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<br />CON lITIGNS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTF: !_CT r..Q,\JS
<br />The undersigned understands that thi5 per iit .r3V be SUjlj~ct tv "deed restrictiDns. which .ay be lore restrictive than City
<br />regulations. The undersigned assules re~ :onsibil~ty for cOlpli~nce with any applicabl~ deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTOI~ AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or n.ltractors to undertah Ilorkl they laY be required to be licensed in accordance with
<br />state and local regulatiflns. If the,.centfactor is not licensed as required by lall, both the owner and contractor laY be
<br />cited for a lisdeleanor \iolation under state law. If the o~nel or intended contractor are uncertain as to "hat licensing
<br />requirelents lay apply fer the intended lurk, they are advised to contact the City of 2ephyrhills Building Deparhent, 18131
<br />788-6611.
<br />
<br />Furtherlore, if the ollner has hired a contractor or cOhtractors, he is advised to have the contractorlsl sign portions of the
<br />.Contractor Sections" of this application for IIhich they lIill be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the 1I0rk. If the contractor wishes you to sign
<br />as contractor that .ay be an indication t,;at he is not properly licensed and is not entitled to perlitting privileges in-the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACr FEES AND UTILITY CONNECTION FEE~
<br />
<br />D. CONSTRUCTION LIEN LAY (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have beE:; provided lIith a copy of .Florida's Construction Lien Lall - HOleOllner's Protection
<br />Guide" prepared by the Florida Departaen! of Agriculture and Consuler Affairs. If the applicant is so.eone other than the
<br />"ollner" , I certify that I have obtained a copy of the above described docu.ent and promise in good faith to deliver it to the
<br />"owner" prior to cOllencelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work lIill be done in cOlpliance lIith all
<br />applicable laws regulating construction, zoning, and land developlent. '
<br />
<br />Application is hereby aade to obtain a perait to do work and installation 'as indicated. I certify that no 1I0rk or
<br />installation has cOllenced prior to issuance of a perait and that all lIork lIill be perforled to leet standards of all laws
<br />regulating construction, City codes, zoni~g regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govern.ental agencies lay apply to the intended worK, and that it is
<br />IY responsibility to identify what actiors I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />Water/Wastewater Tre~t.ent
<br />I Southwest Florida Water HanaQelent District - Wells, Cypress Bayheads, Wetland Areasl Altering Watercourses
<br />I ArlY Corps of EnQineers - Seawallsl DorksI Navigable Waterllays
<br />f Departaent of Health ~ Rehabilitative ~ervices, Environaental Health Unit - Wells, Wastewater Treatlent, Septic TanKS
<br />I US Environaental Protection AQency - A~bestos abatelent
<br />I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.., it is understood that a drainage plan
<br />addressing a "colpensating volule" will Ie sub.itted IIhich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with the worK and not as authority to violatel cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent 'the Building Official fro. thereafter
<br />requiring a correction of errors in plan~! construction, or violations of any code. Every perlit issued shall becole invalid
<br />unless the work authorized by such pertit is cOllenced within six Bonths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of SiX ionths after the tile the 1I0rk is com.enced. One 90 day extension of tile, lay be
<br />allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection .ust be logged durinl each six lonth periodl or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAilURE TO RECOR,) A NOTICE OF COHHENCEHENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANi'ING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMHENCEHENT. JOBS UNDER $2,500 IN YALU, DO NOT NEED TO RECORD AND POST A"N C OF COMMENCEMENT".
<br />
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />STATE OF FLORIDA . .
<br />COUNTY OF ~~...~.. U:tllr-'}yw?')rll'Jln -
<br />The for~ ackn~wledged
<br />before me this .~! 19~ by
<br />JJ~ .
<br />~ '-01.LcJ . -D fI ~ ~ .'-fl\ I Q 0 on)
<br />who is personall~known to me or who has
<br />pl-oduced I. u .
<br />as identification and who 9id/did not
<br />take an oath.' Ii L--fVl .Il
<br />. '-tY\.ll'W.u ~ ~!MOLJc)
<br />
<br />_(Slgnature) tflIChtL.K. 0'\1'-1 'off
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
<br />N~~~ . Publ~. State df Fldrid~
<br />omm. EJlp Feb' 4, 19"5
<br />8..mdea thru PICHARD," "
<br />. ns. Agency
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknowledged
<br />1') by
<br />
<br />who is pel-sc,nall y known te, ml! Cl}- who has
<br />produced
<br />as identification and whc. did/did (mt
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Name Typed! Pr i nted Dr Starr'i ied)
<br />NOTARY PUBLIC
<br />
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