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<br />A, NOT1CE or O[iD R[STRICTIONS
<br />Th. under..igned underBtanc1ll that this permit Ill&Y be .ubject to "deed rutriction." which
<br />may be more re.triotive than City regulation.. The undersigned aaiumea reapons~bility for
<br />conpliance with any applicable deed r..triction..
<br />a, UNLICENSED CONTRACTORS AND CONTRAC'l'OR RESPONSIBILITIES
<br />It the owner ha. hired a contractor or contraotors to undertake work, 'they may be required
<br />to be licensed in accordance with .tate and loc.l regulation.. If the contrector i. not
<br />lioen.ed a. required by law, both the owner and oontractor may be cited for a a1sdemeanor
<br />violation ~der .tate law. If the.owner or intended contractor are uncertain a. to what
<br />licensing requiremants may apply for the intended work, they are advised to contsct the
<br />City of Zephyrhilll Building Department, 813-780-0020.
<br />rUIthe~ore, if the owner hae hired a cOntraotor or contractora, he i. advi.ed to have the
<br />contractorl.) sign po~tionl of the "Contractor Seotion.N of thi. applioation tOr which they
<br />will be responsible. If you. .1 the owner signs as the oontractor, you are indicating thAt
<br />you, ratner than the contractor, are reeponsible tor the work, ,If the contractor wi~hea
<br />you to sign as contractor that may bean ind1ea~ion that. he 1. not properly licenaed and 1.
<br />not entitled to permitting privileges in the City or Zephyrhill..
<br />C, TRANSPORTATION H1PACT r[ES AND OTILITr CONNJ:CTION rEES
<br />0, CONSTROCTUION LItN LAW (CMPTtIt 713, FLOlUOA sTATtins, AS AHENDED)
<br />I certify th~t I, the ;pplicant, haye b.en provided with a copy of "rlorlda'. Conatruction
<br />lien Law - Homeowner's.Protection Quid." prepared by the Florida Department ot Aqrloulture
<br />and Consw.er Affairs, I f the "pplicant ia aOlMone other that tt)e ~owner'., I ceri:ty that I
<br />have obtained a copy ot the above deaoribed document and promi.e in good taith to deliver
<br />it to the "owner" prior to cOlMlenc8lllent.
<br />E, COWTRACTOR'S/OWNER'S AfFIDAVIT
<br />I certify that all the information in thia application is accurate and that all work will
<br />be done in Compliance with all applicable law. regulating con.truotion, zoning, and land
<br />developnent.
<br />l\ppliqation is hereby made to obtain a pernit to do work and installation ae indicated. I
<br />Certiry that no work or installation haa oomnenced prior to ilauahoe ot a pernit and that
<br />~ll work will be pQrt'onn'1d to me.t atand.rda of all law. nqulatinq construction, City
<br />codes, zoninQ regulations, and land developlllent re9ulations in the jur1adiotion. I aho
<br />certify that I underltand that the regulation. ot other qovernnental agencie. ~y apply to
<br />the intendad work, and tnat it is my reeponaibility to identity wn.t aotione I mu.t take to
<br />be in compliance. Such agencie. include but are not limited to: -Department of
<br />Environrnent~l Regulation-Cypre$s Bayheads, Wetland Area. and invironrnentally Sensitive
<br />Landa, Water/Wastewater Treatment
<br />"Southwest Florida Water ~~nagement District-Wells, Cypreas Bayheads, Wetland ~eaa,
<br />Altering Wacercoutses
<br />'~y Corps of &ngineerl-Se~wall., Docks, Navigable Waterways
<br />"Department or Kealth - Rehabilitative Servic.., Environmental Health Onit-Wells,
<br />Wastswater Tre~tment, Septic Tanka
<br />"O,S, ~nvironaent.l Protection Agency-Asbestos abatement
<br />I allo certify that, if fill ~teri.l ie to ba used in Flood Zone "AN or ~A,etc.N, it i.
<br />under.tood that a drainage plan addressing a .co=penaatinq volume" will be submitted which
<br />is prepared by a protessional engineer reqistered in the State ot 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 />autharity to violate, cancel, a~ter, or .et aside. any provisions ot the technical codea,
<br />nor shall i..uance ot a permit prevent the Building O:ttioial from thereatter requirinq a
<br />correction or errore in plans, construotion, or. violations ot any cod.. ~very pernit
<br />inued $na11 bacOlllCl invalid unl... the work authorized l;ly such permit is cOI1Ul\enced within
<br />six ~nChs or lsluance, or it work authorized by the parait 1. au.pended or abandoned tor '.
<br />period of six ~onths after the time. the work 1s co~.nced. One 90.day extension of tiMe
<br />may b. allowed tor tn. permit with fee charge of $15.00. The extansion shall be requa.ted
<br />10 writinq to'the 8uilding Otlicial. An approved inepectionmu.t be lOQged during each six
<br />Month period, or the project will be cOnsidered abandoned.
<br />~ING TO OWN~R: YODR ~ILOR! TO AECOaO A NOTICE or COMMENCtH!NT HAY RESULT IN YOUR
<br />PAYING TWICE FOR IHPROVEHENTS TO.YOOR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR Nl ATTORNEY ~FORE RECORDING YOOR NOTICE or COMMENCEHENT. JOB.S UNDtR
<br />", l3 '" ",,,, 00 "'" ""t '1 ~ .., '0" A '''''I<''' OF <:c.."..........
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<br />LJ~/r(a.1L2
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<br />SIGNATUREi Oh'Ni:R OR AGi:NT SIGNATURE I CONTRACTOR
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<br />STATE or ':1!l1t5
<br />COONTY Of
<br />The fOregOing. instrument w~~n6Wledqed
<br />Before ~th.iS ~dJi'. of .2QM
<br />~ ^I'''I~ . ,p
<br />Iname ot person acknOwledged)
<br />who is personally known to ~e, or
<br />
<br />Owho hal prodUced
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<br />. , pJJ;;;r''''C'''OOI
<br />~a1ld whoD cUd d ot tak~
<br />A~ '
<br />
<br />Si9nature of perlon takinq acknowledgement
<br />
<br />STATE or ~RlDA
<br />COUNT\, or
<br />The toreqoinq instrument was acknowledqed
<br />Before me thill ----Pay ot , 20_
<br />by
<br />(n&me or peraon Aoknowledqed)
<br />~ho i. personally known to me, or
<br />
<br />o who h~. produoed
<br />(type ot identification)
<br />and who Ddid Q;iid not take an olltn
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<br />Signature of person takinq .oknowled~ent
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<br />NUlQ typed. pr~c:::KL~~tNOTARY I'U8UC - STATE 01' I'U:llIQA
<br />COMMISSION., DD4e1817
<br />EXPIRES 911712008
<br />IONIlIDlHRU ~AIWt
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<br />N~ typed, printed or e~amped
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