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<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" whir;:;h
<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 state and local regulations. If the contractor is not
<br />licensed as required by law, both the owner and contractor may be cited for a misdemeanor
<br />violation under state law. If the owner or intended contractor are uncertain as to what
<br />licensing requirements may apply for the intende~ work, they are advised to contact the
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />Furth~~more, if the owner has hired a contractor or contractors, h, 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 contractor that may be an indication that he is not properly licensed and is
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION 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 "ownerll, I cerify that I
<br />have obtained a copy of the above described aocument and promise in good faith to deliver
<br />it to the "ownerll prior to commencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<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 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 />*Army Corps of Engineers-Seawalls, 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 i~ to be used in Flood Zone "All or "A, etc.", it is
<br />understood that a drainage plan addressing a "compensating volumell will be submitted 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 and not as
<br />authority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter ~equiring a
<br />correction of errors in plans, construction, or violations of any code. Every permit
<br />issued shall become invalid unle.. the work authorized by such permit is commenced within
<br />six months of issuance, 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 ~bandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE 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 COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENTII.
<br />
<br />
<br />d1.'J!j /J -',<<
<br />StGNATURE. OWNER OR AGENT
<br />
<br />A/> ~ 13",,&
<br />SIGRATURE: NTRACTOR
<br />
<br />STATE OF FLORIDA ~.() S(
<br />COUNTY OF /1 0 .
<br />The foregoing in~rument was acknowledged__
<br />Befa!,e l?;~s day Of~{lIZ{ ( , 20,05
<br />by LG '/-ff?- .
<br />~me of person acknowledged)
<br />~ho is personally known to me, or
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing ins rument was~~&knowle~ed _
<br />Before me this ay of t:JtJL{ L , i~
<br />by -6
<br />......----(name of person acknowledged)
<br />~ho is personally known to me, or
<br />
<br />
<br />Dwho has produced
<br />(type
<br />and whoO did ~ot
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Owho has produced
<br />~pe of identification)
<br />and who Odid 0:lld not take an oath
<br />
<br />~ A. {bf~
<br />
<br />Signature of person taking acknowledgment
<br />
<br />_~ lJ, (1~jJd
<br />
<br />Signature of person taking acknowledgement
<br />
<br />f3rz-vc E A - II 58 ~ L
<br />Name type~~~~& stamped
<br />;.~ j My Commission 00116710
<br />~ Of,..df Expires June 22. 2006
<br />
<br />T?(ZuG(~ If - ASr;]f: t-
<br />Name typed, printed or stamped
<br />i~ ~ Bruce A Asbel
<br />. ~ : My Commission 0011671 G
<br />~ Of,..df Expires Jllne 22. 2000
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