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<br />CONDITIONS OF PERMIT AFFIDAVIT <br />A. NOTICE OF DEED RESTRICTIONS <br /> <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 CONTRACTORS AND CONTRACTOR RESPONSIBILITIES <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 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, 813-788-6611. <br />Furthermore, if the owner has hired a contractor or contractors, he is advised 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 indicating that <br />you, rather than the contractor, are responsible for the work. If ~he 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, 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. CPNTRACTOR'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 constru~t~on; zoning, 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 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 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, 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 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.", 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 VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT". <br /> <br />~~~ <br />SIGNAT~ OWNER OR , <br /> <br />STATE OF FLORJDA <br />COUNTY OF P;IL~8~h,.a;-J <br />The foregoing instrument was acknowledged <br />Before me this t'2 day of ...:Ti..Ji-Lf ' 19.27 <br />by,-lbl,/AI 4- ~~ <br />(name of perso acknowledged) <br />igwho is personally known to me, or <br /> <br />_4L'7H fii- <br /> <br />SIG~URE: CONTRAC R <br /> <br />STATE OF FLORIDA /J J\ . / <br />COUNTY OF ,-L// ~S /..:5CJF7:7i-t.:7h <br />The foregoing instrument was acknowledge~ <br />Before me this .L..2::::.....day of 'Y, ' 19 t+- <br />by ~H/'o..\ H. r",.L~ <br />v<. (name of pers n acknowledged) <br />~ is personally known to me, or <br /> <br />o who has produced <br />(type of identification) <br />not take an oath. <br /> <br />Dwho has produced <br />(type of identification) <br />and who Ddid ~id not take an oath <br /> <br />dJ~AJ(~ ~vY)ch <br /> <br />st9nature of pefs n taking acknowledgment <br /> <br /> <br />Signature of p r on taking acknowledgement <br /> <br />Name typed, <br /> <br /> <br />~"'~'." -~ <br /> <br />Name ifJ. ' <br /> <br />.."",..... <br />'tJ." <br /> <br />cc;" <br /> <br />~< <br /> <br />tamped <br />DA V1D RON~ <br />STATEClF~ <br />i EXPIRES: ~27. _ <br />CClU CiC.... '- <br /> <br />prOAVlD RON~ .... d <br />CIllM STATE OF ~ <br />~-=.,- <br /> <br />-,~ <br />