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<br />CONDI':'IONS OF E'ERMIT J'.FFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "dee~ restrictions" which
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed r~strictions.
<br />B. UNLICENS~D CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contracto~ or contractors to undertake work, they may be required
<br />to be licensed in accordance with state and loc~l regulations. If the contractor is not
<br />licensed as required by law, both the owner and contractor Inay 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 Sections" of this application for which they
<br />will be responsible. If you, as the owner signs as the contr~ctor, you a~e indicating that
<br />you, rather than the contractor, are responsible for the wor~. 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 .~D UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, .have bee~ 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 tha1: 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 corrunencement.
<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 corrunenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regulating co~struction, City
<br />codes, zoning regulations, and land development regulations in the juri.sdiction. I al~Q
<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 rnust tak~ 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-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-We:ls,
<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 wh.ich
<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 w~rk 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 pJ.ans, 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 of six months after the time the work is corrunenced. 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 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 IMPROVEMENT~ .:J YOUR PROPERTY. 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 POST A "NOTICE 0 OMNENCEMEN'l"'.
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by
<br />
<br />acknowledged
<br />, 19_
<br />
<br />STJl.TE OF FLORIDA
<br />Polk
<br />COUNTY OF ________
<br />The foregoing instrument was acknowled~tfRl
<br />Before me this 2~_day of Decem~er_, 1'9"__
<br />by Jame~ W. Will1ams, Pres1dent
<br />
<br />(name of person acknowledged)
<br />aho is personally Known to me, or
<br />
<br />(name of person acknOWLedged)
<br />o who is personally ~l1own to me, or
<br />
<br />o who has produced .___
<br />(type of identification)
<br />and whoD did Ddid not . take an oath.
<br />
<br />.Dwho has produced
<br />(type of identification)
<br />Ddid ~id not take ai: oat:h
<br />
<br />Name typed, printed or stdmped
<br />
<br />
<br />Signature of person taking acknowledgement
<br />
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