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<br />A. NOTI~E OF DEED RESTRICTIONS <br />Th~ undersigned understands that this permit may be subject to "deed restrictions" which <br />may be more restrictive than city regulations. The undersigned assumes responsibility for <br />compliance with any appiicable deed restrictions. <br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSiBILITIES <br />If the owner. has hired a contractor or contrqptors to undertake work; 'they may be required <br />to be licensed in accordance with state and i~cal regulations. If the contractor is not <br />licensed as required by law, both the owner and contractor maybe cited for a misdemeanor <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 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 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 conunencement. <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 />Appliqation is hereby made to obtain a permit to do work and installation as indicated. I <br />certify that no work or installation has conunenced 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 developmerit 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 include but are not limited to: *Department of <br />Environmental Regulation-Cypress Bayheads, Wetiand Areas and Environmehtally 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 certi~y 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 "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, construction, or violations of any code. Every permit <br />issued shall become invalid unless the work authorized by such permit is conunenced 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 conunenced. One 90 day extension of time <br />may be allowed for the permit with fee charge of $~5.00. .The extension shall b7 requeste~ <br />in writing to 'the Building Official. An approved 1nspect10n must be logged dur1ng each S1X <br />month period, or the project will be considered abandoned., ' <br />WARNING TO OWNER: YOUR FAILURE TO RECORD A ~OTICE OF COMMENCEMENT MAY RESULT IN YOUR <br />PAYING TWICE FOR IMPROVEMENTS 'TO YOUR PROPERTY. It 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 'tNOTICE OF COMMENCEMENT". <br /> <br />SIGNATURE: CONTRACTOR <br /> <br />SIGNATURE: OWNER OR AGENT <br /> <br />acknowledged <br />, 2 u.:.....- <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />The foregoing instrument was <br />Before me. this ~day of <br />by <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 />,20_ <br /> <br />(name of person acknowledged) <br />o who is personally known to me, . or <br /> <br />(name of person acknowledged) <br />C1ho is personally known to me, or <br /> <br />Owho has produced <br />(type of identification) <br />and wlioD did Ddid not take an oath. <br /> <br />o who has produced <br />(type of identification) <br />and who 0 did D:iid not take an oath <br /> <br />Signature of person taking acknowledgment <br /> <br />Signature of person taking acknowledgement <br /> <br />Name typed, printed or stamped <br /> <br />Name typed, printed or stamped <br />