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<br />CONDI'.','IONS O~ PERMIT AFFIDAVI'r
<br />A. NO'rICE Oil' DlllmD RES'1'RIC::'l'IONS
<br />'l'b.e undersigned understands that tinill pE:rmic may be subject to "deed restrictions" whioh
<br />may be more restrictive than C1ty t'eUlllations. 'l'he undersigned assumes responsibility far
<br />compliance \lith any appli.cable deed [Elstl.ic.~it)nB.
<br />B. UNLICENSED CON'l'RACTORS AND CONTRAC'l'OF. RJ!lSI?ONSIBILI'l'IES
<br />If the o~mer has hired a contractor or cont.-:act.ors to undertake work, they may be required
<br />I to be licensed in acoordance w1th stolte and local regulations. If the contractor 1s not
<br />licensed as required by law, both thE! OWlIer and contractor may be cited for a misdemeanor
<br />violation under state law. If the o\'1I1er or intended contractor are uncertain as to what
<br />liceusing requirements may apply for the intended Hor.k, they are advised to contact the
<br />CHy of Zephyrhills Bu1ld1ng Departme,nt, 013-786-6611.
<br />Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
<br />Gontractor(s) sign portions of the "Contraotor Sections" of this application for wh10h they
<br />will be responsible. If YOll, as the owner signs as the contractor, you are indicating that
<br />you, rather than the contraotor, are responsible for the work. If the oontractor wishes
<br />~'Oll to sign as contractor that may be an indication that he is not properly licensed and is
<br />Hot entitled to permitting privileges in the City of Zephyrhills.
<br />C. 'l'RJ\NSI?OR'l'A'I'ION IMPAC'l' FEES AND U'l'UITY CONNEC'l'ION FEES
<br />D. CONB'l'RUC'l'UION MEN LAW (CHAE"l'ER '713, FLORIDA S'l'ATUTES, AS AMENDEm)
<br />] cert! fy that I, the applicant, have been provicted Hith a copy of "Elorida's Construction
<br />1i~n Law -- Homeowner' IS Protection Guide" prepared by the li'lorida Department of Agricul tllre
<br />and Consllmer Affairs. If the applicant is someone other that the "owner", I cedfy that I
<br />have obtained a copy of the above described ~ocument and promise in good faitll to deliver
<br />it to the "owner" prior to commencement.
<br />E. CON'l'RAC'l'OR' S/OWNER' S AFFIDAVI'1'
<br />I certify that all the information 1n this application is accurate and that all Hark will
<br />be done in compliance with all applioable laws regulating construction, zoning, and land
<br />development.
<br />Applioation is Ilereby made to obtain a permit to do work and installation as j,ndioated. I
<br />certJfy that no work or installation has commenced pripr to iSliuanae of a permit and that
<br />all work Hill be performed to meet standards of all laws regulating oonstruotion, City
<br />codes, zoning regulations, and lalld 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 r~sponeibility 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 Seneitlve
<br />Lands, Water/Wastewal:er 'Preatment
<br />*Bouthwest H'loricta Water Management District-Wella, Cyp.reaa Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-SeaHalls, Docks, Navigable Waterways
<br />*Uepartment of Health & Rehabilitative Services, EnVironmental Health Unit-Wells,
<br />Wal'ltewater 'l'reatment, Septio 'l'anks
<br />*u.S. Environmental Proteotion Agency-Asbestos abatement
<br />]: also certify that, if fill material is to be used in Il'laad Zone "A" or "A, etc. f1, it is
<br />understood that a drainage plan addressing a "compensating volume" will be submttted Vlhich
<br />is prepared IlY a professional engineer reg.ietered in the state of Florida prior to permit
<br />issllance.
<br />A permit issued shall be construed to be a license to proceed with the work i!md not as
<br />autllority to violate, cancel, alter, or set aside any provisions of the technical codee,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />doueation of errors in plaua, construotioJl, or violations of any oode. Every permit
<br />luued shall beoome invalid unleu the work authorized by suoh permit is aonullenced wHldn
<br />liiH month. 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 conunenced. One 90 day eHtension of thlle
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Offioial. An approved inspection must be logged during eacll six
<br />month period, or the projeot will be considered abandoned.
<br />WARNING '1'0 OWNERI YOUR FAII.tJRE TO RECORD A NO'l'ICE OF COMMENCEMEN'l' MAY RESUJ.'l' IN YOUR
<br />PAYING 'I'WICE B'OR IMPROVEMEN'l'S TO YOUR PROPER'l'Y. IF YOU IN'l'END 'I'D DB'I'AIN FINANCING, CONSUL'l'
<br />WITH YOUR I,ENDER OR AN A'I"l'ORNEY BEB'ORE RECORDING YOUR NonCE OF COMMENCEMEN'I'. ,JOBS UNnER
<br />$2,500 IN VAI,UE DO NO'I' NEED '1'0 RECORD AND POB'l' A "NO'l'ICE OF COMMENCEMEN'I'".
<br />
<br />SIGNATURE I OWNER OR AGENT
<br />
<br />SIGNATURE I CONTRACTOR
<br />
<br />-_._-----~...-----
<br />
<br />S'PA'I'E OF H'I,ORIDA
<br />COUN'I'Y OF
<br />'l'he foregoing instrument was
<br />aefore llIe this _____ day of__
<br />by
<br />
<br />acknowledged
<br />, 1~_
<br />
<br />BTA'l'E OF FLORIDA
<br />COUN'I'Y OF
<br />The foregoing instrument was
<br />Before me this _J.iay of
<br />by
<br />
<br />acknowledged
<br />, 19~
<br />
<br />(name of person ackno~-Iledged)
<br />IJ Hho is personally known to me, or
<br />
<br />D~lo has produced
<br />(type
<br />and who!] did Ddid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />(name of person acknowledged)
<br />Qho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identifioation)
<br />and who Ddid DUd not take an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment I
<br />
<br />Name typed, print.;d ~-;tamp~~----
<br />
<br />Name typed, printed or stan~ed
<br />
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