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<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictions"
<br />may be more restrictive than City regulations. The undersigned assumes responsi'
<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, ,
<br />to be licensed in accordance with state and local regulations. If thr
<br />licensed as required by law, both the owner and contractor may be citT
<br />violation under state law. If the owner or intended contractor are l
<br />licensing requirements may apply for the intended work, they are adv~ ~
<br />City of Zephyrhills Building Department, 813-780-0020. )~ -~Q~
<br />Furthermore, if the owner has hired a contractor or contractors, he L-- ~ ~ ~O~
<br />contractor(s) sign po~tions of the "Contractor Sections" of this apr; 'IVFz/l{ S
<br />will be responsible. If you, as the owner signs as the contractor, '~~/I{MO
<br />you, rather than the contractor, are responsible for the work. If the
<br />you to sign as contractor that may be an indica~ion that he is not propeL
<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, have been provided with a copy of "Florida's _-"()."~~'Ero'n
<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 />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 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 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 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 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 such permit is commenced within
<br />six 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 be 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 abandone
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF C
<br />PAYING TW E FOR IMPROVEMEN TO YOUR PROPERTY. IF YO
<br />WITH YOU ENDER OR AN ATT EY BEFORE RECORDING YOUR OT
<br />$2,500 N V LUE DO T NE TO RECORD AND POST A "NOT CE
<br />
<br />
<br />SIG ATURE: OWNER OR AGEN SIGN
<br />
<br />STATE OF FLORID~ ~ STAT
<br />COUNTY OF ,.~<; C COUN 0
<br />The foregoing ins ent was pc knowledged ~The foreg n? iQ~~ent was fcknowledge~~
<br />Befo this ay of~tl~ , 2QGL~, Before me thlS ~ay of J~ , 20co....
<br />by by
<br />(name of person acknowledged) -.~ (name of person acknowledged)
<br />~o is personally known to me, or ~ho is personally known to me, or
<br />
<br />
<br />T IN YOUR
<br />7\NCING, CONSULT
<br />JOBS UNDER
<br />
<br />o who has produced
<br />(type
<br />'00 di~ ~did not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Owho has produced
<br />(type
<br />D:ii no
<br />
<br />of identification)
<br />take an oath
<br />
<br />
<br />Wi
<br />Name typed, printed or stamped
<br />~ ~ Janice L Clar\(
<br />. "J . Myeommi&&ion. 00109364
<br />'TJ Expires Apri115. 2006
<br />
<br />
<br />ture of person taking
<br />
<br />LC~
<br />
<br />\
<br />W/c&
<br />typ~~ p1j~(~r stamped
<br />!~, My ComfT\iSIiOO OD1~~
<br />,.,..~ Expite& April 15. 2006
<br />
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