|
<br />A. NOTICE OF DEED ~ESTRICTrONS
<br />'The undersigned understands that this permit may be subject to "deed restrictions~ which
<br />may be mOre restrictive than City regulations. The undG~signed assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AND CONT~~CTOR RESPONSIBILITIES
<br />It the owner has hired a contractor or contractors to undertake work, thay may be required
<br />to be licensed in accordance with stat& and local regulations. If the contractor is not
<br />licensed as required by law, both the owner ~nd contractor may be cited for a misdemeanor
<br />violatton 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/5) sign portions of the ~Contractor Sections" of this application for which they
<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 indica~ion that he i8 not properly licenseQ and is
<br />not entitled to permitting privileges in the City of Zephyrhills,
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUrON LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify 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 Agricultura
<br />and Ccn$umer Atfair8. It the appli.cant is someone other that the "owner", I eerity that I
<br />have Obtained a copy of the abo~e described document and promise in good faith to deliver
<br />it to the "owner" prior to c()),l'lmencement,
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />r 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 const.t;;,uction, z,oning, and land
<br />development.
<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 alao
<br />certify that ! understand that the regulations of ether governmental agencies ma~f 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 T~eatmant
<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.8, Environmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be USQd in Flood Zone "AU or "A, etc.", 1t is
<br />'-1ncierstood that a drainage plan addressing a "compensating volume" will be submitted Hhic!l
<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 p&l.:'mit prevent the EUilding Official from thereafter requiring c'!
<br />correction of errors in plans, construction, or violations of any code, Every permit
<br />~.ssl.led Shall become irnralid unless the Hork authorized by such permit is commenced wi thin
<br />six month~ of issuance, or if work authorized by the permit is Suspended Or abandoned fora
<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 axt&nsion Shall be requested
<br />in writing to the Building Official. lit: 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 MAY RESOLT IN YOUR.
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COH~1ENCEMENr. JOBS ONDEF,
<br />$2,500. IN VALUE DO NOT NEED TO RECORD AND POS'l' A "NOTICE OF COMME.NCEMENT".
<br />
<br />SIGNA'rURE: OWNER OR AGENT
<br />
<br />.......;..
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF' FLORIDA
<br />COUNTY OF
<br />The foregoing instrument Was
<br />Before me this _ d,3Y of
<br />by
<br />
<br />acknOwledged
<br />,20-.,
<br />
<br />STATE OF FLORIDA
<br />COON'l'Y OF
<br />The foregoing instrument was
<br />Before me this __day of
<br />by
<br />
<br />acknowledged
<br />, 20_
<br />
<br />(na~e of person acknowledged)
<br />O\1ho is personally known to me, or
<br />
<br />OWho has prodUced
<br />(type of identification)
<br />~nd wh,)D did Ddid nc.t take an oath,
<br />
<br />(name of person acknowledged)
<br />Chho is personally known to me, Or
<br />
<br />o who has produced---., _
<br />(type ot identification!
<br />and who Odid Qjid not taKe an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
<br />1 L
<br />
<br />G . d_oV09' orL_
<br />
<br />~lll~~A~~~7 ~n I I "
<br />
<br />!A/I'I,' 7 . 0 11 (I n 7 . 77 ' I P!M
<br />
|