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<br />CUNVITI0NS OF PERMIT AFFIDAVIT
<br />A, NOTICE OF DEED RESTRICTIONS
<br />The und'er~igned understands tqat this permit may be subject ::to "deed restrictions" which
<br />~ay be more restrictive than City regulations, The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. 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 contraotor 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 Depart~ent, 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 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 penroitting priVileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTEtI, 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 Guide" prepared by the Florida 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 commencement,
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />I certify that all the infonmation in this application is accurate and that all work will
<br />be done in compliance with all ap.plioable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a penroit to do work and installation as indioated, I
<br />certify that no work or installation has oommenoed prior to issuanoe of a penroit and that
<br />all work will be perfonmed to meet standards of all laws regulating construction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiotion, I also
<br />certify that'I understand that the regulations of other gover~ntal agenoies 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 agenoies include but are not limited to: *Department of
<br />Environmental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment .
<br />*9.outhwest Florida Water Management District-Wells, Cyp.ress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Acmy 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 till material is to be used in Flood Zone "A" or "A,etc.", it is
<br />understood that a drainage plan addressin~ a "compensating volume" will be submitted which
<br />is prepared by a prQfessional engineer registered in the State of Florida prior to permdt
<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 oodes,
<br />nor shall issuanoe of a penmit prevent the Building Offioial from thereafter requiring a
<br />correction of errors in plans, oonstruotion, or violations of any oode. Everyper:mit
<br />issued shall become invalid unless the work authorized by Buch per-mit 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 oommenced. One 90 day extension of time
<br />may be allowed for the permit with fee oharge of $15.00. The extension shall be requested
<br />in writing to the Building OffioiaL An approved inspection must be logged during each six
<br />month period, or the project will be oonsidered abandoned. .
<br />WARNING TO OWNER: YOUR FAILURE TO RE<:::ORD 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 BII'OIUi RICORDING YOUR NOTICE OF COMMENCIMINT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A uNOTICE OF COMHENCEHENT"~
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />SIGNATURE: CONT~OR
<br />
<br />r,Jt
<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 />, 1SL-
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF .
<br />The foregoing lustrqment was
<br />Before me this ~ay of
<br />by
<br />
<br />ac~nowledged
<br />, 19-:....
<br />
<br />(name of person aoknowledged)
<br />Tt who is p.rsonally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoO did Odid not take an oath.
<br />
<br />(name of person aCknowledg.d)
<br />[1ho is personally known to me, or
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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