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<br />A. NOTICE Of DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" \~hich
<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 requlre(
<br />to be licensed in accordance with state and local regulations. If the contractor is not
<br />llcensed as required by l.aw, 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 wnat
<br />licensing requirements may apply for the intende~ work, they are advised to contact the
<br />City of Zephyrhills Building Department, 613-766-6611.
<br />Furthermore, if the owner has hired a contractor or contractors, h~ is advised to have th,
<br />contractor(s) sign portions of the "Contractor Sections" of this application for which th'
<br />will be responsible. If you, as the owner signs as the contractor, you are indicating th
<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 indication that he is not properly licensed and
<br />not entitled to permitting privileges in the City ot 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 Constructio
<br />lien Law _ Homeowner's Protection Guide" prepared by the Florida Department of Agricultur
<br />and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that
<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 indica~ed.
<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, Clty
<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 I
<br />the intended work, and that it is my responsibility to identify what actions I must cake
<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 whi
<br />is prepared by a professional engineer registered in the State of Florida prior to perml
<br />issuance.
<br />A perffilt 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 ~equiring a
<br />correction of errors in plans, construction, or violations of any code. Every permit
<br />issued shall become invalid unle.. the work authorized by such permit is commenced withi
<br />six months of issuance, or it work authorized by the permit is suspended or abandoned fc
<br />period of six months .fter 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 request
<br />in writing to the Building Official. An approved inspection must be logged during each
<br />month period, or the project will be considered ~bandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CON:
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UN DE
<br />$2,500 IN VALVE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
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<br />A;;;::j 7) Ptl^<: A ~ 7J (~
<br />
<br />SIGNATURE: OWNER OR AGENT SIGNATURE ONTRACTOR
<br />
<br />STATE OF FLORI~\~~ -...~, '""" STATE OF FLORI~ ~
<br />COUNTY OF ~ COUNTY OF ~ --
<br />The foregoing instrument was acknowledged ~ The foregoing instrument w~nowled~e
<br />Before me this""-\ day of t-...-..\-:J"" , 20tr...J bBeyfOr~~~~~ ~a.y of ~ .- , ~cS
<br />by\"c--..l\~'b'O~ .' ~~~
<br />~na of person acknowledged) ~name of person acknowledged)
<br />~ho is personally known to me, or ~ho is personally known to me, or
<br />
<br />Dwho has produced Dwho has produced
<br />. ~type of identification) ~pe of identiflcat
<br />~ and WhoO,did O<f~d not~e an oath"if:), and who SJdid on:~t-:k~
<br />
<br />~~ A~Q,9'\-.,.." ~ .. ~,~Qs .
<br />
<br />Signature of person taking acknowledgement Signature of person taking acknowledgml
<br />
<br />Name typ'ed rinted or stamped
<br />,.,~ NoIaty PubIc Slate of Florida' .
<br />. . Sabrina Rae Cant
<br />~ . -; . My COIMlission DD463268
<br />OJ": . Ex(ltf8S 0811812009
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