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<br />A. NOTICE OF DEED R~~TK~CT~UN~
<br />Th~ undersigned understands that this permit may be subject to "deed restrictionsU which
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B, UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the ~wner has hired a contractor or contr~ftors to undertake work, they may be required
<br />to be llcensed in accordance with state and local 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 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 "Contractor SectionsU 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 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 include but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetiand 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.u, it is
<br />understood that a drainage plan addressing a "compensating volumeu 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 />$2,500 ~;Z-TO RECORD AND POST A "~7MENT" ,
<br />
<br />
<br />
<br />SIGN~RE: OWNER OR AGENT . ,ZIGNATURE: CONTRACTOR
<br />
<br />kE OF FLORIDA ;/ STATE OF FLORIDA, ?
<br />COUNTY OF . HIi..,LS81CIZou(;t1 COUNTY OF IIILI....ttJoQ)u6/f
<br />The foregoing instrument was acknowledged The foregoing instrument was ~;knoWledged_
<br />Before me this /tt"H day of "/,,J../ '- , 20o.{;' Before me this fl."" day of /fp _L , 20 06
<br />by ct..J$S ~ "'1. He f... f...€t?IlI""-J by EI../$$-? 1'-/. /10 Lt...; -c",,J
<br />(name of person acknowledged) (name of person acknowledged)
<br />~who is personally known to me, or C1ho is personally known to me, or
<br />
<br />Owho has produced
<br />(type of identification)
<br />
<br />~d ~k~
<br />~~ . .
<br />Signature of person taking acknowledgment
<br />
<br />
<br />Name
<br />
<br />
<br />N~"~J~'zibinted or stamped
<br />:rtliJ. C 8th MUllins
<br />.. \ "om
<br />~t ~ eXPI;;~~~'::t, ~D527014
<br />SO"O.HIllY ~'I" 'In . 2010
<br />SUfa"ce, In. 1lOo.3115-7019
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<br />Expi,..tn ~ ~;g:~.."O
<br />DCfIIOIO TlOy '.tn -lnlllrtn.l, 1M .....101S
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