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<br />CU.lWJ 'l'.tuH~; V.I:' PI.';[(M.L'" A,I:":'JL'AVJ.',':
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may b~ subject to "deed restrictionsN whi~h
<br />may be more restrictive than City regulations. The undersigned assumes responsibi'lity for
<br />compliance with any applicable deed restrictions.
<br />B.- UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or cont.cactors to undertake work, they may be required
<br />to be licensed in accordance with slale and loc.,l regulations. If the contractor is not
<br />licensed as required by law, both the owner and contractor may be cit~d for a misdemeanor
<br />violation.under sta~e 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 />Furthe~ore, if the owner has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor SectionsN of this' application for which the~
<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 indicat-ion that he is not properly lic,ensed 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 certlfy that I, the applicant, have been provided with a'copy of "Florida's Construction
<br />lien Law-Homeowner's Protection GuideN prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "ownerN, I cerify that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "ownerN prior to conunencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I ce~tify that all the information in this application is accurate and that all work will
<br />be done in compl;ance 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 inq.icated. . I
<br />certify that no work or installation has conunenced prior to iss,uance 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 ~ctions 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 Whter 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-WeltS,
<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 "AN or "A,etc.-, it is
<br />understood that a drainage plan addressing a "compensating volumeN 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 licensp. 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 requiring a
<br />correction of errors in plans, construction, or violations of any code. Everype.rmit
<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 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 '1'0 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 />WITII YOUR LENDER OR AN }\'l'TORNEY BEFORE RECORDING YOUR NO'rICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POSTJ" OTICE OF COMMEN/""i~'.
<br />
<br />_~lA) if~
<br />
<br />SIGNATURE: OWNER OR AGENT S ATURE: CONTRACTOR
<br />
<br />~'.J~,.'.~'
<br />
<br />STATB'or~n,oRIDA
<br />COUNTY',OF
<br />The "foregoing instrument was ackno~lledged
<br />Before me this day of , lL
<br />by ,
<br />"(name ofPperson acknowledged)
<br />Clwho 1s personally known to me, or
<br />
<br />o wb~ has pr~duced
<br />(type
<br />and whoDdid Ddid not
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The forego~ng instrument was
<br />Before me this day of
<br />by
<br />
<br />acknowledged
<br />, 19~
<br />
<br />of identification)
<br />take an oath.
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<br />Si'gnature 'Of person taking acknowledgement
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<br />Signature of person taking acknowledgment
<br />
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<br />'..' ..... \.'.
<br />
<br />Name typed~ printed or stamped
<br />
<br />Nallle typed, printed or stamped
<br />
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