|
<br />~~,\Wl.:t""
<br />~'>;f.tj?""'~~i
<br />\'-~. j
<br />. ...:1..".1
<br />~
<br />
<br />!I11
<br />
<br />:;;i"..J:
<br />
<br />i~u
<br />- ~
<br />~ >0
<br />~
<br />
<br />CONDITIONS OF PEPMcrT AFFIDAVIT
<br />A. NOTICE or DEED RESTRICTIONS
<br />The undersignea understands that this permit may be subject to ~deea restrictionsM which
<br />~y be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable daea restrictions.
<br />11. 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 SectionsH of this application tor which they
<br />will be responsible. If you, as the owner signs as the contractor, you are indicat~ng 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 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 I.Jl..W (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 GuideH prepared by the Florida Department of Agriculture
<br />and Conaumer Affairs. If the applicant is someone other that the "owner", r 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 pe~t to do work and installation aa inaicated. 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 alao
<br />certify that I understand that the regulations of other governmontal agencies may apply to
<br />the intended work, and that it ia 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-Wella, Cypreas 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 materLal is to be used in FlOod Zone ~A" or "A,etc.N, it is
<br />understood that a drainage plan addressing a ~compensating volumeH will be aubmitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to p~Dmit
<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 iasuance of a pe~t prevent the Building OffiCial from thereafter requiring a
<br />correction of errors in piano, construction, or violations of any code. every permit
<br />issued shall become invalid unless the work authorized by such pe~t 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 1a commenced. One 90 day extension of.time
<br />may be allowed for the permit with fee charge of $15.00. The extension ahall 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. JOllS UNDER
<br />$2,500 IN v.ALUE DO NOT NEED TO RECORD AND POST A ~NOTIcE OF COKMENCEMENTH.
<br />
<br />
<br />j~~ ~~
<br />
<br />
<br />STATE OF FLORIDA D r CO
<br />COUNTY OF r a ..
<br />The foregoing i2(~rument was acknowledged
<br />Before me this day of ()(l:h,J-py, ~,
<br />by:-Tl(\4 0.1' II
<br />-or. (name of person acknowledged)
<br />~WhO is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />Ddid not
<br />
<br />
<br />STATE OF FLORIDA '7)
<br />COUNTY OJ!' r ~ (.tl
<br />The foregoing instrument was a~~wledged
<br />Before ,III! this ~r. of t!Jr __r" , N~'
<br />by ~(jnf\~1'\
<br />...r.~ (name of person acknowledqed)
<br />~o is personally known to me, or
<br />
<br />o who has produced
<br />(type of identificatLon)
<br />o 0 did Dlid not take an 0 h
<br />711.
<br />
<br />
<br />
<br />ignature of taking acknowledgement
<br />
<br />,'~~'~"'" Debra M. Howard
<br />Name ti8~~". ~'a~~/I~~ miRES
<br />o",,~. :~g Septembe 20, 2002
<br />-.,7i......"~<i',~ BONDED THRU fROY FAIN INSURANCE,INC.
<br />'~',H~.,~~,"~
<br />
<br />(L
<br />ignature of ,ffl~pn takin!t>Eftim~nt
<br />~f'-"'''~~; MY COMMISSION fI CC871443 EXPIRES
<br />
<br />Name typecV."...,.~d ~5Nri YFAlNINsuRANCE,INC.
<br />"'-H;,;,tt,',..
<br />
<br />v 'd
<br />
<br />I ~ 0 I '0 N
<br />
<br />SlliH~AHd3Z ~O AIIJ
<br />
<br />NdH: t 100&'6 'PO
<br />
|