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<br />LVnV~I~~NB OF PE~IT AFFIDAVIT
<br />A. NOTIC~ OF DEED RESTRICTIONS
<br />The Undecsigned undecotande t~ot thh penolt may he .ubjeat ,.to "deed. cooteiation.- whiah
<br />...y he ,,",ce ce.tciathe then cttYcegulotion.. The undecsi9ned ee._e ceeponsibility Loc
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AND CONTRAcToR RESPONSIBILITIES
<br />If the ownec ho. hiced e aontc.atoc oc contceatoco to undect.ke wock, they..y be cequiced
<br />to be licensed in accordance with state and local regulations. If the contraotor is not
<br />licensad as required by law, both the owner and contraotor may be cited for a mdsdemaanor
<br />violation under state law. If the owne~ or intended contractor are unoertain as to what
<br />licensing requirements may apply for the intended work~ they are advised to contact the
<br />City of Zephyr~ills BUilding Depart~ent, 813-788-6611.
<br />Furthermore,. if the owner has hired a contraotor or:contraotors, he is advised to have the
<br />aontceatoceol oign poction. oL tbe "eontc.ator .ectio..- of this .ppliaotion for whiab th.y
<br />will be ...ponsible. U you, as th.. ownec sign. as the contr.ator, you ..e india.ting thot
<br />you, rather than the contractor, are responsible for the work. If the oontractor wishes
<br />you to sign as contractor that may be an indioati~n that he is not properly licensed and is
<br />not entitled to permitting priyileges in the City of Zephyrhills.
<br />C. TRAH~PORTATION IMPACT FEES AND UTILITY CONNECTION FIIBS
<br />D. CONSTRUCTUION LIEN L1Uf (CHAPTB:R 713, FLORIDA S'rATUTE~, AS ,AtfJ!lHDED)
<br />I certify that I, the applioant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Pr~tection Guiden 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' SimmER'S AFFIDAVIT
<br />I certify t~atall the information in thia application is accurate and that all work will
<br />be ~one in compliance with allap'plicable laws regUlating oonstruction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indioated. I
<br />aertify thof no wock oc in.tallotion ho. oaomenced prior to i..u.noe of a permit and thot
<br />all work will be perfo~ed to meet standards of all laws regulating construction, City
<br />codes, ZO~ing regulations, and land development regulations in the jurisdiotion. I also
<br />certify that "I understand that the regulations of other goverpmental 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. Suoh agencies include but are not limited tOI *Department of
<br />EnVironmental RegUlation-Cypress Bayheads, Wetlend Areas and Environmentally Sensitive
<br />Lends. Water/Wastewater Treatment .
<br />*S.outhwest Florida Water Management District-Wella, CypEess Bayheads, Wetland Areas,
<br />Altering Watercour~es
<br />*Army Corps of Bngineers-Seawa11s. DOCks, NaVigable Waterways
<br />*Department of Health , Rehabilitative Servioes, Environmental Health Unik~Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.s. Environmental Protection AgencY-~bestos abatement
<br />I also certify that, if till material is to be l1sed in Flood Zone ~\An or "A, etc. n, it is
<br />understood that a drainage plan addressin~ a "compensating volumeN will be submitted which
<br />is prepared by a prQfessional engineer registered in the State of Florida pricr to perQdt
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with' the work I!md not as
<br />authority to violate, cancel, alter, or set aside any prOVisions of the technical oodes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construction, o~ violation. of any oode. avery.per.mit
<br />issued shall beQome invalid unless the work authorized by suoh permit is OOmmenc~d within
<br />six month. of i..uanoe, or if' work authorized by the permit is SUspended or abandoned for a
<br />period of six months after the time the work is oommenoed. One 90 day extension of time
<br />may be allowed for the pe~t with f~e oharge 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 t~e project will be considered abandoned. \ '
<br />WARNING TO OWNER: YOUR FAILURil TO RECORD A NOTICE 01' COMMJ!lNC~NT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR'PROPBRTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LINDER OR AN ATTORHI!:Y BEFOJU: RECORDING YOUR NOTIC1!i OF COMMI:HCI!IMENT. JOBS UNDI!iR
<br />$2,500 IN VALUE DO NOT NEBD TO RECORD AND POST A "NOTICE 01' COMMENCEMENT"'.
<br />
<br />. SIGNATURE. OWNBR OR AGEN'!'
<br />
<br />SIGNATURZ. CONTRAcTOR
<br />
<br />_r1~~
<br />
<br />STATB or FLORIDA
<br />COUNTY OF
<br />The foregoing instrument Was
<br />Before me this _ day ot
<br />by
<br />
<br />(name of person acknolfledged)
<br />'q who is personally known to me, or
<br />
<br />acknowledged
<br />, 1!l.-
<br />
<br />STATE 01' FLORIDA
<br />COUNTY OF .
<br />The foregOing instr~nt was
<br />Betore me this ~ay of
<br />by
<br />
<br />acknOWledged
<br />, 19~
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoO did Ddid not take an oath.
<br />
<br />(name of person acknowledged)
<br />[J,ho is persone11y known to ae. or
<br />
<br />o who' has produoe~
<br />. (type of identification)
<br />and who Ddid OUd not take im oath.
<br />
<br />Signature of person taking ecknowledgement
<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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