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<br />JAN/24/2006/TUE 09:07 AM
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<br />ZEPHYRHILLS BUILDING
<br />
<br />FAX No, 813-780-0021
<br />
<br />p, 003
<br />
<br />A.' ~OTIGE OF DEED RESTRICTIONS
<br />trh~ .und8Tsigned understands that this permit may be subject to "daed re::ltriction::l" which
<br />may be more restrictive . than City reg{llat'iohs. the underl;ligned aasumes responsibility'for
<br />.oompliance with any applicable deed restrictions, .' .'
<br />B. UNLICENSED CONTRACTORS .AND CON'l'RACTOR RE:SPONSIBILITIES
<br />If .the owner. haS hired acontraotO;I;' or contr<;\$,Jtors to undert.ake work, 'they may be required
<br />to be licen::led in aocordance with state and focal regulationil.. It the cont'r:.'actor is nO,t
<br />)..ic8psed as J:"equired by law, both the owner and contJ:"actor may"be cited for a misdemeanor.
<br />violation under s~ate law: If the owner or inten~ed contractor are uncertain as to. what
<br />licensing requirements may <Olpply for the iritended work, they are 'advised to contact the
<br />city of Zephyrhills Building Department, 813-780-0020.
<br />Furthermore, if the owner haB hired a contraotor or contraotors, he i::l advised to have th~
<br />contractO;t:' (s) ::Iigppo;r;-tions of. the. "Contractor, sections" of. this applioation for which they
<br />.will be responsible, If yciu,' .as the owner 'signs astheaontractor, 'you a-re indicating that
<br />you~ rather than the contractor, are re$pansible for the work, ,If the contractor wishes
<br />you to sign as contractor tnat maybe an indication that he is not properLy'lioensed and is
<br />not entitled to permitting l?ri'vil,~gesinthe City of ZephyrhiUs.
<br />C: TRANSPORTATIbN IMPACT FEES AND OTILITY CONNBCT~ON .FEES '
<br />p. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIPA:STATUTES, AS AMENDED)
<br />I certify that!, the applicant, hay~ b.el!m provided with a: copy"of "Florida's Construction
<br />lien :i:;aw _ Homeowner's.!?rotection Guide" prepared' by the Florida Department of Agriculture
<br />and Con::lumer Affai~s. If the applicant. 1::1 someone other that the "owner", I ceri;Ey that I
<br />ha've obtained a copy' of the above described document imd prom{se in good ;Eaitb 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 accu~ate and that all work will
<br />be done in oompliance with ,all applicable laws regulating construction, zoning, and land
<br />development. .'
<br />Applisation is hereby made to obtain a'permit to do work and installation as.indicated, I
<br />ce~tify that no work qr in::ltallation has commenced prior to issuance of a permit and that
<br />all work wiil b~ performed to meet sta~dards of all laws regulating construction, City
<br />code::l, zoning regulations, and land dev~lopmerit regulations in the jurisdiction. I also
<br />certify that IunderBtand that the'regulations of other governmental agencies may apply to
<br />-the intended w~rk, a~d that it is my responsibility to identify what actions I must take to
<br />b~ in oompliancB. Such agencies include but are not limited to: *Department of
<br />Environmental Regulation-Cyp~e9saayhead5, Wetiand Areas and Envi~onmentally sensitive
<br />~ands, Water/Wa::ltewater Treatment ' . .
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads,'Wetland AreaB,
<br />Altering Wi:l.tercoursB5 ' . ... .
<br />*Army COrp::l of Engineers-Seawalls, Docks, Navigable'WaterwaY5
<br />*Pepartment of' Health & Rehabilitative Services, EnviroPffiental Health Unit-Wells,
<br />Wastew~ter Traatment,Septic Tanks' ..
<br />*U.8. Environmeptal Protection Agency-Asb~stos abatemen~
<br />I also certify t'hat, if fill material is. to pe used in Flood Zone "A" or "A, ete. ", it is
<br />understood that a drainage plan add~eBsing al:compen::l~ting volume" will be submitted which
<br />i::l prepared by apro~essional engineer registsred in the state ot Florida prior to permit
<br />issuance. ~.
<br />A permit il;ll3ued shall ,be ,conatrued'~o'be a licen::le to prQceed with the work a.pd 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, c.onstruction, or violat;i.ons of ~ny code. Every pe;J;"mit I
<br />is::Iued shall become invalid unle~~ the work authori~edby such permit is cOlnmenced within I
<br />siX months of issuance, or if work authorizedbyths permit is Buspended or aband~ned fOr\~
<br />peri~d of six mo~ths i:l.fter the time,tpe work i~ commepced. Ooe 90 da~ extension of time i
<br />may be allow@~ for the permi t with fee charge of $15.00 '. The extension shall b~ requested'i
<br />in writing to the BuildingOffioial. An approved inspection must be logged during each si~
<br />month period, or the project will be considered ~bandoned.. .
<br />WARNING TO OWNER: YOORFAILURE TO RECORD A 'NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />~AYING TWICE FOR IMPROVEMENTS 'TO'YOUR P~OPERTY. IF yOU INTEND TO OBTAIN FINANCING, CONSULT
<br />wiTH YOUR LENDER OR AN ATTORNEY BEFORE RE~ORDING YOUR. NOT~CE .OF COMMENCEMENT. JOB~ UNDBR
<br />$2,500 IN VALUE DO NOT NEED TO RECQRDAND PO-5T A \'NOTICE OF COMMENCEMENT".
<br />
<br />
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<br />.~~ SIGNATURE' CONTRACTOR
<br />
<br />STATE OF FLORIDA. .. _ /
<br />COqNTY OF . ",,.p.m!!L-, . .
<br />The foregoing instrument was acknowledged
<br />.:~~:-~J~hi<~~ d!YOf (nMM ,2o!)J,
<br />
<br />~~ (name' of person acknowledged) ,
<br />"""'who is per::lonally known to nie,-'o:r:
<br />
<br />Owho has produced
<br />(type of identifica.tion)
<br />andAoD did Odi~ottye an oath.
<br />
<br />ulj/L LQd~
<br />
<br />Signature of .person taking acknowledgement
<br />
<br />STATE OF WDORIDA
<br />COONT~ OF
<br />The fotegoing instrument was
<br />Before me thig ~ay of
<br />by"
<br />
<br />acknowledged
<br />" 20_
<br />
<br />(nameot person aCKno~lectged)
<br />[1ho is personally known to me, or
<br />
<br />Dwho has produced
<br />(type of ideptification)
<br />and who Ddid [J::I.idnot talee an oath
<br />
<br />Si9natu~e ot person taking acknowledgment
<br />
<br />"
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typ~d, printed or ! B~.
<br />. ~~~o;
<br />O,f\:
<br />
<br />tl'6;:-~ :"-;~:;::ile of Florida
<br />AIii' /. :()"
<br />MvC'm>T"SSCon 00452959
<br />Ex,)!re:, .1/.2012009
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