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<br />CONDITIONS OF PERJ'1IT AFl:<"IDAVIT
<br />
<br />A. NO'l'lCE aii' DEED RES'l'RIC'I'IONS
<br />'fhe undersigned understands thqt th:Ls p~nni t may bd :ll1b}ect:o "deed restJ:ictions" which
<br />may he more l:estrictive than City n:gulat:ions, 'I'll,: lll1J':rsi<Jned assumes responsibility for
<br />complic:mce with any applicable de;::ct l':Stl:ictJol1ti.
<br />B. UNLICENSED CON'I'RAC'l'ORS AND CON'l'HACTOR RESPOloJElII3Il,II'IE:S
<br />I f the OWH:r has hired a contractor O,C contractors to under'take work, they may be r.equired
<br />to btl Ii censed in accordance wlth sta1:t: and local reglllati.ons. If the contractor. is not
<br />lioensed as required by law, both t.he o~mer and contractor may be cited for a misdemeanor
<br />violation under state law. If the owner or intended cuntractor. are uncertain as to wllat
<br />licensing requirementl:i may apply foe the intended work, they are advised to contact the
<br />City of Zephyrhills Building Depa.t:tment, 813-788-6611,
<br />Furtherlllol.'e, it the oymer has hired a contractor: or contractors, he is advised to have the
<br />contractor(s} sign portions of the "Contractor SectionsN of this application for which they
<br />will be responsible. If you, as the owner signa <lS the contractor, yo\,! are indicating that
<br />you, I:ather than the contractor, are responsible for the Hor'k. I f the contractor \'>/ishes
<br />you to sign as contractor that may be an indication that he is not properly licellsed and is
<br />not enUtled to permitting privileges in the City of Zephyrh1.11s.
<br />C. 'l'RANSPOk'l'ATION IMPAC'l' FEES AND U'l'ILI'l'Y CONNECTION !J'EES
<br />D. CONS'l'RIIC'fUION LIEN LAW (CllAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />I cert1.fy tllat I, the applicant, have been provid~d with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applictllllt 1.13 someone other that: the "ownerN, 1 Gerify that I
<br />have obtained a copy of the above described document and prom1.se in good faith to deliver
<br />it to the "ownerN prior to commencement.
<br />El. CON'I'RAC'rOR' S/OWNER' S AFFIDAVIT
<br />I certify that all the information in this application is accurate alld that all work will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />dev~lopment.
<br />Applioation is hereby made to obtain a permit to do work and 1.nstallation as indicated. I
<br />ce~tify that no Hork or installation has conunenced prior to issuance of a permlt 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 1n tbe jur1sdictlon. 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 IlIllSt take to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Environmental RegulaU on-Cypress I:layheads, Wetland Areas and Environmentally SensJ.tive
<br />Lauds, Water/Waste\~ater 'rreatment
<br />*Soutllwest li'lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Aony Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*u.S. Envi.t:onmental Protection Agency-Asbestos abatement
<br />1 also oer.tify that, if fill material is to be used in Flood Zone qAN or "A,etc.", it is
<br />understood that a drainage plan addressing a "compensating volume" 'will be submitted ~dlioh
<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 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 allall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construction~ or vio~ations of any code. EveI:Y peI:mit
<br />issuC'ld l3hall become invalid unleas the w01:k authori:zoed by auch permit 1.s cOllunenced Hlthin
<br />six months of issuance, or if work authorized by the permit is suspended or abandoqad for a
<br />period of elx 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 writing to the Buildlng Official. An approved inspection must be logged durJng each'six
<br />month period, or the project will be considered abandoned.
<br />WARNING 'fa OWNER: YOUR FAIUJRE 'fQ RECORD A NO'rICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
<br />PAYING TWICE li'Ok IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'fEND TO OB'l'AIN li'INANGING, ~qN{WL'r
<br />WI'fH YOUR LENDER OR AN A'I"rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'l'. . JOBS Ul~fJER
<br />$2,500 IN VAL\JI!: DO NO'!' NEED '1'0 RECORD AND POS'l' A "NO'I'ICE OF COMMENCI!'.MENT".
<br />
<br />SIGNA'l'lJRE: OWNER OR AGENT
<br />
<br />SIGNA'I'URE: CONTRACTOR
<br />
<br />acknowledged
<br />__, 19_
<br />
<br />STA'fE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument wc\s aoknoHledged
<br />Before me thJs ------siay of-----" 19
<br />by
<br />(name of person acknowledged)
<br />[1ho is personally known to me, or
<br />
<br />S'l'A'rE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this ____ day of
<br />by'
<br />
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />Owho has produced
<br />(type
<br />and who[] did [} did not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Dwho has produced
<br />(type of identification)
<br />and Hho Ddid C}Ud not take an oath
<br />
<br />Signatur'e of person taking acknowledgement
<br />
<br />Slgnature of person taking acknowledgment
<br />
<br />Nallle typed, printed or stamped
<br />
<br />Hame typed, printed or starnptld
<br />
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