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<br />MAR/iJl/2005/TUE 10:37 AM ZEPHYRHILLS BUILDING
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<br />FAX No. 813-780-0021
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<br />p, 003
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<br />A. NOTICE OF DEED RESTRICTlONS
<br />Th~ unde~signed undarstands that this permit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations, The unqe!signed 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 wit~ 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 misdemeanor
<br />violation under state law. If the owner or intended contraotor are unoertain as to what
<br />licensing requirements may apply for the intended work, they are advised to contact the.
<br />City of Zephyrhills Building Department! 813-780-0020~
<br />Furthermore, if the owner has hired a contraotor or oontraotors, he is. advised to have the
<br />contractorlsJ sign po~tions of the "Contractor Sectionsff Of ~his ~pplioation for which they
<br />will be responsible. If you, as the owner signs as the oontraotor,you are indicating. that
<br />you, rather than the contractor, are responsible for the work. If the contraotor wishes
<br />you to sign as contractor that may be an indioa~ion that he is not proper~y licensed and is
<br />not entitled to permitting privileg~s in the City of Zephyrhills;
<br />C, TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />0.. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />1 certify that I, the applicant, haye been provided with a oopy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guideff prepared by the Florida Department of Agrioulture
<br />and Consumer Affairs. If the applicant is someone other that the "owner", r cerify that:I
<br />have obtained a copy of the above described document and. promise in good faith to deli~er
<br />it to the "owner" prior to commencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the information in this application is
<br />be tlone in compli~nce with all applicable laws regulating
<br />development. .
<br />Appliqation is hereby made to obtain a permit to do ~ork and installation as indicated. I
<br />certify that no work or insta~lation has commenced prior ~o 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 l~nd.development regulations in the juriSdiction. I also
<br />certify that I understand th~t th~ regulations of other governmentalagencles may apply ,to
<br />the intended work, and that it is my responsibility to identify what aotions I must take~to
<br />be in compliance. Such agencies include but are not, limited to: *Depa~tment of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Soutnwest ~~orida Water Management Oistrlct-we~~9, Cypress Bayheads, Wet~apd 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, Environmenta~ 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 submitted which
<br />is prepared by a professional engineer registe~ed 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 technioal oodes,
<br />nor shall issuance of a permit prevent the Building bfficia~ from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any cOde. Every permit
<br />issued shall become invalid unless 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 commenoed. 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 d4ring each s~x
<br />month period, or 'the project will Qe considered abandon~d.
<br />WARNING TO OW~ER: YOUR ~AlLURETO R~C~RD A NOTIC~ OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWIC~ FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CON~PLT
<br />WITft YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOT!CE OF COMMENCtHENT, . JOBS UNDER
<br />92,500.IN VAL~E NOT NEED TO RECORD AND ~OST' A "NOTICE OF COMM~EN ENT".
<br />
<br />STATE OF FLORIDA ~
<br />COUNTY OF STATE OF FLORIDA /1)
<br />Th6 forego1ng instrnment ~~s COUNTY OF ~
<br />~ .,~ &oknow~edge~ Th f '
<br />bBy"fOl:e me thi.S _. day ot e OrElgo1ng ~nstrument. was aCknOWledged'
<br />, 2lL- J:lefore me thia --!ia'y of 20
<br />
<br />(name of persqn aOKpowledgEldJ by . , or-
<br />o who is personally known to me, or n_ !name of person acknowl~dged)
<br />~ho 1S Personally known to me, or
<br />
<br />o w~ohaa produced
<br />
<br />(type of identification)
<br />~id not take an oath
<br />
<br />accurate and that'all wo:rk will
<br />oonstruotion, zoning, and land
<br />
<br />Owho has produced
<br />(type.
<br />id not
<br />
<br />of identifioation)
<br />take an oath.
<br />
<br />
<br />taking acknowledgment
<br />
<br />taking acknowledgement
<br />
<br />Name typed,. printed or stamped
<br />
<br />.Name typed, printed or stamped
<br />
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