to obtain a per-mit to do werk and installalion as indicated. I
<br />certify that no work or installation has commt~nced prior to issuance of a permit ar:d I:IJ<tt
<br />all work will be performed to meet standards of all laws regulating construction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiction. ] also
<br />certify that I understand that the I:cgulat ions af other governmental agenci~s may appl~... to
<br />the intended work, and that it is my responsibi lity to identify what actions I 1':Ust t:c.ke to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, 'jletland Areas and E!1vironment~.lly Sensi ti -,e
<br />Lands, Water/Wastewater Treatmer.t
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, ~~ei.::lald Areas,
<br />Altering Wat,'rcourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Servic~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 b~ used in Flood Zone "A" or ~A,etc.ff, it is
<br />understood that a drainage plan addressing a -"conpensating volume" will be submitted t./hi ch
<br />is prepared by a prof~ssional engineercegistered in the State of Florida prior to permit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed \"ith the \-lOrk nlld n0t dO
<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 thereafter requirilig a
<br />correction of errors in plans, construction, or violations of nny code. Every permll
<br />issued shall become invalid unless the './ork authorized by such permit. is conur.enced. ,,-lit-hin
<br />six months of issuance, or if work authoclzed by the perr-tit is suspended or abandc,ned tOl: <~
<br />period of six months after the time the work is commenced. One 90 day exten:5ion of til!ie
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be request.l'-d
<br />in writing to the Building Official. Jm approved inspection must be logged during each Silo
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD 1\ NO'l'ICE CF COM}olENCE;"l.ENT MAY HESUVr ; N YOUt<
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUI< PROPERTY. IF YOU INTEND TO OBTAIN E'IIJANCING, C0NSU1/f
<br />~~OUR LENDER OR AN ATTORNEY BEE'ORE RECOP.DING ~'UR NOTICE O!! COl"'J.1ENCE."'lENT. ,TOrs.:: UNDEP
<br />l' . 50p IN VALUE Dp NOT NEED TO RECORD AND POS'I' "N 'rICE OF CO~CF.MON'l''''
<br />
<br />~/LY2~ ' ~----
<br />
<br />SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
<br />
<br />. STATE OF FLQ.I:lI D!\
<br />COUNTY OF ~~
<br />The foregoing instrument was acknowledged
<br />Bef...()re me this ~ day of R.brU11.rLj , ~ S-
<br />by [',>() ~ IA!L m ("c c "-
<br />(name of person acknowledged)
<br />~o is personally known to me, or
<br />
<br />STATE OF FLOHID!\
<br />cour.!'l'Y OF _ '"PO....5-C!. 0 -----
<br />The foregoinq inst.rument wC\S- eckno\'lledged
<br />~. ,.<#-.. ~ru..c:u-... . .:J-aIS
<br />Befo~ me L.hJ.s -L~day of '1, ]~--
<br />by ~ ~. \^-D-... IIY\P & i-'- -..
<br />_ (name of person acknowledg~dl
<br />~ is personally kno"'ln to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoO did 0 did not ta ke an oa th .
<br />
<br />~~. CL-.o(~
<br />
<br />Signature of person taking acknowledgement
<br />
<br />o \."ho has pr0d'-l~ed _____________
<br />(type of identificat~ool
<br />
<br />:t::~da:,~_:J}te an O'.~__m
<br />
<br />
<br />SignatuJ:e of "f>l:son t'1kinq ackno\oJ] edqme;:t
<br />
<br />.~ S~'''''.,t...~
<br />Name typed, ~nT'~j~~~
<br />'\;",::,1 ~ July 22,2008
<br />
<br />Harne tY~x~~I~stamped
<br />-!JjMyCommisaionD0340488
<br />'~::,I ExpnsJuly22.2008
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