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<br />CONDY'J'IONS OF PERMIT AFF'IDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />"rile understgned understands that LILLa penni\: may he slIbject to "deed restrictions" \<Ih1ch
<br />may be mor.e r.estrictive than City t'eglllations. The undersigned assumes respollsibJ lity for
<br />compliance Hi th any applicable deedr:esh:ictions.
<br />B. UNI,ICENSED CON'l'R1\CTORS AND CONTHl\CTOR RES E'UIISISIl,I'['IES
<br />If the OHl1er has hired a contractor or contractors to ulldertake work, they may be reqlltred
<br />to be licensed in accordance vilt!) state and Incal l:egulatJoIlS. If the contractor is not
<br />lJcensed as reql11red by laH, both the Ol-mel:' and contractor may be cJ ted for a misdemeanor
<br />violation under state laH. If the CHmer or intended contractor are 1I1lcertaln as to what
<br />licensing requirements may apply fo!: the intended \vork, they are advised to contact the
<br />City of Zephyrldlls Bul1dlng Department, 013-788-6611.
<br />F'urtherlllore, if the oHnet' has hired a contractor or contractors, he is advised to have the
<br />contractor (s) sign pOl-'tions of the "Contractor Sections" of this app,U,cation for Hhich they
<br />Hill be responsible. If you, as the owner signs as tIle contractor, you are indicating that
<br />you, rather than the contractor/ are responsible for the'vlOtlc. If the contractor wishes
<br />you 1:0 sign as contractor that may be an indicati.on that he is not properly licensed and 1s
<br />lIot entitled to permitting privileges in the City of Zephyrhills.
<br />C. 'l'RANBPOR'l'A'rTON IMPAC'l' FEES AND U'l'ILITY CONNECTION FEES
<br />D. CONSrrRUC'l'UION LIEN LAW (CHAP'l'ER '713, FI,ORIDA Srl'A'l'UTES, AS AMH'.NDED)
<br />1 certify that I, the applicant, have been provided Hith a copy of "Ji'lod,da's Construction
<br />I ien Law - Homeowner's Protection Guide" prepared by the ff'lorida Department of Agricul t\lre
<br />and Cons\lmer Affairs. If the applicant is someone other that the "owner", I carify that I
<br />have obtaJnecl a copy of the above described doc\lment and promise in good faith to deliver
<br />it to the "owner" prior to conunencement.
<br />E:. CON'l'HAC'['OR' S/OWNER' S AFF'IDAVl'l'
<br />1 certify that all the information in this application is accurate and that all Hork vJ11.1
<br />be done in compliance with all appllcable laws regulating construction, zonJng, and land
<br />development.
<br />Appl.lcatJ on .is hel:eby made to obtaJn a permit to do work and installation as indicated. I
<br />cert:Jfy that no Hork or installation has conunenced pr.lor to issuance of a permit:. and that:
<br />all work wlI1 be performed to meet standards of all laws regulating oonstruotJon, City
<br />codes, zoning regulations, and land development regulations in the jurisd.1.ctJon. I alsn
<br />ae.rt i ty that I understand that the regulations of other governmental. agencies may apply to
<br />the intended work, and that lt is my responsibility to identify \'Ihat act.lons I must take 1:0
<br />be in cOlnp.llance. Such agencies include but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Envlronrnentally Sensit.lve
<br />I,allds, Water'lWastewal:er '['reatment
<br />*Southwest FJorida Water ManagemeIlt DJstr1ct-Wells, Cypress Bayheads, Wetland Areas,
<br />Alted,ng Watercourses
<br />*Army Corps of Engineers-BeaHalls, Docks, Nav1gable Waterways
<br />*Ilepartment: of Health & RehabilJtative Services, Environmental Health Unlt-Wells,
<br />Wastewater 'l'reatment, Septlc Tanks
<br />"'u.S. Environmental Protection Agency-ASbestos abatement
<br />I also certify that, Jf 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" \<1111 be submitted Vlhlch
<br />Js prepared ))y a professional engineer registered in the State of FlorJda prlor to permit
<br />issuance.
<br />A permit lssued shall be construed to be a license to proceed Hith the Hark and not as
<br />authority to violate, cancel, aiter, or set aside any provisions of the technical codes,
<br />nor shall iss\lance of a permit prevent the 8uJlding Official from thereafter requJr.ing a
<br />correcU,on 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 Hithin
<br />silt months of issuance, or if \'1ork authorized by the permJt is suspended or abandoned for a
<br />period of six mouths after the time the work is conunenced. One 90 day extension of time
<br />may be allowed for tile permit Hith fee charge of $15.00. The extension shall be requested
<br />ill \<Iriting to the Building Official. An approved inspection must be logged dud ng each a1),
<br />mouth per-lod, Dr the project wlll be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR FAII.URE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RIr.SlJIiI' HI YOUR
<br />P1\YING TWICE IroR IMPROVEMENTS '1'0 YOUR PROPER'ry. IE' YOU IH1'END TO ORr1'AIN FINANCING, CONSUI.'I'
<br />WITH YOUR LENDER OR AN A'l''l'ORNEY BEFORE, RECORDING YOUR NO'l'ICE OF COMMENCEMEH'l'. ,fOBfl UNDER
<br />$2,500 IN VALUE DO NOrl' NEED '1'0 RECORD AND POST A "NO'l'ICE OF COMMENCEMEN'l'".
<br />
<br />SIGNATURE: OWNER OR AGH'.NT
<br />
<br />SIGNA'1'URE: CONTRAC'l'OR
<br />
<br />S'lWl'E OF Fr,ORIDA
<br />COUNTY OF'
<br />'J'he foregoing lnstrument Has acknowledged
<br />Before me this _____,_ day of_______, l~_
<br />by ______
<br />(name of person acknowledged)
<br />[J who is personally known to me, or
<br />
<br />STA'l'E: OF FLORIDA
<br />COUN'I'Y OF '_______
<br />The foregoing illstrmnent Has acknowledged
<br />Before me this __>.slay of--------, 19
<br />by
<br />(name of person acknowledged)
<br />[1ho 1s personally known to me, or
<br />
<br />[] Hha has produced
<br />(type
<br />and Hho[] c:!ld []dJd not
<br />
<br />[] who has produced___
<br />(type of jdentification)
<br />and who Ddid ClUe:! not talce an oath
<br />
<br />of identification)
<br />take an oath.
<br />
<br />~_.._-----_._---~.-._.~~---,----------------
<br />
<br />Signature of person taking acknowledgement
<br />
<br />-~_._._------------------------
<br />
<br />Signature of person taking acknoHledgment'
<br />
<br />-~._- -..-._______~__~4_____.______~___._._...________.~____..
<br />
<br />Name typed, printed 01: stamped
<br />
<br />Name typed, pr~nted or
<br />
<br />stamped
<br />
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