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<br />',AJJW.1.',I:J.l:JfII5 OF PERMIT AFFIDAVIT
<br />A. NOTICB; OF DEED RESTRICTIONS
<br />The und'ersigned underatands t~at thin pe,rmi.1: may be Subject :,to "deed' restrictions" which
<br />may "be more restrictive than City' ~euulat:ions. The undersigned assumes responsibility for
<br />cOblpliance with any applicable deed J:estdct:ions.
<br />B. UNLICENSED CONTRACTORS AND CONTRAcTOlR RESPONSISII.ITII!:S
<br />If the owner has hired a contractor or cont:r:actors to undertake work, they lIlay be required
<br />,to be licensed in accordance with Stelte Rnd local regulations. If the contraator is not
<br />licensed as required by law, both thE. owner and contraotor inay be oited for a misdem.anor
<br />violation under state law. If the o~me~ 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, 813-788-661,1.
<br />Furthermore,. if the owner has hired a oontractor or'contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contraotor Sections" of this applioation for which they
<br />w~ll be responsible. If you, as the owner signs as the oontr~otor, you are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor wishes
<br />you to sign aa contractor that may be an indioati~n that he i. not properly lioensed and 1.
<br />not entitled to pe~tting priyileges in the City of Zephyrhills.
<br />C. TRAN~PORTATION IMPACT, FBES AND UTILITY CONNECTION FBES
<br />D. CONBTRUCTUION LIEN LAJf (CHAPTER 113, FLORIDA STATUTBII, AS ,AttENDI!lD)
<br />I oertify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Pr~teotion Guide" prepared by the Florida Department of Agrioulture
<br />and Consumer Affairs. If the applioant is someone other that the "owner", I cerify that I
<br />bave obtained a copy of the above described dooument and promise in good faith to deliver
<br />it to the "ownerH prior to commenoement.
<br />E. CONTRACTOR' a/OWNER' a AFFIDAVIT
<br />I oertify t~at ,all the information in this application is accurate and that all work will
<br />be ~one in complianoe with all ap'plioable law. regUlating oonstruction, Z9ning, and land
<br />development.
<br />Applioation is hereby made to obtain a penmtt to do work and installation as indiaated. I
<br />oertify that no work or installation ha. oommenoed prior to iSSUance of a permit 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 gover~ental 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 oompliance. Suoh agencies include but are not limited tOI *Depart~ent of
<br />Environmental RegUlation-Cypress Bayheads. Wetland Area. and Environmentally Sensitive
<br />Lands. Water/Wastewater Treatment ,
<br />*Bouthwest Florida Water Management Distriot-Wells, Cyp~ess Bayheads, Wetland Areas,
<br />Altering Wateroour~es
<br />*Army Corps of Bngineers-Seawalls. Docks, Navigable Waterways
<br />*Department of Health , Rehabilitative Servioes, EnVironmental Health Uni~-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.8. Environmental Proteotion Agenoy-~be.tos abatement
<br />I also certify that, if till material is to be used in Flood Zone ~A" or "A,etc.H, it is
<br />understood that a drainage plan addressin~ a "compensating volumeN will be submitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to penmit
<br />issuanoe.
<br />A permdt issued shall be construed to be a lioen.e to proceed with' the work and not as
<br />authority to violate, canoel, alter, or set aside any provisions of the technioal aodes,
<br />nor ahall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, oonstruotion, or violation. of any oode. Ivery ,permit
<br />issued shall beQome invalid unless the work authorized by suoh permit is aoameno~d within
<br />six months of is.uance, or if' work authorized by the penmtt is SUspended or abandoned for a
<br />period of six ~nths after the time the work is oommenoed. One 90 day extension of ti~
<br />may be allowed for the pe~t with fee aharge of $15.00. The extension shall b. requested
<br />in writing to the Building Official. An approved inspeqtion must be logged during each six
<br />month period, or t~e projeot will be considered abandoned. \ '
<br />WARNING TO OWNER I YOUR FAIWRI: TO RECORD A NOTICE 01' COMMBNc~NT MAY RBSULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMBNTS TO YOUR'PROPBRTY. IF YOU INTBND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LINDI!lR OR I\N ATTORNEY BBFOJ\& RBCORDING YOUR NOTICJ!\ OF COMMBNCIMBNT. JOB5 UNDBR
<br />$2,500 IN VALUE DO NOT NEED TO RICaRD AND POST A "NOTICE or COMMINCI!'.MBNTN.
<br />
<br />SIGNATURE I OWNBR OR AGEN'!'
<br />
<br />~ '~/~
<br />51 , Rml CONT OR / '
<br />
<br />r,~~
<br />
<br />STATE OJ!' J!'LORIDA
<br />COUNTY OF
<br />The foregoing instrument wa.
<br />Before me this _ day of
<br />by
<br />
<br />(name of person ackno~ledged)
<br />'0 who is personally known to me, or
<br />
<br />acknowledged
<br />, 1!L.-
<br />
<br />STATB OF FLORIDA
<br />COUNTY 01' ,
<br />The foregoing instrqment was aoknowledged
<br />Betore me this ~ay of , 19 ~
<br />by
<br />(name of person aOknowledged)
<br />[1ho is persona11y known to me, or
<br />
<br />o who has produoed
<br />(type of identification)
<br />and whoO did Odid not take an oath.
<br />
<br />o who' has produce~
<br />, (type of identifioation)
<br />and who Odid [}lid not take an oath,
<br />
<br />Signature of person taking acknow1edgement
<br />
<br />Signatu~e of person taking aoknowledgment
<br />
<br />Name typed. printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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