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<br />A. NOTICE OF DEED R~~T~~~T~UN~
<br />The ~ndersigned understands that this permit may be subject to "deed restrictions" which
<br />may be more restric~lve than City regulatiohs. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. ONLICENSED CONT:~~\.C~ORS l\..ND 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 i6ca1 regulation~. If the contractor is not
<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 ar~ 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 oi contractors, he is advised to have the
<br />contractor(s) sign pOftions of the "Cohtractor Sections" of this ~pplication for which they
<br />will be iesponsible. 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 IMPF~CT FEES AND UTILITY CONNECTION 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 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 ~Iith all applicable laws regulating construction, zoning, and land
<br />development.
<br />Appli~ation is hereby n\ade to obtain a permit to do work and installation as indicated. I
<br />certify that no work or installation has commenced prior to issuahce 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 each 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 />$2,500 IN V UE DO; NOT NEED TO RECORD AND POST A "NOTICE OF~MMENCEMENT'"
<br />
<br />~ y: ~
<br />
<br />ATURE: CONTRACTOR
<br />
<br />
<br />,.
<br />
<br />Dwho has produced
<br />(type of identification)
<br />
<br />~i~~~e an oath.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF l!iLL.{Llo ,z()u61f
<br />
<br />The foregoing instrument was acknowledged
<br />Before me this ;z:rrf day of /lptZlL.. , 20 Di.
<br />by ELtS5;<f 1'-/. Ho I-t..G<;JrJ
<br />(name of person acknowledged)
<br />~hO is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />not t e an oath
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF . HI/...LS8iDIZO"Ctl
<br />The foregoing instrument was acknowledged
<br />Before me this ~ day of "'1'4.1 f- , 2~'
<br />by cu.$SI/ "..,. HcL<-cFtZllI"-J
<br />(name of person acknowledged)
<br />pg who is personally known to me, or
<br />
<br />
<br />Name type,*,t '. ~ etlkatfetfi:MtRni\s
<br />~~ )~ Co~miSSion # 00527014
<br />':J.1.~'''~~ ExpIres March 9. 2010
<br />.WU\\.\ i:'o",~~ ~;~01 Fa..:, ;m::.ur~n"tJ, IRe 30..j.:"i,j5'7019
<br />
<br />Name t.:' v ~~ ~8betb:MtlUimJ>ed
<br />:*i i*: Commission # 00527014
<br />~~~......~.Expires March 9, 2010
<br />'st~ Bo"d9dTmv Fain -Insurance Inc 800.385-7019
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