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<br />OCT/04/2004/~ON 04:08 PM ZEPHYRHILLS BUILDING
<br />
<br />FAX No, 813-780-0021
<br />
<br />p, 002
<br />
<br />A. NOT1CE OF OttO RtSTRICTIONS
<br />Thll undersigned unde.stands that thi,. permit may be subject to "deed restriction,," which
<br />maybe mO~e restriotive thanClty requlations, The undersigned aasumes respon8~bility for
<br />conplian~e with any 8pplicable deed re"trictions.
<br />B~ UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />It the owner has hired a contractor or contraatars to undertake work, 'they may be required
<br />to be licensed in accordance with state and local requlations, If the contr8ctor is not
<br />lioensed as required by 1891, both the owner and oontractor 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 tor the intended work, they are advised to contact the
<br />City ot Zephyrhills Building Department, 813-780-0020.
<br />Furthermore, if the owner ha.s hired a cOntractor or contractors, he is advised to have the
<br />contractor(sl sign po~tion" of the "Contractor Seotions~ of this application for which they
<br />will be responsible. It you. as the owner siqns as the oontractor, you are indicating that
<br />you, rather than the contractor, are re.ponsible for the work. .If the contractor wishes
<br />you to sign as contractor that may bean indioa~ion that' he is not properly licensed and is
<br />not entitled to permittlnq privileges in the City or Zephyrhills.
<br />C. TRANSPORTATION IMPACT FtES AND UTILITY CONNECTION FEES
<br />O. CONSTROCTUION LI!:N LAW (CHAPTtR 713, FLORIDA STATUTES, AS AMENDED)
<br />I certiry that I, the applicant, hay. been provided with a copy.of ~Florida'. Conatruction
<br />lien Law - Homeowner's.Protection Guid." prepared by the Florida Department of Aqriculture
<br />and Conswaer Affairs. If the applicant is sOlll4ona other that the ~own.r", I cerify that I
<br />have obtained a oopy ot the above described document and promi8e in qood raith to deliver
<br />it to the ~owner" prior to cOIIllllencement.
<br />E. CONTRACTOR'S/OWNiR'S ArFlOAVIT
<br />I certify that all the intormation in this application is accurate and that all work will
<br />be don. in compliance with all applicable laws regulatino construction, zoninq, and land
<br />developnent.
<br />Appli~ation is hereby made to obtain a perMit to do work and instaliation as indicated. I
<br />Certify that no work or installation ha. aommenced prior to i.suahae of a permit and that
<br />all work will be pertormQd to meet standards of all laws regUlating construction, City
<br />codes, zoninq regulations, and land deTelo~rit regulations in the jurisdiotion. I also
<br />certify that I understand that the reoulations or other governmental aqencies may apply to
<br />the intended work, and that it is my responsibility to identity what actions I mU8t take to
<br />b. in compliance. Such agencies include but are not limited to: .Department ot
<br />Environmental Requlation-CyprQS,. Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />"Southwest Florida Water Management District-Welle, Cypress Bayheads, Wetland Areas,
<br />Alterinq Watercourses
<br />"Army Corps of Engineers-Seawalls, Docks, Nav1qable Waterways
<br />"Department or Health , Rehab~litative Services, Environmental Health Unit-WellS,
<br />Wastewater Treatment, Septic Tanks
<br />.U,S. Environmental ProtQction Agency-~bestos abatemen~
<br />I also certify that, if fill material i8 to be used in Flood Zone ~AH or ~A,etc.H, it i8
<br />understood that a drainage plan addressing a ~compen.ating volumeH will be submitted which
<br />i8 prepered by a protessional gngin.er registered in the State ot Florida prior to permit
<br />issuance.
<br />A permit issued shall.be con~truedto be a license to proceed with the work and not as
<br />authority to violate, cancel, a,lter, or set aside any provisions ot the technical codes,
<br />nor shall issuance ot a permit prevent the Buildinq Otrioial from thereatter requiring a
<br />correction of errors in plans, construotion, or violations ot any code. Every permit
<br />issued shall becoma invalid unless the work authorized by suoh permit is commenoed within
<br />six ~nths of issuance, or it work authorized by the perait is suspended or abandoned ror'a
<br />period of six nonths after the tLme the work is oommenced. One 90'day extension of time
<br />may be allowQd tor the PQrmit with fee charge ot $15.00. The extension shall be requested
<br />in wr1tinq to 'the Building Ottioial. An approved inspection must be logqed during each six
<br />Month period, or the project will be considered abandoned.
<br />~ING TO OWNER: YOOR rAILORE TO RECOIlD A NOTICE OF CCleOolENC!:HEN'1' HAY RESULT ni YOUR
<br />PAYING TWICE FOR INPROVEMENTS TO'yOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE O~ COMMENCEMENT. JOgS ONDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT".
<br />
<br />SIGNATURE I CONTRACTOR
<br />
<br />SIGNATURE: OWNtR OR AGENT
<br />
<br />STATE OF FLORIDA
<br />CooNT)' OF
<br />The toreqoin9 instrument was
<br />Before me this _ day of
<br />by
<br />
<br />acknowledged
<br />2L
<br />
<br />STATE OF FLORIDA
<br />COUNT1( or
<br />The toregoing instrument was
<br />Before me this -----Pay of
<br />by
<br />
<br />aclalowledged
<br />,20_
<br />
<br />(nAme of person acknOwledged)
<br />Owho 1s personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and wlioOdid Odid not tak.. an oath.
<br />
<br />(name ot person aoknowledged)
<br />~ho is personally known to me, or
<br />
<br />Owho has prOduced
<br />(type of identification)
<br />and who Odid Diid not take an osth
<br />
<br />Signature of per~on taking acknowledoeMent
<br />
<br />Signature of per80n taking aaknowled~ent
<br />
<br />Name typed, printed or stamped
<br />
<br />Nama typed, printed or 8tamped
<br />
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