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<br />A. NOTI~E 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 responsibjltty 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 iocal 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 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 contractor or contractors, he is advised to have the
<br />contractor(s) sign po~tions of the "Contractor Sections" of this application for which they
<br />will be responsible. II 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 indica~ion 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, haye 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 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 />Appli~ation 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 certi~y that if fill material is to be used in Flood Zone "A" or "A, etc.", ~t lS
<br />understood that a d~ainage 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 license to procee~ wlth the work a~d not as
<br />authority to violate, cancel, alter, or set aside any provislons of the technlcal.c~des,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requlr~ng a
<br />correction of errors in plans, construction, or violations of any code: Every perml~ .
<br />issued shall become' invalid unless the work authorized by.su~h permit lS commenced wlthln \
<br />six months of issuance, or if work authorized by the per.mlt lS suspended or a~ando~e~.for ,a
<br />period of six months after the time the work is commenced. One 90 d~y extenslon 0 lm~ d
<br />ma be allowed for the permit with fee charge of $15.00. The extenslon shall b7 reques e.
<br />inYwriting to 'the Building Official. An approved inspection must be logged durlng each SlX
<br />
<br />:~~N~e~;o~~N~~:th~o~~o~:~iu;~l~ob:E~~;~i~e~~~I~~a~~o~~~~:;~M~~TO~~I:E~~~~N~~N~~U~ONSULT
<br />
<br />~~~~N~O~:I~~N~~~ ~~P~~V:~~~~~E~OB~~~~EP~~~~~~~~G ~~U~ONOTICE OF COMMENCE~ENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT.
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />Before me this _____ day of __' 2L-
<br />by
<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 />, 20_
<br />
<br />(name' of person acknowledged)
<br />Owho is personally known to me,or
<br />
<br />(name of person acknowledged)
<br />C1ho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoO did Odid not take an oath.
<br />
<br />o who has produced . .
<br />(type of identiflcatlon)
<br />and who Odid DUd not take an oath
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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