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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A, . NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" whi~h
<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, 613-766-6611.
<br />Furthermore, if the owner hss 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 the,
<br />will be responsible. If you, as the owner signs ss the contractor, you are indicating tha'
<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 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 s_one 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 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 tc
<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
<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 s1
<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, CONSUl
<br />WITH yOUR LENDER OR AN ATTORNEY BEfORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMEN.CEMENT".
<br />!
<br />
<br />~, '73 uM
<br />SIGNATU E: OWNER OR AGENT
<br />
<br />J1 ~ i? ppp~
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA 'P.t'lS
<br />COUNTY OF LJ1" (. f!:J
<br />The foregoing instrument was acknowledged
<br />Before rr.e this....l3..r- day of o:rvfJJ/;;t.. , ~2$Jb
<br />by ~(/0E A.. A-t;.a~L.
<br />~name of person acknowledged)
<br />~who is personally known to me, or
<br />
<br />o who has produced
<br />/ftype
<br />and whoO did edid not
<br />
<br />STATE OF FLORID~^ ~-
<br />COUNTY 0 F ,... ...:> C 0
<br />The foregoing instrument was ac~~owled~~~
<br />Before me thi~ 1.2-day of (';1:TlJIJitIL , W":
<br />by I 12Uc.-~ .4. f}~~ L--
<br />~~(name of person acknowledged)
<br />~o is personally known to me, or
<br />
<br />of identification)
<br />take an oath,
<br />
<br />Owho has produced
<br />u;ype of identificati
<br />and who Odid l!ldfd not take an oath
<br />
<br />signature of person taking acknowledgement
<br />
<br />0/zU((:: ~ I Asf!,tL-
<br />
<br />~ (J.. ~
<br />
<br />(1A~ A. aJ~
<br />
<br />Signature of person taking acknowledgmen
<br />
<br />,&v C It tl- '\ 4501-:: L
<br />Name typed, printed or stamped
<br />
<br />Name typed,
<br />
<br />printed or. ,,:,,-trmped
<br />...' ':"<-., Bruce A ,.;roDe
<br />;.a *MY commission CC74f!IffIJ
<br />"'!!!!..l Expires June 22. 2002
<br />
<br />L: ~ Bruce A Astlel
<br />*~; *M>I commission CC'4B677
<br />~.1 Expires June 22, 2002
<br />
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