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<br />Bob Youmans
<br />
<br />788-5262
<br />
<br />03/24/2000 02:30:07 PM
<br />
<br />P.2
<br />
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to ~deed restrictions" which
<br />may be mo~e ~estric~ive than City r~qulations~ The undersigned assumes responsibility fQ~
<br />compliance with any applicable deed restrictions,
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESrONSIBILITIES
<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 Buildinq Department, B13-7BB-6611.
<br />Furthermore, if the owner has hired a contractor or contractors. he is advised to have the
<br />contractor (5) 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 the contractor wishes
<br />you to sign as contractor that may be an indication that he is not properly licensed and i.
<br />not entitled to permitting privileges in the City of Zephyrhilis.
<br />C, TRANSPORTATION IMPACT f'BES AND UTILITY CONNECTION f'EES
<br />D. CONSTRUCTUION LIEN LAW (CHA(>TER 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 />Application is hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no work or inatallation has commenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of .11 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, JlJate.c/WasLewater T.reat.rnent
<br />.Southwest Floricia Water Manaqement District-Wells, Cypress Bayheads, l'Ietland Areas,
<br />Alterinq Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health 4 Rehabilitative Services, Environmental Health Unlt-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 ~lood 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 ot 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 writinq to the Building official. An approved inspection must be logged durinq 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 ~ROrERTY. 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 rOST A "NOTICE OF COMMENCEMENTH,
<br />
<br />
<br />SIGNATURE: CONT~CTOR
<br />
<br />S TE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrUment was
<br />Before me this_ day of
<br />by
<br />
<br />acknowledqed
<br />, l~_
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this --Slay of
<br />by
<br />
<br />acknowledged
<br />I l~-=--
<br />
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />of identification)
<br />take an oath.
<br />
<br />(name of person acknowledged)
<br />C1ho is personally known to me, or
<br />
<br />o who has produced
<br />itype of identificaLlun)
<br />and who Ddld [):lid not take an oath
<br />
<br />o who has produced
<br />(type
<br />and whoO did Ddid not
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person takinq acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
<br />03/24/2000 FRI 13:34
<br />
<br />[TX/RX NO 5832] ~ 002
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