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<br />A. NOTlqE OF DEED R~~TK1~T1UN~ <br />Th~ undersigned understands that this permit may be <br />may be more restrictive than city regulations. The <br />compliance with any applicable deed restrictions. <br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES <br />If the owner has hired a contractor or contr~ptors to undertake work, they may be required <br />to be licensed in accordance with state and local regulations. If the contractor is n01 <br />licensed as required by law, both the owner and contractor may be 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 "Coritractor 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, have 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 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 />Appli~ation 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 will 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, Wetland 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 certify 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 "compensating 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 commenced 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 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 e~ch 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 TO 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 VA~)D NOT NEED TO RECORD AND POST A "NOTICE OF ~OM~~CEMENT'" <br /> <br />///" . ~~/~. ... <br />" //// <br />. . ~/~- <br />SIG~RE: CONTRACTOR <br />/ <br /> <br />subject to "deed restrictions" which <br />undersigned assumes responsib~lity .for <br /> <br /> <br />- <br /> <br />SIG <br /> <br />STATE OF FLORIDA <br />COUNTY OF . Hl/.-t.S8iOtZlJUGrI <br />The foregoing instrument was acknowledged <br />Before me this IZfH day of ~fll/..l '- , 2~' <br />by c'-' $S" ,...,. He L. r..;F/lI'1"-J <br />(name of person acknowledged) <br />~who is personally known to me, or <br /> <br />STATE OF FLORIDA <br />COUNTY OF lIiLL.5Llo flDu6-1'1 <br />The foregoing instrument was acknowledged <br />Before me this 12ft! day of /ll"ttlL- r 20 ~ <br />by . EL/S.5-? 1'-1. 1-/0 Lt. G ~",J <br />~. (name of person acknowledged) <br />~ho is personally known to me, or <br /> <br /> <br />acknowledgement <br /> <br />Owho has produced <br />(type of identification) <br /> <br />~di~p.~e an oath <br /> <br />Signature of person taking acknowledgment <br /> <br />o who has produced <br />(type of identification) <br />ot an oath. <br /> <br />Name t~ped, printed or stamped <br />~%~V..:.VI;.:.. Eliz~beth Mullins <br />g~ 'tb,". i~ Commission # 00527014 <br />~~~~~ Expires March 9.2010 <br />fff.,~ tlr,trld~d 'Troy fain " in"':,",',t~ ,ft, JO;)-.)85.7019 <br /> <br />Name :b\t\H~, ~d.n..t~d N rFitamped <br />~'SVA~""~ cnzaoern MU uns <br />-"'i "~C .. <br />:*~ :*: OmmlSSIOn # 00527014 <br />~~....~,~ Expires March 9, 2010 <br />'ifl,. BDndod Troy Fa... '''"raneo. In,. 800'3$"';~ <br />