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<br />rllA J1V, olr/OU-UUlt
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<br />
<br />SIGNATURE i
<br />
<br />A, NOT1CE or DUD Ri:STRICTIONS ,
<br />"Thll undeuigned understands th"t this permit may be subject to "deed restrictions" which
<br />may be more re.triotive than City requlations, The undersigned aseume. re.pon8~bility for
<br />conpliance with any applicable deed restrictions.
<br />B, UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />It the ownar has hired a contractor or contraatora to undertake work, 'they may be required
<br />to be 11censed in accordance with state and loc.l requlationa. If the contractor i. not
<br />lioensed a. required by law, both the owner and aontractor may be cited for a aisdemeenor
<br />v101ation under atate law, If the'owner or intended contractor are uncertain a. to what
<br />licen.ing requirements may apply tor the intended work, they are adYised to contact the
<br />City ot Zephyrhills Building Department, 813-780-0020,
<br />!'urthenuore, if the owner hu hired a cOntraator or contractor', he ie advised to have the
<br />contractor!s) sign po;tions of the "Contractor SeotionsN of thia applioation fOr which they
<br />will be responsible, It you, &s the owner ,iqna a. the oontractor, you are indicating thAt
<br />you, ratber than the contractor, are re.ponsible for the work, ,If the contractor wishes
<br />you to .1gn a. contractor that may bean ind1oa~ion thst' he is not proper!y licens.d and i,
<br />not entitled to permitting privileges in the City or Zephyrhills.
<br />C, TRANSPORTATION IHPACT FEES AND UTILITr CONNECTION FEES
<br />0, CONSTROCTUION LIOl LAW (CMPTtP. 713, n.oaIDA 'TATuns, AS AMENDED)
<br />I certiry that I, the ~pplieant, haye been provided with a eopy'of ~rlorida'. Construction
<br />lien Law - Homeowner', ,Protection Guide" prepAred by the FloridA Department ot Aqrioulture
<br />and Con.uraer Affair., I f the opplicant is eOlMone other that tile ~owner", I cerify that I
<br />have obtained a oopy ot the above desaribed document and promiae in qood taith to deliver
<br />it to the "owner" prior to c01l\l1lencelllent.
<br />E, OOIlTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the information in thil application is accurate and that all work 91111
<br />be done 1n compliance with all applicable law. regulating construation, zoninq, and land
<br />developroent,
<br />Appliqation is hereby ~de to obtain a perRit to do work and instaliation a8 indioated. I
<br />certity that no work or in.tallatian ha. aomnenced prior to i..uahae ot a permit and that
<br />all work w111 be p~rtormed to meet standarda of all lew. requlat1ng construction, City
<br />codes, 20nin<;/ requlations, and land deyeloplllerit regulations in the juri.diotion. I also
<br />certify that I understand that the reOulation8 ot other governmental aqencie, ~y apply to
<br />the intended work, and that it i8 my re8Ponaibility to identity wn.t aations I muet take tel
<br />be in compliance, Such agencies include but are not limited to: -Department ot
<br />Env1ronmental RegUlation-Cypress Bayheads, Wetland Areae and EnVironmentally Sensitive
<br />Lands, Water/Wa.tewater Treatment
<br />.Southwest Florida Water Man4geaent District-WellS, Cypress Bayheads, Wetland Areae,
<br />Alter1nQ Watercourses
<br />'Army Corps of &AgLneer.-Seawalls, Docks, NaY1qable Waterways
<br />'Department or Health ~ Rehabilitative Services, Environmental Health Onit-Wells,
<br />Wastewater Treatment, Septic Tank.
<br />'U,S. ~nvironmental Protection Agency-Asbestos abatemen~
<br />I al.o certify that, if fill ~terial 18 to be used in Flood Zone "AN or ~A,lItc.N, it 11
<br />understood that a drainage plan addres8inq a .oo=pensating volumeH will De submitted which
<br />18 prepared by a protes.ional angineer regietered in the State ot Florida prior to permit
<br />188uance,
<br />~ permit i.sued .hall,be construed to be a license to proceed with the work and not as
<br />authority to violate, cancel, a.lter, or ,et a.ide, any provisions ot the technical codel,
<br />nor shall issuance ot a permit prevent the Bu11d1nq Ottioial trom thereatter requiring a
<br />correction or errors 1n plans, construotion, or violation8 ot any cod.. Every pemit
<br />issued shall bec~ invalid unlos. the work authorized by suah permlt i. commenced within
<br />.1~ ~nths or issuance, or it work authorized by the pernit ie su.pended or abandoned tor 'a
<br />period of six nenth. after the tUbe, the work 1. coamonced. One 90 'day extension of tiMe
<br />may be allowed tor the permit with fee charge ot $15.00, The extension shall be requested
<br />1n writing to 'the Building Ottioial, An approved inspection must be loqqed durinq e.ch six
<br />Month period, or the project will be cOnlidered abandoned.
<br />WARNING TO O~ER: YOOR rAILOR! 70 RECOaD A W01ICR or COMMENCtHENT HAY RESULT IN rOUR
<br />PAYING TWICE FOR INPROVEHENTS TO'YOOR PROPERTY. IF YOU INTEND TO OBTAIN FIWANCING, CONSULT
<br />WITH YOUR LENDER OR NI ATTORN EYBEroRE RECORDING YOUR ,1I0119E or COMMENCEH~EN'l", JOBS UNDER
<br />S2,500 IN VALUE DO NOT NEED TO RECORDMD POST t:S,NOTICE OF COttiEl'lCENENTH. ,
<br />
<br />, ,~~ Y'v\ '
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<br />SIGNATURE, CONTRACTOR
<br />
<br />7M{tJ
<br />
<br />OWNi:R OR AGi:NT
<br />
<br />STATE or FLORIDA
<br />COOW7Y or
<br />The toregoinQ instrunent Was acknowledged
<br />Sefore lIle this _ day of I ,2L
<br />by
<br />InAme or person acknowladglld)
<br />o who 1s personally iulown to ne, or
<br />
<br />StATE or ~RIDA
<br />COUNT\' OF
<br />The toregOing,i~nstrument W~,OWledgeq.,
<br />Before l!!!. thil! 't ot, 20 ~
<br />by""",,' ViI _~~
<br />\f: (n~ ot per.on aaknowledqed)
<br />ho 1s personally known to me, or
<br />
<br />who has prOduced '
<br />\ /l"Of~identifiC" nn)
<br />4~ w~o Odid~ Qf;U tA'Jk a th
<br />
<br />JL11~/v .. f~
<br />Signature of person taking .akn~l~dgment
<br />MONICA L. WATSuN'
<br />HQT~ PU8lJC. STATE OF l'LORIDA
<br />Name typed, pr~~~'11
<br />
<br />, DClID 1HIlU ,....".~1
<br />
<br />Owho has produced
<br />[type of identifiCation)
<br />a.nd whoO did Odid not take an oath.
<br />
<br />Signoture of persen taking acknowledoe~ent
<br />
<br />N~ typed, printed or 5tarnped
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