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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A~ ,NOT~CE OF DEED RESTRICTIONS
<br />The undersigned understanQs that this permit may be subject to ~deeQ 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 />r~ 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 citeQ 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 SectionsH 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 Zephyrh111s.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAE'TER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provideQ with a copy of ~Florida's Construction
<br />lien Law - Homeowner's Protection GuideN prepared by the Florida Department of Agriculture
<br />and Consumer Affa~r*. If the applicant is someone other that the ~ownerH, I cerif~ that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the ~ownerH prior to commencement.
<br />E. CONTRACTOR' S/OWNER' 5 AFFIDAVI:T
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />deV'elopment.
<br />Application is hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no work or installation has commenced prior to issuance of a permit and that
<br />all ~ork 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 li~ted tOt *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 />*Ar.my Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Deparbment of Health & Rehabilitative Services, Environmenta~ 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 ~AH Or ~A,etc.H, it is
<br />understood that a drainage plan addressing a "compensating volumeh will be submitted which
<br />is prepared by a professional engineer registered ih the State of Florida p~ior 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 per~t
<br />issued shall become inva~id unless the work authorized by sueh permit is commenced ~thin
<br />si& 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 permit with fee charge of $15.00. The extension shall be requested
<br />in ~rit~ng 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 CO:MMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTA!N FINANCING, CONSULT
<br />WITH YOUR LENDER OR. AN ATTORNEY BE!"ORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A ~NOTICE OF COMMENCEMENTH.
<br />
<br />
<br />~J1l ~/
<br />
<br />SIGNAT E: OWNER 0 AGENT SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing i7~trument was acknowledged
<br />Before me this M day of Au 9 . ~....Q?t1D~
<br />by l1J j , J I A-m ;:::;. tV)/ p_
<br />(name of person acknowledqed)
<br />~ho is personally known to me, or
<br />
<br />0tSrl-D
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this day of
<br />by
<br />
<br />acknowledged
<br />, 19......:..-
<br />
<br />o who has produced
<br />(type of identi!ication)
<br />'d not take an oath.
<br />
<br />(name of person acknowledged)
<br />[1ho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and who Ddid [}::lid not take an oath
<br />
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name ,~~~, pri%~ eS.mAhamped
<br />i:~'J:i/?;\ MY COMMISSION' CC773960 EXPIRES
<br />;'~"~':Q'E September 9. 2002
<br />'1~;;"v(?id BO~lill1R\J tl!~ FAIN MUlANCf. IIlC.
<br />'li"'I" v V ~ (, v l~ .
<br />
<br />Name typed, printed or stamped
<br />
<br />SllIH~AHd3Z jO A1IO
<br />
<br />~V90:8 lOOl '9 '2nV
<br />
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