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<br />CONDITIONS OF iERMIT AFrIDAVIT
<br />A. NOT.ICE OF' DEED RESTRICTIONS
<br />The und.r~1qned underatanda th~t thie permit may be ~ubject to ~doed restrict10nBN which
<br />may be more restrictive than City regulations. Th. undersigned a..um.. responsibility for
<br />oompliance with any app11aable d..d rCDtriction~.
<br />B. UNLICENSED CONTRACTO~ AND CONTRACTOR RESPONSIBILITIES
<br />If the owner ha. hired a contractor or ~ontr.ctors to undertake work, tbey ~y be requir6Q
<br />to be licensed in accordanoe with state ana local regulation.. If the cont~.ctor is not
<br />licenseQ a4 required by law, both tQe owner and contractor may be cited tor a misdemeanor
<br />violation under state l.w. If the owner or intended oontractor are uncertain as to whAt
<br />licen~ing requirement. mAY apply for the intended work, they are adVised to contact the
<br />City of Zephyrhill. a~11din~ D.partment, 813-786-6611.
<br />i'urt:.h.noor.... if t:.h& o~r haiR h'i ~.d a M^"'.............",t-:^... ^""" ~....""'r~_...._.._ ,,_.... _M". __-' .._ 'L.._..__
<br />
<br />contractor(s) sign portions of the "Cont~Actor SeetionsN of th18 application fo~ whieh they
<br />will be ~e.pon$ible. If you, a~ the owner signe a~ the contractor, you are indlcat~ng that
<br />you. rather th.n tn. oontractor, are reapon.ibl. for the work. If the contracto~ w1.ho~
<br />you to .ign aa contractor that ~y be an indication that he 1s not prop.rly licensed and i$
<br />not .ntitl~ to pe~tting privileqes in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />,D. CONSTRUCTUION LIEN LAW (CHAPTER '713, FLORID.I. STATUTES, AS AMENDED)
<br />t certify that It the applicant, have b..n provided with a copy of ~rlor~d~" Construction
<br />lien Law - Homeowner'a Protection GuideH prepared by the Floriaa Department of Agriculture
<br />and Cons~r Affairs. If the applicant is someone other that the "ownerN, I oerity that I
<br />have obta1ned a copy of the above d.soribed doo~ent and prom1.. in good faith to doliver
<br />it to the ~owne~n prior to commencement.
<br />E. CONT~CTOR'S/OWNER'S AF~lDA~T
<br />I certify that all the info~tion in this application 1s accurate and that all work will
<br />b. donw in compliance with all applioable lawa regulating eonat~uotion, zoninq, and land
<br />development.
<br />Application 18 hereby made to obtain. permit to do wo~k and installation .a indicated. I
<br />certify that no work or installatlon has commenced prior to issuanoe of a permit and that
<br />all work will he perfor.med to meet .t.ndarda of all law. regulatin9 construction, City
<br />codes, zonin~r.gulations, and land development regulations in the jurisdiction. I &lao
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended work, at'ld that it i8 my r..ponillibllity to identJ.fy what !lotions I Rn.u,t take to
<br />be in compliance. Such agencies include but are not 11mdted to: *Department of
<br />Environmental Reg~lation-Cyprea~ Bayheads, Wetl.nd Areas and Envi~onmentally Sensitive
<br />Lands, Water/Wastewate~ Tr.atment
<br />*Southweat Florida Water Hanaqement District-Well., Cypress Bayheads, Wetland Areas,
<br />Altering Wat.reour...
<br />*AImy Co~p~ of Engineers-seawalla, Docks, Navigable Waterways
<br />*Department of Health' Rehabilitative Serviee., Envi~onment.l Health Unit-Well.,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. ~nv1ro~nt.l Proteotion Agency-Asbestos kb.te~nt
<br />I alBO certify that, if fill material 1s to be used in ~lood Zone ~AN or ~A,.tc.", it is
<br />understood that a d~ainag. plan addreesinq a ~compen.~ting volumeN will b. submitted which
<br />1s prepared by a professional engineer registered in the State of rlo~ida prior to p~rmit
<br />hsuance.
<br />A per.mit issued shall he ~onstrued to be a lioen.. to proceed with the work and not as
<br />authority to violate, cancel, alter, or .et .aid. any prov1~ion. of the technical oodes,
<br />nor shall issuance ot a permit prevent the Buildinq Otfic1al from thereaft~r requiring a
<br />correction of errors in plans, construction, or v1olatio~8 of any code. Every pe~t
<br />i~5Ued shall become invalid unless the wo~k authorized by such per.mit 18 commenced within
<br />six months of issuance, or if work a~tho~1z~ by the peomit is suspended or abandoned for a
<br />period ot ~ix months after the time the work is commenced. One 90 day extension of 'time
<br />may be allowed tor the permit with fe. chlrg. of $15.00. The ext.nsion Ih.ll be requested
<br />in writing to the Building Ott101&1. An approved inspection muat be lo~~.d during ..oh 8ix
<br />month period, or the projeot will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN'l' MA't RESULT IN YOUR
<br />~AYING TWICE FOR IMPROVEMENTS '1'0 YOUR I?ROn~TY. rr YOU INTEND '1'0 O!TAlN !'~CIN(3, CONSUJ"T
<br />WITH YOUR 'LENDltR OR AN ATTORNEY BEFORE RECORDING YOUR NOTIC! or CO)JMENCEMENT. JOBS UNO!~
<br />
<br />
<br />1"SuOO a=ro~ AND PD'T~~.
<br />
<br />SIGNA: URE: OWNER OR ~T ., ATU I 'I'M R
<br />
<br />STATIil OIi' Ii'LORIDA S,o . al {'
<br />COUNTY OF '- ......f{) \ \\
<br />T~~ foregoing instrument wa. aOKnowledged
<br />Before me ~hi5 ~ day of ADci \ ,~. I
<br />by f'cr~ ('J(\e.. . 1
<br />(n~e of person acknowledged)
<br />)(who is personally known to me, or
<br />
<br />STATE OF FLORIDA <'.{)M' _ _1'\ _
<br />COUNTY Oil' ~\6\OX...Q.
<br />The fo~egoing in~ rument waa !lcknowledgad
<br />Be.tor me t 1s . ay of . , ~.1l::Ql) t
<br />by '.
<br />(n~ of person ackncwledq4d)
<br />~hO i. personally known to m., or
<br />
<br />o who hu produo.d
<br />(type of identification)
<br />d no take an oath
<br />r:>
<br />
<br />
<br />
<br />
<br />ignatuLe of rson akin cknowledgment
<br />
<br />JLtilher~ k. Wt\-t
<br />Name typed, rint.d or tamped
<br />
<br />~.".y 'iI~ KIM:.ijQ~LY ,f... KIGHT
<br />~';[ , d MY &~WsslCllW # CC 166458
<br />~., . EXPIRES: 08/1112002
<br />....OFt\:
<br />1-800.!.NOTAIlY FI& NOW)' ServloeS & Bonwnl Cb
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<br />MY COMMISSION # CC 166458
<br />EXPIRES: lJ8/1112002
<br />
<br />!R800<i.NOTAR.Y Fla Nntilry S!"'n.'tft'~' & Bonding Co
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