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<br />vV"U~~~~NB OF PERMIT AFFIDAVIT
<br />A. ,NOTIC~ OF DEED RESTRICTIONS
<br />Tho Und~rsignod nuderotondo t~ot thie po_t ".y ho ..uhjoct ,to "dood uotdctiono- which
<br />may be more restrictive than City' ~egulations.. Th." lllndersigned aSSUmes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AND CONTRAcTOR RESI?ONSIBI:t..ITIES
<br />If tho ownor h.. hiud 0 nootroctor or aontron'orO tn nudertoko work, they..y he required
<br />. to be licensed in accordance with state ClOd local reuulations. If the contractor is not
<br />licensed as required by law, both the owner and. contJ[aotor may be oited for a miSdemeanor
<br />violation under state law. If the owne~ or intended contractor are uncertain as to what
<br />licensing requirements may apply for the intended wOl~k, they are advised to contact the
<br />City of Zephyr.tills Building Depart~ent, 813-788-661.l.
<br />Furthermore" if the owner has hired a contractor or'oontractors, he is advised to have the
<br />contractor(s) sign portions of the "Contraotor Seettonsu of this application for which they
<br />wJ,ll be responsible. If you, as the owner signs as t:he 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 indication t:hat he is not properly licensed and is
<br />not entitled to perndtting priVileges in the City of Zephyrhills.
<br />C. 'I'RAN~PORTATION IMPACT .FIES AND UTILITY CONNECTION' FilES
<br />D. CONSTRUCTUION LIEN LAIr (CHAPTER 113, FLORIDA S'i'ATUTEtJ, ABAMBNDIlD)
<br />I certify that I, the applicant, have been provided Idth a copy of "Florida'liI Construction
<br />lien Law - Homeowner's Protection Guide. prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is som.eime other that the "ownerN, 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/mINER' S AFFIDAVIT
<br />I certify t~at ,all the information in this application is accurate and that all work will
<br />be ~one in compliance with allap'plicable laws regUlating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a penmit to do work and installation as indicated. I
<br />cortify thot no work or inotoll.tion h.o oaomonnod prinr to i.ooonco of . poxadt ond th.t
<br />all work will be perfo~ed to meet standards of all laws regUlating const~uction, City
<br />codes, zO~ing regulations. and land development regulations in the jurisdiction. I also
<br />certify that 'I understand that the regulations of other gover;hDlental agencies may apply to
<br />the intended work, and that it is my responsibility to identify what actions r must take to
<br />be in compliance. Such agencies include but are not limited to: *Departblent of
<br />EnVironmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment ,
<br />*Southwest Florida Water Management Distriot-Wells, CypJi:ells Bayheads, Wetland Areas,
<br />Altering Watercour,es
<br />*Army Corps of Bngineera-Seawalls, Docks, Navigable Waterways
<br />*Department of Health , Rehabilitative Services, EnVironmental Health Uni~~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 \lsed in Flood Zone ~'AN or "A, etc.., it is
<br />understood that a drainage plan addressin~ a "compensating volumeN will be submitted which
<br />1s prepared by a prQfessional engineer registered in the State of Florida prior to permit
<br />issuance. , \
<br />A permit issued shall be construed to be a license to prooeed 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 permQt prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any code. BverY.per.mit
<br />issued shall beQome invalid unless the work authorized by such pe~t is commenc~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 time
<br />,may be allowed for the pe~t with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspeQtion must be logge~ during each six
<br />month periOd, or the project will be considered abandoned. \
<br />WARNING TO OWHER: YOUR FAILURII TO RECORD A NOTICE OF COMMBNCIM&NT MAY RESULT IN YOUR
<br />PAYING TWICE I'OR IKI?ROVEMafTS '1'0 YOUR' PROPERTY. II!' YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LBHDIR OR AN ATTORNEY BII'OJU; RECORDING YOUR NOTICE 01' COMMBNCIHINT. JOBS UNDBR
<br />$2,500 IN VALUE DO NOT NEED TO RICORD AND POST A "NOTICE OF COMMENCEMENT"'.
<br />
<br />. SIGNATURE. OWNER OR AGENT
<br />
<br />)(
<br />
<br />,
<br />SIGHATURIl: CONTRAcTOR
<br />
<br />r.f~
<br />
<br />STATE OJ!' B'LORlDA
<br />COUNTY or .
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by
<br />
<br />acknowledged
<br />, 1 !l...-
<br />
<br />STATE or FLORIDA
<br />COUNTY OF .
<br />The foregoing Instr~nt was ac~nowledged
<br />Before me this ~ay of , 19..:..:....
<br />by
<br />(name of person acknowledged)
<br />[1ho is personally known to me, or
<br />
<br />(name of person .ckno~ledged)
<br />'0 who is per.sonally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoOdid 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 />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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