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<br />A. NOTIC.E OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to. "deed restrictians" which
<br />may be more restrictive tban city regulations. The undersigned assumes responsibility for
<br />campliance with any applicable deed restrictians.
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the awner has hired a cantractar or cantractars to undertake wark, . they may be required
<br />to. be licensed in accardance with state and l~cal regulatians. If the cantractar is not
<br />licensed as required by law, bath the awner and cantractar may be cited far a misdemeanar
<br />vialatian under s~ate law. If the awner ar intended cantractar are uncertain as to. what
<br />licensing requirements may apply far the intended wark, they are advised to. cant act the
<br />City af Zephyrhills Building Department, 813-780-0020:
<br />Furthermare, if the awner has hired a contractar ar cantractars, he is advised to. have the
<br />cantractar(s) sign partians af the "Gahtractar Sectians" af this ~pplicatian far which they
<br />will be responsible. If yoU, as the owner signs as the contractor, you are indicating that
<br />yoU, rather than the contractor, are responsible for the work. If the cootractor wishe'
<br />you to sign as contractor that may be an indication that hs is not properly licensed and is
<br />nat 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, hay!;! been provided with a capy'af "Flarida's Canstructian
<br />lien Law _ Hameawher's.protectian Guide" prepared by the Flarida Department af Agriculture
<br />and Cansumer Affairs. If the applicant is sameane 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 "awner" priar to. canunencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infarmatian in this applicatian'is accurate and that all wark will
<br />be dane in compliance with .all applicable laws regulating canstructian, zaning, and land
<br />develapment.
<br />Appli~ation is hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no. wark ar installatian has canunenced priar to. issuance af a permit and that
<br />all wark will be performed to. meet standards af all laws regulating canstructian, city
<br />eades, zaning regulatians, and land develapmerit regulatians in the jurisdictian. I also.
<br />certify that I understand that the regulatians af ather gavernmental agencies may apply to.
<br />the intended wark, and that it is my responsibility to. identify what actians I must take to.
<br />be in campliance. Such agencies inolude but are nat limited to.: *Department af
<br />Enviranmental Regulatian-Cypress Bayheads, Wetiand Areas and Enviranmentally Sensitive
<br />Lands, water/Wastewater Treatment
<br />*Sauthwest Flarida Water Management District-Wells, Cypress Bayheadsl Wetland Areas,
<br />Altering Watercaurses
<br />*Army Carps of Engineers-Seawalls, Dacks, Navigable Waterways
<br />*Department af Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Enviranmental Pratectian Agency-Asbestas abatement
<br />I also. certify that, if fill material is to. be used in Flaad Zane "A" ar "A, etc.", it is
<br />understaad that a drainage plan addressing a "campensating valume" 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 .canstruedta be a license to praoeed with the wark and nat as
<br />autharity to vialate,cancel, alter, ar set aside any pravisians of the technical cades,
<br />nar shall issuance af a permit prevent the Building Official fram thereafter requiring a
<br />carrectian af errors in plans, canstructian, ar vialatians af any cade. Every permit
<br />issued shail become invalid unless the work authorized by euch 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 ~e allowed for the permit with fee charge of $15.00. The e.tension shall be requested
<br />in writing to'the Building Official. An approved inspection must be logged during each six
<br />manth periad, or the project will be cansidered abandaned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. Ie YOu INTEND TO OBTAIN 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 RECORD AND POST A "NOTICJ;:JbF COMMENCEMENT".
<br />
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<br />~'lr~ c} ,;lp,;t,J/ ~H(,f ,i- ~~
<br />
<br />SIGNATURE: OWNERMOR AGENT I S~TURE: CONT~ OR
<br />
<br />STATE OF FLORIDA' 'l7_ ~. ~ATE OF FLOAIOA 1/.
<br />COUNTY OF . . b&:1 (){ COUNTY OF
<br />The farfjain? ~~ns ument wa"^~ck~o~i.~dged - The foregoing inst~ument was:f,fF~~w1,7dged -
<br />Before thH C,~.of ,jJ~ 2<Lk~ Before me t)l.i,s ~ay of . f "tl, 20 Zi
<br />by ',,,, "". ~, ' bY' ;)!1 rr-e'> h '" j ,,~ ;"
<br />(name of person acknowledged) , / '(name of person acknowledged)
<br />t:i.wha..;bs pe.rsanally . awn to. me, . ar fPqha is persanally knawn to. me, ar
<br />. L ~ I) '3&3-J /,,~ -
<br />~ha has praduced .tA ~.s-;t - s-f'f,O 0 who. has praduced
<br />( ype af identificatian) . (type af identificatian)
<br />at take an oath. and WhO,9~~ ~/,ot take an oath
<br />
<br />W ~ . L_.-.:;::...---"-)~7 /P"v"/ ..
<br />C=-___ ,- "
<br />Signature of person taking acknowledgement Signature of person taking acknowledgment
<br />
<br />".,. Rui!\ 0 Forrester
<br />aX' aJ1l~aommls I
<br />~ '.I Expires August 01 2006
<br />.Of'"
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<br />
<br />Name typed,
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<br />ri~~ ar EO~~ANf
<br />~~ MY COMMISSION # 00469894
<br />~~~i FXl'lRES: Sepl.8.2009
<br />'''OF'''~
<br />(407) 398-0153 Florida NoIarI SerVice.com
<br />
<br />Name typed, printed
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