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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A~ NOT~CZ OF DEED RESTRICTIONS ,
<br />The undersigned understands that this pe~t may be subject to ~d.ed restrictions" which
<br />may be more re.tr~ctive than C1ty regulat1ob.. The under.igned a..wmeB responsibility for
<br />oompliance with any applicable d.ed restrictions.
<br />B. UNLICENSED CONT~CTORS AND OONT~CTOR RESPONSIBILITIES
<br />If the owner ha. hired a contractor or contractors to undertake work. they may be required
<br />to be l!censed in accordance with state and local regulations. If th~ contractor is not
<br />licen..d as required by 1aw, .both the owner and contractor may be cited for a misdemeanor
<br />violation under state llW.. .It the owner or 1ntended contractor are uncertain as to what
<br />licensing requirements mat apply tor the intended work, they are advised to contact the
<br />'City of Zephyrhills Building Department, 813-788-6611.
<br />Furthermore, if the owner has h1red a contractor or contractors, he is advised to have the
<br />contractor(s) 8ign portions of the ~Contractor Sections" of this application for which they
<br />will be responsible. If you, as the owner signa 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 .s contractor that may be an ind1cation that he is not properly licensed and ie
<br />not entitled to pe~ttinq privileges 1n the city ot Zephyrh11ls.
<br />C. TRANSPORTATION IMPACT Ji'EES.JrnD UTILI'1'Y CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTBR 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been prOVided with a copy of "Florida's Construction
<br />lien Law - Homeowner'. Protection Gu1deN prepared by the Flori~a Department o~ Agriculture
<br />and Consumer Affairs. If the applicant Ie someone other that the ~ownern, I cerify that I
<br />have obtained a copy or the above described Qocument and pr~8e 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 infor.mat1on in this application is accurate and that all work wil1
<br />be done in co~li.nce with all applicable laws regulatinq construction, ~oning, and land
<br />development.
<br />Application Is hereby made to obtain a perm1t to do work and installation as indicated. I
<br />cert1fy that no work or installation has co~ced prior to issuance of a permit and that
<br />all work will be perfo~ed to meet standarda of all laws regulating construction, city
<br />cod.., 'zoning regulations, and 1and developmant regulations in the jurisd1ct1on. I also
<br />certify that 'I understand that the regulations of other governmental agencies may apply to
<br />the intended wo~k, and that it 18 my respo~1bility to identify what actions I must take to
<br />be in complianc@. Such agencie. include but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland ~eas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Southw..t Florida Water M.n.g~ent Distriot-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*A%my Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health , Rehabilitative Services, Environmental Health Unit-Wella,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environmental Protection Agency-Asbestos abatement
<br />I also oertify that, if fill material is to be used in Flood Zone "A" or ~A,etc.", it is
<br />understood that a drainaqe plan addressing a "compensating volume" will be submitted which
<br />is prepared by a protessional engipe.r registered in the St.~e of Florida prior toper.mit
<br />issuance.
<br />A per.Mit issued shall be construed to be a license to proceed with the work and not as
<br />authority to violate" canoel, alter, o~ set aside any provisions of the teohnical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring 8
<br />co~rectlon of .r~ors in plans, construction, or violations of any code. Every permit
<br />issued shall become invalid unle.s the work authorized by such p.~t is c~nced within
<br />six months of issuance, or if work authorized by the permit 1s suspended or abandoned for a
<br />period of six months atter the time the work 1. commenced. One 90 day extension of t1me
<br />may be allowed for the permit with fe. charge of $15.00. The extension shall be requested
<br />in writing to the Building Otfic1al. An ~pprov.d 1nspection must be logged during each six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNBR: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND '1'0 OBTAIN FINANCING, CONSUL'!'
<br />WITll YOUR LINDER OR AN ATTORNEY BlCrolU!: RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE 00 NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEHENTh.
<br />
<br />SIGNATURE I OWNER OR. AGENT
<br />
<br />j)! ~ K;d, ~
<br />SIGNATURE: CON'l'MC'l'OR
<br />
<br />a cknowledqed
<br />; 1!L-
<br />
<br />STATE OF FLORIDA ,. l. I
<br />COUNTY OF /VIA 11.<1, -(:'] m..c1'
<br />The foregoing instrument wa~' ck
<br />Before me this ~ da <>f' '
<br />by
<br />
<br />
<br />owl edged
<br />~~.;;
<br />
<br />'\
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this day of
<br />by
<br />
<br />(name of person ackno~ledged)
<br />o who is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoDdid Ddid not take an oath.
<br />
<br />(name of person acknowledged)
<br />Chho is personally known to me, Q~
<br />
<br />'mwho has produce?:~/'?I"l~.i~L( liLl,,j~l~i/-"';"
<br />~ (type of i @ntificat10nl
<br />and who 0 did
<br />
<br />
<br />t
<br />
<br />
<br />~ \': "
<br />
<br />tak1nq acknowledgement
<br />
<br />Slgnatu~e,of pe
<br />
<br />(h J,~ L/YlJ. L~ l1i ,J
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