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<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be sub:lect to ~deed restrictions" which
<br />may be more restrictive than City regulations. The undersigned assumes resprmsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBIl.I'rIES
<br />If the owner has hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in/accordance with st~te ~nd local regulations. If the. contractor is not
<br />licensed as required by law, both the owner and contraotor may be cited for a mdsdemeanor
<br />violation under state law. If the owner or intended contractor are uncertain as to what
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills Building Department, 813-788-6611. .
<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 Bections" of this application for which they
<br />will be responsible, If you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor wishes
<br />you to sign as contraptor that may be an indication that he is not properly licensed and is
<br />not entitleq to permitting prfvileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEEB AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUIQN LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AB AttENDED)
<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 Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the ~owner", I cerify that I
<br />have obtained a copy of the above described document and p~omdse in good faith to deliver
<br />it to the ~owner" prior to commencement. '
<br />E. CONTRACTOR'S/OWNER'S AFFlDAVlT
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no work or installation has commenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regUlating construction, City
<br />code~, zoning regulations, and land development regulations in the jUrisdiction. I also
<br />certify that'I understand that the regulations of other governmental agencies may apply 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, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment .
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Anny corps of Bngineers-Seawalis, Docks, Navigable Waterways
<br />*Department of Health , Rehabilitative Services, Environmental 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,etc.", it is
<br />understood that a drainage plan addressing a ~compensatingvolume" will be s~bmitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to permit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work ~nd not as
<br />authority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a permdt prevent the Building Official from thereafter requiring a
<br />corr_otion of errors in plans, construction, or violations of any code. Every permit
<br />issued shall become invalid unless the work a~thorized by such pe~t is commenced within
<br />six months of iS8ua~ce, or if work authorized 'by the permit is suspended or abandoned for a
<br />period of six months after the time the work Is commenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTIC~ OF COMMENCEMENT ,MAY 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 RECORDING YOUR NOTICE OF COMMENcI!:HENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT".
<br />
<br />- -----... ............,u'...... -~ I.. .G.t.ru.~l~ ~ n.c 1: }.J~.l"\.V 1--1:
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<br />~'i.~~L
<br />SiGNATURE I 0 Ii': OR AGENT
<br />
<br />SIGNATURE I CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF '?Ar.5e;o
<br />The foregoing lnstrument was acknowledged
<br />Before me this~ day o~~e~, -;~4'
<br />by
<br />
<br />(name of person ackno~ledged)
<br />'Owho is personally known to me, or
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this ~ay of
<br />by
<br />
<br />acknowledged
<br />19~
<br />
<br />o who has produced
<br />(type of identification)
<br />not take an oath.
<br />
<br />(n~e of person acknowledged)
<br />[Lho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and who Ddid Diid not take an oath
<br />
<br />
<br />Signature of person taking aoknowledgment
<br />
<br />-g; KaRilA .. KMAiA.ky
<br />Name typed, printed. ~ 0022212.1
<br />
<br />~CII'~ Expires June 11, 2007
<br />
<br />Name typed, printed or stamped
<br />
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