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<br />CONDITIOHS OF PERMIT AFFID~VIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersLgned understands that thts penni t may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. The undersign/!.l>d assumes responsibility f~r
<br />oompllance with any applicable deed restrictions.
<br />B. UNLICBNSED CONTRACTORS AND CONT~CTOR RES?ONSIBILITIE5
<br />I f the own.el: has hired a cont::-~ctor or contractors to undertake work, they may be requi:reci
<br />to be licensed in accordance wi.th state and local :ceg'ulations. Ii the contractor is not
<br />licensed as requ.irElo by lai!(, both the owner and contractor may be cited for a misdemeanor
<br />violation under state law. If the owner or int@nded contra~tor are uncertain as to what
<br />licensing requirements may app~y tor the intended work, they are advised to contact the
<br />Ci t:y of' Zli:!plW~hil.ls Building Department, 813-788~6611.
<br />Furthermore, :..f the owner has hired a cont:racto~ or contractors, he is advised to have the
<br />contractor(sJ sign portions of the "Contractor Sections" of thi~ application for which they
<br />wj.ll be responsible. If you, as the owner signs as the contractQr, you ar~ ind.1ca'Cinq that.
<br />you, ra~her than the contractor, are responsible for the work. If the contractor wishes
<br />you to slgn as contractor that may be an indication that he is not. properly licel'sed 2nd is
<br />not entitled to permitting privileges in the City of zephyrhills.
<br />C. TRANSPORTATIO~ IMFACT tEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA S1ATUTES, A3 AMENDED)
<br />I certify that I, the appli.cant, have be~n provided with a copy cf "Florida's Construction
<br />li~n Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and Consumer Affai~$. If the applicant is someone other that the "owner", I cerify that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the ~ownern prior to commenc~m@nt.
<br />E. CONTRACTOR'S/OWNER'$ AFFIDAVIT
<br />I certify that all the information in this application i~ accurat~ and that all work will
<br />be donoz,in compl.iance with all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application lS hereby made to obtain a permit to do work and installation as indicated. I
<br />cert.J.ty that no work or installation has corornenced 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 develcprnent regulations in the jurisdiction. I also
<br />certify that I under~tand that the regulations of other governmental ag~ncies may apply to
<br />the intended work, and that it is my responsibility to identify what actions I must take to
<br />O@ in compliance. Such agencies include but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Envirop~entally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Alted..ng Waterc01.U::s~s
<br />*Army Corps of Engineers-Seawalls, Decks, Navigable Waterways
<br />*Department of Health & Rehabilitativ~ Services, Environmental Health Unit-Wells,
<br />Wa~tewater Treatment, Septic Tanks
<br />".U. 5. Enviromnental Prot.ectiDn Agency-Asbestos abat.ement
<br />I also cert~~y that, 1~ fill material is to be used in Flood Zone ~Au or ~A,etc.H, it is
<br />understood that. d. drainage plan addressing a "compen.sat.i.ng volwn.e" w;i.ll be suhm;i.tted which
<br />is prepared by a professional engineer registered in the State of Florida prior to permit
<br />iesuance.
<br />1\. pern-.it issued shall he construed to be a license to proceed with the work and not .as
<br />autho.::i.ty to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance or a pe~t prevent the Building Official from thereafter requiring a
<br />correction of errors in plan::s, GQnl5ltruction, or vio1.ation.s of i!l.o'Y code. Every p~:r:mi.t
<br />i5sued shall b",cQI"!'le invalid 1.m).E!!;5S the work authorized by 5UC-...h permit is commenced within
<br />six months of issuance, or if work authorized by the pe:r:~t is suspended or abandoned for a
<br />p.niod of. ;;:.tx months after the time the work is cOIrlmenced. One 90 day e}~tension of time
<br />may be allowed for the permit with fe~ charge of $15.00. The extension shall be requested
<br />J.n 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: ':(O:JR FAILURE TO RECORD A NOTICE OF COMMENCEMEN"T 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. JOaS UN)ER
<br />$2,500 IN VALUE DC NOT NEED 'TO RECORD AND POST A "NOTICE OF COMMENCEMEIIT".
<br />
<br />
<br />SIGNATURE: OWNER OR A.GENT
<br />~6L.L.Esl.y 'DEvGLD1'MEN
<br />STATE OF f~RID.A.
<br />COUNTY OF r~~
<br />The foregoing instrument was ackncwledoed
<br />Before. me .thiS ~{'day ot 'l;--IJ- , ~.:,iou(
<br />by ....l..f-..I ('/1':~)'" .' K" II. )-.L,I/
<br />(name of person acknowledged)
<br />IDwho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identi~ica~1on)
<br />andlf1hoOll did . 0 r-. ~ot ~~~e _~ Gel th.
<br />L)i~..-//)-- l :;{~/~
<br />
<br />Si~nature of person taki~g ~~~nowl&dgement
<br />
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<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />;1-
<br />STATE. OF F.LOP.IDA /) ,,(
<br />COUNTY OF l~,-,' - C)
<br />'The foregoing in?tr ent W~~1Cknowledged
<br />Befo~ me this ~y of ,y.... , 3:901001
<br />by /N-o I .ee "
<br />(name of person acknowleQg~d)
<br />C1ho is personally known to me, or
<br />
<br />m who has produced {jU~;k~:, ).., tLdSQ
<br />(type of identification)
<br />a7:w~o q. did _" ~.. '. not ta~=.., an oath
<br />~- //1,,- ~,z4/~-
<br />
<br />Signature of person taking ackl'lcwl",dgment
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<br />n tOD
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