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<br />V.jIU~/LUUi/MUh U4:UO rM ~rtirKtlJLL~ bUj~l~
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<br />tAl No. ~13-'/80-0021
<br />
<br />P. 002
<br />
<br />A. NOT1CE OF OttO RtSTRICTIONS
<br />The undersigned Ullderstan~ that this permit llUIy be subject to "deed restrictions" which
<br />may be more restriotive than City requlationa. The undersigned sssumes respona~bility for
<br />conpliance with any applicable deed restrictions.
<br />B. UliLICEN9ED CONTRACTORS .'.NO CONTRACTOR RESPONSIBILITI!S
<br />It tn. 'owner has hired a contractor or contraotora to undertake work, . they ~Y be required
<br />. to be licensed in accordance with at ate and local regUlations. If the contractor i. not
<br />lioensed .s required by law, both the owner and oontractor may be cited for a a1sdeme8nor
<br />violation under atate law. If the.owner or intended contractor are uncertain ae to what
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />City ot Zephyrhills Building Department, 813-780-0020.
<br />Furthenuore,. if the owner has hired a contractor or contracto:t'8, he is advised to have the
<br />contrsctor(s) sign po~tions of the ~Contractor SeotionsN of this application tor which they
<br />will be responsible. It you. as the owner signa a. the oontractor, you are indicating thAt
<br />you, rather than the contractor, are re.ponsible tor the work. .If the oontractor wishes
<br />you to slgn '5 contractor that may be an ind1ca~ion that. he is not prOperly llcOnaed and i8
<br />not entitled to permitting privileg~a in the City or Zephyrhills.
<br />C, TRANSPORTATION IHPACT FtES AND tl"J'ILITY CONNECTION FEES
<br />0, CONSTROCTUION LICN LAW (C~PTt~ 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the _pplicant, haye been prOvided with a cOPy.of -rlorida's Construction
<br />lien Law - Homeowner's.Protection Guide" prepared by the Florida Department ot Aqriculture
<br />and Consumer Affairs. If the applicant i. '~one other that the ~ownerh, I cerity that I
<br />have obtalned · COpy or the above dasoribed document and promi.e in good faith to deliver
<br />it to the .owner" prior to cOlMlenc8lllent.
<br />E. OONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the information in thi. application is .ccurate and that all work will
<br />be done in compliance with all applicable laws regulating con.truction, zoning, and land
<br />dovelopnent.
<br />Appliqation is hereby made to obtain a pernit to do work and instaliation as iAdloated. I
<br />Certify that no work or installation ha. comm.nced prior to i,suahoe ot a permit and that
<br />all work will be pertormed to meet standards of all law. requlatlng construction, City
<br />codes, zoning regulations, and land developIMrit requlations in the jur18diotion. I also
<br />certify that I understand that the regUlations ot other governmental agenci.s ~y apply to
<br />the intended work, and that it is my ra.ponsibility to identity w~t aotions I mu.t take to
<br />be in compliance. Such agencies include but are not limited to: .Department ot
<br />EnVironmental Regul_tion-Cypress Bayheads, Netland Areas and EnVironmentally Sensitive
<br />Lands, Water/Wa.tewater Treatment
<br />'Southwest florida Water ~anog~ent District-Welle, Cypress Bayheads, Wetlana Are.s,
<br />Altering Watercourses
<br />'~y Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />"Department or Kealth , Rehabilitative Services, Environmental Health Onit-WellS,
<br />Waatewater Treatment, Septic Tanks
<br />'U.S. Environmental ~rotection Agency-Asbestos abatement
<br />I also certify that, if fill m4terial i8 to be u.ed in Flood Eone ~AH or ~A,etc.H, it i.
<br />under.tood that a drainage plan addrea.1ng a -oompensating volume" w1ll be submitted which
<br />is prepared by a protessional engineer registered in the State ot Florida pr10r to permit
<br />i.suonce,
<br />A permit issued shall.be construed to be . license to proceed with the work and not as
<br />authority to violate, cancel, a.!ter, Qr .et a aide. any provisionll ot the technical codes,
<br />nor ahall issuance ot a permit prevent the Building 0:ti01.1 troM thereatter requiring a
<br />correction or errors in plans, conattuotion, or violations of any code. Every pernit
<br />issued shall becama invalid unle.s the work author1zed by such permit i. commenced within
<br />.1x ~nths ot iseuance, or it work authorized by the pernit i. suspended or abandoned tor'a
<br />period of six months after the time the work is commenced. Ooe 90.'day extension of tiMe
<br />mAy be allowed tor the permit with fee charge or $15.00. The extension shall be requested
<br />in writing to'the Building Ottioial. An approved 1n.peotion must be logged during each six
<br />Month period, or the project will be oOn.1dered abandoned.
<br />~ING TO OWNER: YOOR ~ILORE TO AEOOaD A NOTICE or COMMENCEMENT HAY RESULT IN YOUR
<br />PAYING TWICE FOR IN~ROVEMENTS TO.YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR ~ AT'l'ORNE:Y B2FORE RECORDING YOUR NOTICE or COMMENCEMENT. )08.S UNDER
<br />$2.500 IN VALUE DO NOT NEED TO RBCORDAND POST A .NOTIC! OF COHMENCEMENT".
<br />
<br />SIGNATURE i OWNi:R OR AGi:NT
<br />
<br />SIGNATURE I CONTRACTOR
<br />
<br />STArE OF F'LORIDA
<br />COON'n Of"
<br />The foregoing instr~ent was
<br />Before me this _ day ot
<br />by
<br />
<br />acknowledged
<br />.2<L.
<br />
<br />StATE OF noR-lOA
<br />COUNT\' or
<br />The toregoing instrument was
<br />Before me thi. ~y of
<br />by
<br />
<br />acJcnowledged
<br />,20_
<br />
<br />ln~e. or pereon acknowladgQd)
<br />Owho is personally known to me, or
<br />
<br />Owho has prodUCed
<br />(type of identification)
<br />and WhoO dJ.d Odid not tah an oath.
<br />
<br />(n... ot person aoknowledged)
<br />~ho i. personally known to me, or
<br />
<br />Owho has produoed
<br />(type ot identification)
<br />and who Odid C):1id not take 8n oetn
<br />
<br />Signeture of person taking acknowledgement
<br />
<br />Signature of person taking aoknowled~ent
<br />
<br />Name typQd, printed or ~tamped
<br />
<br />Name typed, printed or 'Camped
<br />
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