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<br />~UNUITI0NS OF PERMIT AFFIDAVIT
<br />A. NOTIC~ OF DBBD RESTRICTIONS
<br />The und~rsigned understands t~at this permit may be subject:,to ~deed restrictions" which
<br />may 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 contractor 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 Department, 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 Sect!ons" 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 he an indication that he is not properly licensed and is
<br />not entitled to perMitting privileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTEtI, ASAHENDED)
<br />.1 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 information in this application is accurate and that all work will
<br />be done in compliance with allap'plicable laws regUlating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indioated. I
<br />certify that no work or installation has oommenoed prior to issuanoe of a perMit and that
<br />all work will be performed to meet standards of all laws regUlating construction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br />certify that 'I understand that the regulations of other governmental 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 to: *Department of
<br />Environmental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*S.outhwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Dooks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmental Health Unit~Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.s. Environmental Proteotion 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 drainage plan addressin~ a ucompensating volume" will be submitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to penmit
<br />issuanoe.
<br />A permit issued shall be construed to be a license to proceed with' the work ~nd not as
<br />authority to violate, cancel, alter, or set aside any provisions of the teohnical 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 code. Everyper:mit
<br />issued shall become invalid unless the work authorized by suoh per:mit is commenced within
<br />six months of issuance, or if'work authorized by the penmit is suspended or abandoned for a
<br />period of six months after the time the work Is commenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered abandoned. '
<br />WARNING TO OWNER I YOUR FAILURJ: TO RECORD 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 LINDER OR AN ATTORNEY BEro~ RECORDING YOUR NOTICE OF COMMENCI!IMBNT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE Of COMMENCEMENT".
<br />
<br />
<br />.(!l~2:Z-;;;& Sl2;L~~2l~
<br />
<br />STATE Of FLORIDA b" r ~
<br />COUNTY 01' en:..:> v 0 .
<br />The foregoing instrument was acknowledged
<br />Before me this~day of 1Vl1J.'I , ~2-
<br />by Q.s:~ f?&:-/ZIZ
<br />, (name of person aoknowledged)
<br />'~o is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoO did QdtQ not take an oath.
<br />
<br />~ A - f1d;~
<br />.
<br />Signature of person taking acknowledgement
<br />
<br />f3{U/G.f' f). f+5!SE L
<br />
<br />Name typed, printed or stamped
<br />8nJC8AAsbel '
<br />11 .... Commission CC748677
<br />* *"" 2002.
<br />:,I Expires June 22.
<br />'\;..'" ,.- . . ...
<br />
<br />STATE 01' rLORID~A Cc .
<br />COUNTY OF ., -> 0_
<br />The foregoing instr~ent was a~nowledged
<br />Before me this LJay of fVlfJ. { , _2a1z.
<br />by &;~G REc;pr--
<br />(name of person acknowledged)
<br />~ is personally known to me, or
<br />
<br />r,")
<br />
<br />o who' has produced
<br />, itYPe of identification)
<br />and who Ddid 8fid not take an oath
<br />
<br />.~ A. U-d2
<br />
<br />Signatu~e of person taking acknowledgment
<br />
<br />Name
<br />
<br />.13'WG~ A. f} S/)E L
<br />typed, printed o~lstamped
<br />.. 8nJC8AAS
<br />"b' My commission CC748611
<br />\...l Exl"res Jun~~~~2002
<br />
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