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<br />A. NOTICE OF DEED RESTRICTIONS <br />The undersigned understands that this permit may be subject to ~deed restrictions" ,which, <br />maY'be'more restrictive than City regulations. 'The undersigned assumes responsibility for <br />compliance with any applicable deed restrictions. <br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES <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 and local regulations. If the contractor is not <br />licensed as required by law, both the owner and contractor 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 t~e <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 Sections" 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 FEES AND UTILITY CONNECTION F~ES <br />D. CONSTRUCTUIQN LIEN LAW (CHAPTER 713, FLORIDA STATUTES, 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 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~omise in good faith to deliver <br />it to the "owner" prior to commencement. ' <br />E. CONTRACTOR'S/OWNER'S AFFIDAVlT <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 />codes, zoning, regulations, and land development regulations in the jurisdiction. I also <br />certify that '1 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 S~nsitive <br />Lands, Water/Wastewater Treatment <br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, <br />Altering Watercourses <br />*Army Corps of Engineers-Beawalis, 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 "compensating volume" 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 pennit i8su~d shall be construed to be a license to proceed with' the work and 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 Offic~al from thereafter requiring a <br />corr~ction 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 issua~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 permdt 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_ '-'.&.; L .GJS'U"'..L J.. rt.c c ~U.t\.V.L-r <br /> <br />SIGNATURE. OWNER OR AGENT' <br /> <br />SIGNATURE. CONTRACTOR <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />The foregoing instrument was <br />Before me this _ day of <br />by <br /> <br />acknowledged <br />, 1!i.- <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />The foregoing instrument Was <br />Before me this -----Pay of <br />by <br /> <br />(name of person acblo~iedged) <br />Owho is personally knowii to me, or <br /> <br />acknowledged <br />, 19_~ <br /> <br />(name of person acknowledged) <br />[Lho is personally known to me, or <br /> <br />o who has produced <br />(type of identification) <br />and whoO did Odidnot take an oath. <br /> <br />o who has produced <br />(type of identification) <br />and who Odid OUd not take an oath <br /> <br />Signature of person taking acknowledgement <br /> <br />Signature of person taking aoknowledgment <br /> <br />Name typed, printed or stamped <br /> <br />Name typed, printed or stamped <br />