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<br />A. NOnCE OF PEED RESTRICTIONS
<br />The. undersigned understa,nds that this permit may be subj ect to "Jieed r strictions" which
<br />may be more restriotive than City regulations. The undersigned assume responsibility for
<br />compliance with any applicable deed restr.ictions..
<br />B. UNLICENSEP CONTRACTORS ANP CONTRACTOR RESPONSIBILITIES I
<br />If the owner has hired a contractor or contractors to undertake work, they may! be required
<br />to be licensed in accordance with state and local regulations. If the ,contractor is not
<br />licensed as required by law, both the owner and contractor may be cited for a ~isdemeanor
<br />violation under state law. If the owner Or intended contractor are un6ertain as to what
<br />licensing requirements may apply for the intended work, they are. advis~d to contact the
<br />City of ZephyrhillS Building Department, 813-780-0020. !: :
<br />Furtharmore, if the owner has hired a contractor. or contractors, I ha iSjadvised to hava the
<br />contractor (s) sign pOrtions of the "Contractor sections" of this, appli6ation for which they
<br />will be responsible. If you, as the ownar signs as the contractpr, yov are intlicating that
<br />you, rather than the contractor, are responsible for the work. jIf tha ; contractor wishes
<br />you to sign as contractor that may be an indication that he is ~ot properly licensed and is
<br />not entitled to permitting privileges in the City of zephyrhill~.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES .
<br />D. CONSTRUCTUION LIEN LAW (CaAPTER 713, FLORIDA STATUTES, AS ~ENPED),
<br />I certify that I, the applicant, haye been provided with a copy:of "Florida's Construction
<br />lien Law _ Homeowner's Protection Guide" prepared by the Florida Pepartment of Agriculture
<br />and Consumer Affairs. If the applicant is som~one other that the "owner", I cerify that 1
<br />have obtained a copy of the above described document and promise in gobd faith to deliver
<br />it to the "ownar" prior to commencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the information in this appliciltion is accurate and that all work will
<br />be done in compliance with all applicable laws regulating construction', zoning, and land
<br />development.
<br />Applic;ation is hereby made to obtain a permit to do work and installatiion as indicated. I
<br />certify that no .work or installation has commenced prior to issuance Jf a permit and that
<br />all work will be performed to meet standards of all laws regulating c~hstruction, City
<br />codes, zoning regulations, and land development regulations in the ju~isdiction. 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 nlust take to
<br />be in compliance. Such agencies include but are not limited to: *Pepartment 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 />*Pepartment 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 "N' or "A, etc.", it is
<br />understood that a drainilge plan addressing a "compensating volume" will be submitted Which
<br />is prepared by a professional engineer registered in the State 'of Flotida prior to permit
<br />issuance. i
<br />A parmit issued shall.beconstrued.to be a license to proceed with the work.a~d 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 theteafter requiring a
<br />correction of errors in pla~s, constructio~, or violations of any cod~. 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 c6~enced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The axtensipn shall be requested
<br />in writing to.the Building Official. An approved i~spection 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 M~Y RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. If YOU INTENP TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE MMENCEMENT. JogS UNDER
<br />". ,,' ,. VAWE 00 NOT "'EO '0 l>ECORO ANO '0" A "NOncE ':" ~
<br />
<br />
<br />
<br />SIGNATURE: OWNER OR AGENT RACTOR ~
<br />
<br />STATE OF FLORIPA
<br />COUNTY OF
<br />The foregoing i~strument waS acknOwledged
<br />Before me this _ day of , 2~
<br />by
<br />(name of person acknowledged)
<br />Owho is personally k~own to me, or
<br />
<br />
<br />OF FLORIDA
<br />TY OF
<br />The roregoing instrum6n
<br />Before me this_d;j.y
<br />by
<br />
<br />~o
<br />
<br />
<br />of
<br />
<br />acknowledged
<br />,20_
<br />
<br />Dwbo has produced
<br />(type
<br />and wl10D did Ddid "not
<br />
<br />(name of persot] acknowledged)
<br />!.
<br />is personally known to me, or
<br />I
<br />
<br />D who has
<br />
<br />of identificatio~)
<br />take an oath.
<br />
<br />
<br />Name
<br />
<br />Signature of person taking ~cknowledgement
<br />
<br />Name typed, printed or stamped
<br />
<br />ZOOd
<br />
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<br />
<br />~N[alIna SllIHaAHd3Z
<br />
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