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<br />Lvnu~r~WNS OF PERMIT AFFIDAVIT
<br />
<br />A. NOTICJij OF DEJ!lD RJ!lSTRICTIONS
<br />The' und'ersigned understands tqat this permit: may be subject ;,to "deed' restrictions" which
<br />may be more restrictive than City' :r:egulat:iolls. The undersigned assUDles responsibility for
<br />compliance with any applicable deed restt:ictions.
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contt:actoriJ to undertake work, they lIlay bti!l 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 mdsqemeanor
<br />violation under state law. If the owne~ or intended contractor are uncertain as to what
<br />licensing requirements 1I'lilY apply for the intended work, they are advised to contact the
<br />City of Zephyr~ills Building Depart~ent, B13-1B8-66~1.
<br />Furthermore,. if the owner has hired a contractor or:contraotors, he is advised to have the
<br />contractor(s) sign portions of the "Contraotor Sectlons" 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 indioation that he is not properly licensed and is
<br />not entitled to pe~tting pri~ileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT I'Bms AND UTILITY CONNECTION FBBS
<br />D. CONSTRUCTUION LIEN LAII (CHAPTER 113, FLORIDA STATUTE", AS ,>>tENDBD)
<br />'r 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 />bave 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/OWNBR' S AFFIDAVIT
<br />I certify t~atall the information in this application is accurate and that all work will
<br />be ~one in oompliance with allap'plicable laws regulating construotion, 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 oommenoed prior to iSsUance of a pe~t and that
<br />all work will be perfoDned to meet standards of all laws regUlating construotion, City
<br />codes, zoning regulations, and land development regulations in the jurisdiotion. I also
<br />certify that 'I understand that the regulations of other gove~ntal 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 tOI *Department of
<br />Envi~onmental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment ,
<br />*Southwest Wlorlda Water Management Distriot-Wells, Cyp~ess Bayheads, Wetland Areas,
<br />Altering Watercour~es
<br />*Army Corps of J!lngineers-Se.wall.. Dooks, Navigable Waterways
<br />*Department of Health , Rehabilitative SerVices, Bnvironmental Health Unit~Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.8. Bnvironmental Protection AgencY-~bestos abatement
<br />I also certify that, if ;till material is to be \lsed in Flood Zone ~\A" or "A, etc.", it i.
<br />understood that a drainage plan addressin9 a "compensating volume- will be submitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to pe~t
<br />issuanoe. . .
<br />A permit issued shall be construed to be a license to proceed with' the work .nd not a.
<br />authority to violate, oancel, alter, or set aside any provisions of th6 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 violation. of any oode. Bvery,permdt
<br />issued shall beQome invalid Unless the work authorized by Buoh pe~t is oommenc~d ~ithin
<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 commenced. One 90 day extension of ti~e
<br />may be allowed for the per~t with f~e charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspeqtion must be logged during each six
<br />month periOd, or the projeot will be considered abandoned. \ '
<br />WARNING TO OWNER: YOUR FAlIAJRIl TO RECORD A NOTICE 01' CONMBNC_IDIT HAY RESULT IN YOUR
<br />PAYING TWICE WOR IMI?ROVl!lH&NTS TO YOUR' PROPERTY. II!' YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LINDBR OR AN ATTORNEY BBI"OfU!; RBCORDING YOUR NOTICB OF COMHJ!lHCI!IMBHT. JOBS UNDBR
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<br />
<br />.::i;::~~;ro ~OOQD ~B~~
<br />
<br />r'~i
<br />
<br />STATB OJ!' WLORIDAu.
<br />COUNTY 01' t:::.t::l. c,(J (?
<br />The foregoing ins ument wa8jlcknowledged
<br />Befor ' this day of /7/'A/L , ~~
<br />by A c-
<br />,_. Aname of person acknolfledged)
<br />'~o is personally known to me, or
<br />
<br />o who has produced
<br />~type of identification)
<br />~d not take an oath.
<br />
<br />
<br />Name
<br />
<br />STATE 01' FLORIDA ~ '
<br />COUNTY OF ", 5t!JJ
<br />The foregoing instrqment w~'p~nowledged
<br />Before p)his ~ay of /L, a c:::l~,tJOZ
<br />by u~ /~~rr
<br />__ ~name of person acknowledged)
<br />~ is peraonally known to me, or
<br />
<br />
<br />Name t
<br />
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