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<br />COND.I'rIONS OF PERNI'r AFFIDAVIT
<br />A.. NO'fICE OF DEED RES'1'RIC'fIONS
<br />'1'he undersigned understands thqt this permit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. TIle undersigned assumes responsibility for
<br />con~liance with any applicable deed restrictions.
<br />B. UNI"ICENSED CONTRAC'l'ORS AND CONTRACTOR RESPONSIBII.I'1'IES
<br />If the owner lias 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 Ilot
<br />licensed as required by law, both the omler and contractor may be cited for a misdemeanor
<br />v~olation under state law. If the owner or intended contractor are uncertain as to wllat
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />City of Zephydlills Building Department, 813-768-6611.
<br />Ifurthennore, if the owner has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application for whiell they
<br />will be responsible, If you, as Ule owner signs as the contractor, YQ4 are indicating that
<br />you, l'ather than the contractor, are responsible for the wOl:.'k. 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 privil~ges in the City of Zephyrhills.
<br />C. 'l'RANSPOR'l'ATION IMPACT t~EES AND UTILITY CONNECTION FEES
<br />D. CONS'fRuc'rUION LIEN L.A\tl (CHAP'l'ER 713, FLORIDA s'rATUTES, AS AMENDED)
<br />r certify that I, the applioant, have been provided with a copy of "Florida's Constrllction
<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 "oHner", 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 COllUllencement.
<br />E. CONTRAC'l'OR' a/OWNER'S AFFIDAVIT
<br />I certify that all the information in this application is accurate and tllat all work will
<br />be done in compliance with all appU.cable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indiaated. 1
<br />ce~tify that no Hark 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 construotion, City
<br />codes, zoning regulations, and land development regulations in the jllrisdiction. 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 Bensttive
<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 IJnit-Wells,
<br />WasteHater Treatment, Septic Tanks
<br />*u.S. Environmental I?rotection Agency-Asbestos abatement
<br />1 also certify that, if fill material is to be used in Flood Zone ~A" or "A,etc.H, it is
<br />unde.t:stood that a drai.nage plan addressing a "compensating volume" 'will be subrni tted 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 li.cense to proceed with the work and not as
<br />authority to violate, cancel, alter:, or set aside any provisi.ons 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, con~truction, or violations of any oode. Every pe!mit
<br />is~u~d ahall beoome invalid unless thel work authorized by liuch permit is oommenced within
<br />six months of issuance, or if work authorized by the permit is suspended or abandoij@d tor a
<br />period of ai.l{ months after the - time the work is conunenced. One gO day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be requested
<br />ill wri ting to the Building Official. An approved inspection must be logged during each ldx
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE 'fO RECORD A NOTICE OF COMMENCEMEN'I' MAY RESUt'l' IN YOUR
<br />PAYING 'l'WICE FOR IMPROVEMENTS TO YOUR PROPER'ry. IF YOU INTEND TO OB'fAIN li'INAN(1HHf. CqNljUL'I'
<br />WITH YOUR LENDER OR AN A'I"rORNEY BEFORE RECORDING YOUR NOTICE OF COMNENCEMEN'r. ,JOBS UNDER
<br />$2,500 IN VALlIE DO NO'l' NEED '1'0 RECORD AND POST A "NO'l'ICE OF COMNENCEMEN'f".
<br />
<br />-~-------
<br />,
<br />
<br />SIGHA'I'lJRE: OWNER OR AGEN'I'
<br />
<br />SIGNNl'URE: CONTRACTOR
<br />
<br />S'rA'rE OF E'LORIDA
<br />COUNTY OF
<br />'1'he foregoing instrument was acknowledged
<br />Before me this _,__ day of , 1!:L_
<br />by _____
<br />(name of person acknowl~dged)
<br />Dwho is personally known to me, or
<br />
<br />STA'I'E OF FLORIDA
<br />COUN'rY OF
<br />The foregoing instrument w~s acknowledged
<br />Before me this ----.Slay of---, 19-.:-
<br />
<br />by
<br />
<br />(name of person acknowledged)
<br />[J.,ho is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and who[] did [)did not
<br />
<br />D who has produced__,___________
<br />(type of identification)
<br />and Hho Ddid nUd not take an oath
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Signatul:.'e of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />N-~-l~-t-~;p-~d~- p r T~l t ed~-~-s t amp'ed
<br />
<br />Name typed, printed or stamped
<br />
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