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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that 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 requir~d
<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 misd~ea~o~
<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
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<br />contractor(s) sign portions of the ~Contractor Sections" of this application for which 'they
<br />will be responsible. If you, as the owner signs 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 as contractor that may be 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 STATUTES, AS AMENDED)
<br />I 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 wor~"w+l~
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indicated. -' I
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<br />certify that no work or installation has commenced prior to issuance 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 />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environmental Protection Agency-Asbestos abatement ,
<br />I also certify that, if fill material is to be used in Flood Zone ~A"'or ~A,etc.~: it,:is
<br />understood that a drainage plan addressing a ~compensating volume" will be submitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to 'permit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as,;
<br />authority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />, nor shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any code. Every'. permit , '..
<br />issued shall become invalid unless the work authorized by such permit is commenced within
<br />six months of issuance, or if work authorized by the permit is suspended or abandon~d ~o# 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 $15.00. The extension shall be~equest~d
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING" CONSULT,
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.'JOBS'UNDER
<br />$ , 0 IN E DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENT".
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<br />~~:~yO~FFLORln7.\ !J~..",
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<br />The foregoing inst~ent was acknowle~ged ~)
<br />Befor e t is ay of, . ;<O;J..g ~
<br />by'" ~ '"'i"..".; ',1 "~: j:'t,'i.~
<br />
<br />(name of person ac nowledged)
<br />J&:L.ho is personally known to me, or" '",
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<br />.It<
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<br />STATE OF FLORIDA P
<br />COUNTY OF f ~
<br />The foregoingins~~ent was acknowliiged
<br />Before mEj. this~day Of)~~ . , ~ O~
<br />by tlt\ ~ ~ l U ~",--O--Iz./
<br />(name of person acknowledged)
<br />~who is personally known to me, or
<br />
<br />.
<br />..
<br />
<br />[J who has produced
<br />(type of identification)
<br />and who[J did [J did not take an oath.
<br />
<br />{'J4~ 0\1 (!f;~Jzd~
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<br />Signature of person taking acknowledgement
<br />
<br />..~" Clara l R"'~.."
<br />~*.4vC'Q""'llf;
<br />Name typed, printed~~~,e,<!"s
<br />
<br />[J who has produced
<br />(type of identification)
<br />and who [Jdid [):iid not take an oath'Tl.;
<br />
<br />(1f~ ;A, ~~,.
<br />
<br />Signature of per~on taking acknowledgment
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<br />EipiresAuguat 17. 2003
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