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<br />cmlDI':'.'IONS 0:: PERMIT A::FIDAVI'J'
<br />A. NOnCE OF DEED RES'l'RICTIONS
<br />Th~ undersigned understands thijt thi~ parmit may be subject to "deed restrictionsH which
<br />m~y be more restrictive than City regulations. The undersigned assumes responsibility for
<br />oonlplicmoe with any applicable deedrest:l:ictL:JlH;.
<br />B. UNLICENSED CON'l'RAC'l'ORS AND CONl'RAC'l'OR RESP~)NS LBII,II'IE:S
<br />If the owner lias hired a contr~ctor or contractora to u~dertake work, they may be required
<br />to be licensed in ~ccordaIlce with sti~te and L:lC<t] reglll,:itiuns. If the (lontractor is lIot
<br />licensed as required by law, both lh,= ovmer and contrOlctor may be cited for a ndademeanor
<br />violation under state law. If the owner or intended contractor are uncertain as to wllat
<br />licensing requirements may apply for the intE:lnded work, they are advised to contact the
<br />City of Zephyrhills Building Department, 613-768-6611.
<br />Furtllermore, if the owner has hired a contractor or contractors, he is advised to hav~ the
<br />contraotor(s) sign portions of the "Contractor SectionsH of this application for which they
<br />will be responsible. If you, as the owner signs IS tile oontractor, YQY are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor wislles
<br />you to sign as contractor that may be an indication that he is not properly lioensed and is
<br />not entitled to permitting privil~ges in the City of Zephyrhills.
<br />C. 'I'RANSPOR'l'ATION IMPACT FEES AND U'l'ILI'I'Y CONNECTION FEES
<br />D. CONB'l'RUc'rUION LIEN LAW (CHAP'l'ER '713, E'l,ORIDA STATUTES, AS AMENDED)
<br />r certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection GuideH prepared by the Florida Department of Agriculture
<br />and Consumer Affail:'s. If the appliciant is someone other that the "owner", I cerify that I
<br />have obtained a copy of the above described document and promise in good faitll to deliver
<br />it to the "owner" prior to cOlTunencement.
<br />E, CONTRAC'l'OR' a/OWNER'S AFli'lDAVI'l'
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance with all appli_cable laws regulati.ng construction, zoning, and land
<br />devljllopment.
<br />Application is hereby made to obtain a permtt to do work and installation as indioattild. I
<br />ce~tify that no vwrk or installation has commenced prior to iaauance of a permit and that
<br />all work will be performed to meet standards of all laws regulating construotion, City
<br />codes, ~oninQ regulations, and land development regulations in the jurisdiction. I also
<br />certify that I understand that th~ regulations of other governmental agencies may apply to
<br />the intended work, and that it is my reaponalbility to identify what aotiona I must take to
<br />be in compliance. Such agencies inolude but are not limited tOI *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and J!:nvironmentally SensJ.tive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, 'Cypress Bayheadfi, Wetland Areas,
<br />Alteri.ng Wateroourses
<br />"'ArlilY Corps of Engineers-SeawCllls, Docks, Navigable WaterHays
<br />*Uepartu~nt of Health & Rehabilitative Services, Environmental Healtll 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 qA" or "A,ete.H, it is
<br />understood that a drai.nage plan addressing a "compensating volume" "will be submitted Hhich
<br />is prepared by a professional engineer registered in the State of florida prior to permit
<br />iasuance.
<br />A permit issued ahall be construed to be a license to proceed with the work and not as
<br />authority to violate, cancel, alte:t:, or set aside any provisions of the technioal codes,
<br />nor shall issuallce of a permit prevent the Building Official from thereafter requiring a
<br />correotion of errors in plans, con~truction, or vio~~tiona of any Dode. every p@twit
<br />i/iiaued /iihall become invalid unless the work authodzed by suoh permit is oOllullenoed within
<br />six'month/ii of issuance, or if \vork authorized by the permit is suspended or abandol1tild for a
<br />period of eix months after the time the work is commenced. One 90 day eKtenaion of time
<br />may be allowed for the permit with fee charge of $15.00. The extension ~hall be requea~ed
<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 'fO RECORD A NO'nCE Ob' COMMENCEMENT MAY RESUL'I' IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF you INTEND TO OBTAIN FINANqINq, ~QN'ULT
<br />W!'l'H YOUR LENDER OR AN A'l"l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'l'. JOBS UNDER
<br />.2,500 IN VALUE UO NOT NEED TO RECORD AND pas" A "NOTICE OF COMM~~~N'r" /
<br />
<br />,:#----~
<br />
<br />S~TUREI OWNER OR AGENT SIGNA~'UREI CONTRhCTOR
<br />
<br />acknowledged
<br />,19_
<br />
<br />STA'l'E OF FLORIDA
<br />COUNTY OF
<br />The foregoin9 instrument W~/ii aoknowledged
<br />Before me this -----5.iay of---, 19.....:._
<br />by
<br />(name of person acknowledged)
<br />Qho is personally known to me, or
<br />
<br />Owllo has produced
<br />(type of identification)
<br />and Vlho Odid DUd not t.ake an oath
<br />
<br />fj'rA'rJ!; mf FLORIDA
<br />COUN'rY OF
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by~
<br />
<br />(name of person aoknoWledged)
<br />Owho is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and who[] did Odid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking aoknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or. stamped
<br />
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