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<br />
<br />A. NOTIGE OF DEED R~~TR~C~~UN~
<br />The, undersigned understand~l that this permit may be subj ect to "deed restrictions" which
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any appl:.cabh: deed restrictions.
<br />B. UNLICENSED CONTRACTORS l~N=' CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contr~9tors to undertake work, . they may be required
<br />to be licensed in accordance with state and 16ca1 regulations. 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 or contractors, he is advised to have the
<br />contractor(s) sign po~tions of the "Goritractor 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 indication 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, hav~ 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 corrunencement.
<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 />Appliqation is hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no work or installation has corrunenced prior to issuance of a permit and that
<br />all work wiil 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 bf 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~~. >~OT NEED TO RECORD AND POST A "NOTICE ~:~~7 _
<br />
<br />~~ . ,~~ .
<br />
<br />TURE: OWNER OR AGENT SIGN~~RE: CONTRACTOR
<br />
<br />o who has produced
<br />(type of identification)
<br />an~...q Odid~ ~ke an oath.
<br />
<br />Mt. ~tZ .
<br />
<br />signat2e of person taking acknowledgement
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF #/LL.sdo iZ.ou61'f
<br />The foregoing instrument was acknowledged
<br />Before me this /z:rrl day of /1~t2I'- , 20 D6
<br />by .. E/../S~'" H.l!oLLG-C",,J
<br />~ (name of person acknowledged)
<br />~ho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />id not t ke an oath
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF .HII..-L..St3tOIZOc,r;tI
<br />
<br />The foregoing instrument was acknowledged
<br />Before me this 1Z.-rH day of "'11'4../ '- ,2~'
<br />by €' u $S " ;1-(, 1-10 L. L (f:/ZI4"-J
<br />
<br />(name of person acknowledged)
<br />~who is personally known to me, or
<br />
<br />
<br />acknowledgment
<br />
<br />Name
<br />
<br />t ype j;J.~.~~~tl!tfiaBittf NMlmfS
<br />g:i .-Ji.., '!~ Commission # 00&27014
<br />~~J;:~<i~': Expires March 9, 2010
<br />'",ff.:i''' Bonded Troy F.in - """nance, Inc 800-385-7019
<br />
<br />Name
<br />
<br />ty "i!?".!stNb.nl:. AtClroped
<br />.:~.#.: em MUllinS
<br />~~. . ~lf} Co~mission # 00527014
<br />~1.1.s;..r..~'. Expires March 9, 2010
<br />BOIlo.d Tilly Flln -In....no., Ino 800.38"7018
<br />
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