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<br />A. NOTI~E OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be
<br />may be more restrictive than City regulations. The
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner. has hired a contractor or contr~~tors to undertake work, -they may be required
<br />to be licensed in accordance with state and iocal regulations. If the contractor is not
<br />licensed as required by law, both the owner and contractor maybe cited for a misdemeanor
<br />violatian under s~ate law. If the owner or intended contractar are uncertain as to. what
<br />licensing requirements may apply far the intended wark, they are advised to. contact the
<br />City of Zephyrhills Building Department, 813-780-0020.
<br />Furthermare, if the awner has hired a contractar or contractars, he is advised to have the
<br />contractor(s) sign paftians af the "Gahtractar Sectians" af this ~pplication for which they
<br />will be responsible. If you,..s the owner signs as the contractor, yon are indicating that
<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 is
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C.' TRANSPORTATION IMPACT FEES AND UTILITY CONNECTI.ON FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, haYE;! been provided with a capyaf "Flarida's Canstruction
<br />lien Law _ Hameowner's.protection Guide" prepared by the Florida Department af Agriculture
<br />and Cansumer Affairs. If the appLicant is sameone ather that the "awner", I cerify that I
<br />have abtained a capy af the abave described dacument and pramise in gaad faith to. deliver
<br />it to the "owner" prior to commencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that ." 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 />Appll"ation is hereby made to obtain a permit to do work and instaliation as indicated- I
<br />certify that no. work ar installatian has cammenced prior to. issuance of a permit and that
<br />all work wiil be performed to meet sta~dards of all laws regulating.constructian, City
<br />codes, zoning regulations, and land develapment regulatians in the jurisdictian. 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 nat limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, wetiand 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 Pratection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone "~ or "A,etc.", it is
<br />understood that a drainage plan addreSsing a "compensating volume" will be submitted which
<br />is prepared by a proLessional engineer registered in the state of Florida prior to permit
<br />issuance.
<br />A permit issued shall.be .construedto be a license to proceed with the work and not .S
<br />authority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shail 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 oxtension shall be requested
<br />in writing to.the Building Official. An approved inspection must be logged during each six
<br />manth period, or the project will be considered abandaned.. .
<br />WARNING TO OWNER' YOUR FAILURE TO RECORO A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. Ir YOU INTENO TO.OBfAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT- JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORDANO POST A "NOTICE OF COMMENCEMENT"-
<br />
<br />.&1 1 V~P/\
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />subject to "deed restri~tions" which
<br />undersigned assumes responsibility for
<br />
<br />.~~} 11 J?/\.'
<br />
<br />SIGNATURE:
<br />
<br />CONTRACTOR
<br />
<br />acknowledged
<br />, 2 0.:..-
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Befare me. this _day af
<br />by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregaing instrument was
<br />Befare me this _ day af
<br />by
<br />
<br />acknawledged
<br />,20_
<br />
<br />(name af persan acknawledged)
<br />[1ha is persanally knawn to. me, ar
<br />
<br />(name- af per san acknawledged)
<br />Owho is personally knawn to. me, 'or
<br />
<br />o who. 'has praduced
<br />(type
<br />and wliaO did 0 did nat
<br />
<br />af identificatian)
<br />take an aath.
<br />
<br />Owha has produced
<br />(type of identification)
<br />and who. Odid [):lid not take an oath
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Signature of person taking acknawledgement
<br />
<br />"
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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