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<br />A.' NOTIC.E OF DEED RESTRICTIONS
<br />Tha undersigned understands that this permit may be subject to "deed restrictions" which
<br />may be more restiictivethanCity regulations. The undersigned assumes responsibilr~7 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 required
<br />to be licens~d in accordance with state and f6cal regulations. If the contractor is not
<br />licensed as required by law, both the owner and contractor maybe cited for a misdemea~or
<br />violation under state law. If the owner or intended contractor are uncertain as to what
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />city of Zephyrhills Building Department, 813-780-0020.
<br />Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign po~tions of the "Gohtractor Sections" of this ~pplication for 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 contractor wishes
<br />you to sign as contractor that may be an indica~ion 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 CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, hay~ b.een provided with a copy of "Florida's Construction
<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 />Appllqation 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 wiil 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 inolude but are not 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 Protection Agency-Asbestos abatement
<br />I also certity that, if fili material is to be used in Flood Zone "A" or "A,etc.", it is
<br />understood that a drainage plan addressing a "compensa,ting 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, qonstruction, 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 la
<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 abandoned. .
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS ~O YOUR PROPERTY. IF 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 \'NOTIC OF CO MENCEMENT".
<br />
<br />
<br />SIGNATURE: (C6NTRACTOR
<br />
<br />STATE OF FLORIDA(~ .
<br />COUNTY OF ~~A0
<br />The f9regoing instrument was
<br />Bef re ~e thi day
<br />by ,
<br />
<br />cknowledged
<br />, 20~
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by
<br />
<br />acknowledged
<br />, 2CL-
<br />
<br />
<br />(name of person acknowledged)
<br />Owho is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and whoO did 0 did not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />(name of person acknowledged)
<br />[1ho is personally known to me, or
<br />
<br />~hO has produced i/t!..- .<"1)1... (;go 7,,/lJu
<br />(type f identifi~ation)
<br />.~~id ~id t;ake an 0 th
<br />(<;ZU~, ..--- -/ /~. I .J
<br />/
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature
<br />
<br />
<br />"
<br />
<br />, ",HUll',
<br />.!~.,.~\
<br />Na = . . = d, p~2.d&tl8 stamped
<br />"''''q;'~,,/ 80~DF.D THRU TROY F.l.IN INSUR.l.NC~ INC
<br />
<br />Name typed, printed or stamped
<br />
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