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<br />J5:C:?M ZEPHYRHILLS BUILDING
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<br />FAX No, 813-780-0021
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<br />p, 002
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<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictipns" which
<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 intended work, they are advised to contact the
<br />Cit~ 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 portions at' the "Contractor Sections" of this application for which they
<br />will be responsible. 'It you, a6 the, owner 6igns as the contractor, you are indimiting that
<br />you, rather than the contractor, are responsible for the work. If the contractor wishes
<br />you to sign as Gontractor that m;"y be an indica~ion that he is not pJ:'operly licensed and is
<br />not entitled to permitting privileges in the City of Zephyrhills. '
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION eEES
<br />D. CONSTRUCTUION LIEN LAVI (CHAPTER 713, FLORIDA S'l'ATUTES, AS AMENDED)
<br />I c~rtity 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 cerity 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 AeeIDAVIT
<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 />developm"nt.
<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 identity what actions I must take to
<br />be in compliance. SUGh agencies inclUde but are. not limited to: *Department of
<br />Environmelital Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida water Management District-Wells, Cypres~ Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Arn\y Corps of Engineers-Seawalls, Docks, NaVigable Waterways
<br />*Department of Health & Rehabilitative Services, Environlnental Health Unit~Wells,
<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 whiqh
<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 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 SUGh permit is commenced within
<br />si~ 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 $15.00. The extension shall bl'> requested
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER, YOUR FAILURE TO RECORD A NOT!CE OF COMMENCEMENT M~Y RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. Ie YOU INTEND TO OBTAIN eINANCING, CONSULT
<br />WI YO LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$ 'Slbo 'VAJ,", f T. 0 " ,,"CORD d POST A "'OTIC' UB C""'''C'''ON'''
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<br />TURE: NER OR AGENT SIGNATURE, CONTRACTOR
<br />
<br />STATE OF-FL6~Iu~ ~ ~~~~ STATE OF FLORIDA
<br />COUNTY OF. ~s.~ COUNTY OF
<br />The foregoing instrument acJmowledg~"... The foregoing instrument was acknowledged
<br />Befo this ~ay 0 , 2~ Before me this _day of , 20_
<br />by by
<br />(name of p rson aGkn wledged)
<br />~hO is personally known to me, or
<br />
<br />o who
<br />
<br />
<br />(name of person acknowledged)
<br />C1ho is persona~ly known to me, or
<br />
<br />
<br />of identification}
<br />an oath.
<br />
<br />and who Odid
<br />
<br />Owho has produced
<br />(type of identification)
<br />~id not take an oath
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or stamped
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