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<br />CUIWJ '1'.lUl~:'; U~' l'l';H.M.l'l' ^VI.'JIJ^V.lT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may b~ subject to "deed restrictions" which
<br />maybe, more r.estrictivethan City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. ~ UNLICENSED CONTRACTORS AND CON'fRACTOR RESPONSIBILI1'IES
<br />If the owner has hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accordance wiLh sLaLe and locnl regulations. If the contractor is not
<br />licensed as required by law, both the owner and contractor may be cit~dfor 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 />Further.more,if the owner has hired a contractor or contractors, he is advised to have the
<br />co~~rac~or(8) sign portions of the "Contractor Sections" 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 indication 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..,..~ONSTRUCTUION 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 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 promise in good faith to deliver
<br />it to the "owner" prior to conunencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIUAVIT
<br />I ce,rtify 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 in4icated. ,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 undetstand 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 Axeas,
<br />.Altering Watercourses',
<br />*Army Corps 'of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmental Health Unit-Wel~s,
<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 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 />.corr~ctionof 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 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 NOTICE OF COMMENCEMENT ~Y RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITII YOUR LENDER OR AN A'fTORNEY BEFORE RECORDING YOUR NO'rICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORU AND POST A "NOTICE OF COMM T".
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />
<br />"'1.;;~,.'.~'
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this day of
<br />by
<br />
<br />ackn9wledged
<br />, 19~
<br />
<br />(name of person acknowledged)
<br />o,ho is personally known to me, or
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o who has produced
<br />(type of identification)
<br />and who Ddid [}:lid not take an oath1',
<br />
<br />..- ",,';"':' ,'.." _.
<br />
<br />I."
<br />
<br />Signature c;t person taking acknowledgement
<br />.. ~ ,. ..-".....,...........o.lKoll4'.....' 4..
<br />
<br />Signature of person taking acknowledgment
<br />
<br />~ a:.... \::. " " '.'~ . ...,;.. ';.', \, '.
<br />
<br />Name'. typed~ printed or stamped
<br />
<br />Nallle typed, printed or stamped
<br />
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