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<br />A.' NOTIGE OF DEED RESTRICTIONS
<br />Th~ undersigned understands that this permit may be subject to "deed :testria"tions~' which
<br />may be more restrictive than'City regulations. The undersigned assumes responsibility for
<br />compliance with any appiicable deed restrictions;
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSiBILITIES
<br />If the owner, has hired a contractor or contr~Ftors to undertake work, 'they may be required
<br />to be licensed in accordance with state and local regulations. If the contractor is not
<br />licensed as required by law, both the owner and contractor maybe cited for a misdemeanor
<br />violation under s~ate 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 />cdntractor(s) sign po~tions of the "Cohtractor Sections" of this ~pplication for which they
<br />will be responsible. If ydu,' as ~he 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 contract?r that may be an. indication that he is not properlyli~ensed and is
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C.. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTI,ON FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES,. AS AMENDED)
<br />I certify that I, the applicant, hay~ b,een provided with a' copy 'of "Floridats Construction
<br />lien ~aw _ 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 d~scribed document and promise in good faith to deliver
<br />it to the "owneril 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, zoningt and land
<br />, development.
<br />Application 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 regulatiohS, 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
<br />be in compliance. Such agencies inolude but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetiand Areas and Environmehtally 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 certity that, if fill material is to be used in Flo~d Zone "A" or "A, etc."; it is
<br />understood that a drainage plan addressing a;:'compensa,ting volume" will be submitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to permit
<br />. ~
<br />lssuance.
<br />A permit issued shall.be ,construed to be a license to proceed with the work ~nd 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
<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 $~5.00. ,The extension ehall he requeste~
<br />in writing to'the Building Official. An approved lnspectlon must be logged during each SlX
<br />month period, or the pioject 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 'fa 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 />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENTu. :
<br />
<br />~v:~A J /~/-tr"V~
<br />
<br />RE : CONTRAC~OR--/.h r (J I/') ".
<br />, -r! fV7 I') / 1 !' 1/ J//} /7 r:J v (;'/"'i
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />Before me, this ~day of .r 20_
<br />by
<br />
<br />
<br />
<br />SIGNATURE:
<br />
<br />OWNER OR AGENT
<br />
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by
<br />
<br />a~knowledged
<br />, 2CL-
<br />
<br />D who has produced
<br />(type
<br />and wrioD did D did not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />
<br />(name of persop acknowledged)
<br />[1ho is personally known to me, or
<br />.-./ L~~ ~
<br />6Vwho has produced '
<br />(type of identification)
<br />ho Odi., ~dnot take an oath
<br />~ ~tJO ,
<br />,.1110,
<br />
<br />t u"~ ,o~F:pe!~.som'~ i!Ill<lJ)rnJ33ic know 1 edgmen t
<br />
<br />';~~h~"$} Expires December 12, 2010
<br />"ili"; ,,<r,-' Bonded ThN Troy Fain In..,.n..IIOO-38a..701Q
<br />',RtI.~'\"' .
<br />
<br />(name' of person acknowledged)
<br />D who is personally known to me, . or
<br />
<br />
<br />Signature of person taking a~knowledgement
<br />
<br />.,
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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