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<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRA.CTORS AND CONTRACTOR RESI!?ONS I I3IT,I'fIES
<br />If the owner has hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accordance with state and local regulat~ons. 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 are uncertain as to what
<br />licensing requirements may apply for the intended \-lork, they are advised to contact the
<br />City of Zephyrhills Buildi.ng Department, 013-788'-6611.
<br />Furthermore, if the owner has hired a contractor or contractors, he is advlsed to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application for which they
<br />will be responsible. If you, as the owner signs as the contractor, you are i.ndicating 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. CONSTRUC'fUION LIEN LA.W (CHAPTER 713, FLORIDA S'fATUTES, 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 ced.fy that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prlor to commencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />1 certify that all the information in this application is accurate and that all work will
<br />be done .in compliance w.ith all applicable laws regulating construction, zon.ing, and lRnd
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as lndicated. I
<br />certify that no work or installation has commenced prlor 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 tc
<br />the intended work, and that it is my responsibility to identify what actions I must take t-..
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Environmental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Sensi.tive
<br />Lands, Water/Wastewal:er 'freatment
<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 Tre.tment, 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 hy 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 ~he 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 />silt months of issuance, or if \oj'ork 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 tirite
<br />may be allowed for the permlt with fe's charge of $15.00. 'rhe extenslon 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 '1'0 OWNER: YOUR FAII,uRE TO RECORD A NO'l'ICE OF COMMENCEMEN'l' M1\Y .RESULT IN YOUR
<br />PAYING TWICE I!'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSUL'I'
<br />WITH YOUR LENDER OR AN A'r'!'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VAI,UE DO NO'r NEED 'fO RECORD AND POS'l' A "NOTICE OF COMMENCEMENT".
<br />
<br />~\.JJ.'lUJ_TJ.UN:i (JH' PERMIT nFFIDAVIT
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />~~
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />r-
<br />
<br />S1'ATE OF FLORIDA
<br />COUN'l'Y OF
<br />The foregoing instrument Mas
<br />Before lIIe this __ day of
<br />by
<br />
<br />--,
<br />
<br />19_
<br />
<br />STATE OF FI,QRIDA II . /I.:S h f) r e> t{ e>h
<br />COUN'rY OF I
<br />The foregOing instrument was ac~ogedged
<br />Before mh th% ~day JId/:tf ' ~1>L27
<br />by C at" Ot{:e.. e...
<br />(name of person acknowledged)
<br />[1ho is personally known to me, or
<br />
<br />~WhO has produced &. L'~
<br />(type of identification)
<br />and who Ddid "PUd not take an oath
<br />
<br />ackno~rll.cdged
<br />
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoD did Ddid not take an oath.
<br />
<br />
<br />g acknowledgment'
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Name typed, printed or stamped
<br />
<br />Name
<br />
<br />. S
<br />t ~ :p. t:ClotrImidiolll>QO &a1"ed
<br />~. .~l ExpireS December 12, 2010
<br />~"',i;" t~~'" iGndN Tl1I1f Troy Fmn lhauNlCt 1OQ4IIo.701G
<br />
<br />........'L..'
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