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<br />CONDI';:'IONS OF PERMIT l',FTIDAVIT
<br />A. 'l'-lOT.ICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "'deed J:e:::tLLctions" which
<br />may be more restrictive than City regulations. 'l'h,,~ undersigned assumes responsibi lity [or
<br />compliance with any applicable deed r.::strictioI1:3.
<br />B. UNLICENSJW CONTRACTORS AND CC'NTRi\CTOR HESPONSIBILITIES
<br />If the owner has hired a contrHctc~ 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 Lhe ClImer 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 (lie intended "Iork, t.hey 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 ~Co~tractor Sections" of this application for which they
<br />will be responsible. If you, as the ownEr signs as the contractor, you are indicating 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 l\ND UTILITY CONNr.~CTIO!f FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, !,'LORIDA STATUTES, AS k"1ENDED)
<br />I certify that I, the applicant, .have been provided witlI a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guide" prepared by the fTlorida Department of Agriculture
<br />and Consumer Affairs. 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 "owner" prior to comnencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I c~rtify that all the information in this application is accurate and that all work will
<br />be done in compliance with all appLi.cable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installi'ltion as indicated. I
<br />certify that no work or installation has comnenced priol' to issuance of a permit and tha'c
<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 to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wet land Area~, and Environmentally ::;en~;i. t.i ve
<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 Jl.gency-.I\sbestos aba tement
<br />I also certify that, if fill material is to be used in Flood Zone "A" or "A, etc.", it 1S
<br />understood that a .drainage plan ~ddressing a "comper-sating volume" ",lill be submit.ted vltllch
<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 l.icer;se 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 plans, construction, or violations of any code. Every permit
<br />issued shall become invalid unless the work authorized by such permit is cormllenced \oJitbin
<br />six months of issuance, or if work authorized by t1-,e permit is suspended or abandoned fO.t: a
<br />period of six months after the time the work is cOHunenced. One 90 day extension of ti.me
<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. ]In approved inspection must be logged during each six
<br />month period, or the project wi.ll be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECOF<.D A NOTICE OF' COMJ.'1ENCEMENT HAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PHOPl'~HTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORr: RECORDING YOUH HOTICE OF COMMENCEMENT. ,JOBS UNDEE
<br />$2.500 IN VALUE DO NOT NEED "0 RECORD AND POS,], " "NO'l'IC~~C:Ef~~_____'_____
<br />
<br />
<br />
<br />SIGNATURE' OWNER OR AGENT SIGN-J: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was ac);no"JI(.C(1ged
<br />Before me this ___ day of _____._, 1~__
<br />by
<br />(name of person acknow~edged)
<br />o who is personally ~llown to me, or
<br />
<br />STilT!': Of' fLORIOA
<br />COUNTY OF ---Polk----- ----------------.-
<br />
<br />Th(:':,.--t()r:~..:;<joj-.nl~ in;:>:~ r Lirnen '- ;,'id:;; z:t C1:1~;..,~.~~;J. t2:d9 ed
<br />Before m.f:' th.is,L1;.tL.~jay cf-DQ.GQm~-, 200L_._
<br />by __.,JaIII.ea---R..- W; 11; amf;, Pre!';; dent
<br />(name of person acknowledged)
<br />~h(l is personally ;.;,nown to me, or
<br />
<br />of identificatjon)
<br />take an oath.
<br />
<br />- 0 who ha s p l:oduced_______~_.___._.___.___._______
<br />[type of Identi.ficationl
<br />lK}iid not taJ.:e an oat:h
<br />
<br />Owho has produced
<br />(type
<br />and whoO did 0 did not
<br />
<br />
<br />Name typed, prj
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Name t.yped, printed or stdmped
<br />.
<br />
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