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<br />CONDITIONS OE' PER1"~IT AE'FIDA"VIT
<br />
<br />~ A. .NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands tha..t Lh:l;, pj;:lrmit may b." o;uJl)ec.:t to "deed restdctions" which
<br />may be more n=stl'iotive than City re9ulations. 'I'b,,, \l11d':l'.::d9ned assumes responsibility for
<br />compliance with any applicable deE:d r,,,strictiullo;.
<br />B. UNLICENSED CON'l'RAC'l'ORS AND CON'l'RACTOR RESPONEIIBILI'l'IEJS
<br />I f the o\-./ner has hired a contracto!.' (J,( contractoroS to u::ldertake work, they nlay l,e requi red
<br />to b~ li cenBed 1n accordance w1t:h state and 10c,,1 regula,tlona. If the (~ontractor is not
<br />licensed as required by law, both the o~lfler and contraotor may be oited for a misdemeanor
<br />violation under state law. If the owner or intended contrdctor are uncertain as to Hhat
<br />licensi.ng requirements may apply for the intended work, they are advised to contaot the
<br />city of Zephyrhills Building Department, 813-788-'6611.
<br />Furthermol.'e, if the owner has hirt:!d a contractor or contractors, he is advised to have the
<br />contractor-(s) sign portions of the "Contractor Sections" of this application for which they
<br />Hill be responsible. If you, as the owner signs as the contractor, YQ4 are indicati.ng that
<br />you, rather than the contractor, are responsible for the work. I f the contractor \"iishes
<br />you to s1gn as contractor that m.y be an indication that he 1s not properly licensed alld is
<br />not entitled to permitting privileges in the City of Zephyrhi,lls.
<br />C. 'l'RANSl'OR'l'ATION 1MPAC'l' FEES AND U'l'HITY CONNECTION FEES
<br />D. CONS'l'RIICTUION LIEN LAW (CliAP'l'ER '713, FLORIDA STA'1'UTES, AS AMENDED)
<br />1 cell~tify that I, the applicant, h'.:lve been provided 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 applicant is someone other that the "owner", I cerify that I
<br />llave obtained a copy of the above described document and promise in good faith to deliver
<br />1. t to the "owner" pri.or to cOlnmencement.
<br />E:. CON'l'RAC'l'OR' a/OWNER'S AFFIDAVI'l'
<br />I certify that all the information in this application is accurate and that all Hork will
<br />be done in compliance with all appl1cable laws regulat1ng construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indicated. I
<br />certi fy that no \JOrk or installation has cOllunenced prior to issuance of a penni t and that
<br />all work will be performed to meet standards of all laws regulat1ng construction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiction. 1 c:llso
<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 IllUflt take to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Environnlental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensj.tive
<br />Lauds, Water/WasteHater 'l'reatment
<br />*Southwest Florida Water Management District-Wells, Cypress Baytleads, Wetland Areas,
<br />Altering Watercourses
<br />*Anny Corps of Engineers-Seawalls, Docks, Navigable WaterHays
<br />*IJepat:tment of Health Ii Rehabilitative Services, Envit:onmenta.l Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*lJ. S. Envil.'omnental Protection Agency-Asbestos abatement
<br />1 also certify that, if fill material is to be used in Flood Zone qA" or "A,etc.", it is
<br />undel::stood that a drai.nage plan addressing a "compensating volume" 'will be subrnitted vlhi.ah
<br />it; prepared by a professional engineer registered in the State of Iflorida pdor to permit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />autllority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a perm1t prevent the Building Official from thereafter requiring a
<br />cor,rection of errors in plans, construction, or vio~ations of any oode. Every permit
<br />issued shall become invalid unless the work authorized by such permit is cOllunenced Hithin
<br />slx months of issuance, or if work authorized by the permit is suspellded or' aballuol1ed for a
<br />period of sLx months after the time the work is commenced. One 90 day extension of time
<br />may be alloHed for the permit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Buildi.ng Official. An approved inspection must be logged during each. six
<br />lI~nth period, or the project will be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR FAIWRE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
<br />PAYING 'l'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB'l'AIN t'INANqINq,~\lN~UL'I'
<br />WITH YOUR LENDER OR AN A'l'TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'l'. ,JOBS UNfJER
<br />q2,500 IN VALUlil DO NO'!' NEED '1'0 RECORD AND POS'l' A "NO'l'ICE OF COMMENCEMEN'IlII.
<br />
<br />SIGNA'l'URE: OWNER OR AGENT
<br />
<br />SIGNA'1'URE: CONTRACTOR
<br />
<br />acknowledged
<br />, 19_
<br />
<br />STA'l'E OF nORIDA
<br />COUNTY OF
<br />The foregoing instrument w~s aaknowledged
<br />Before me this ----------5iay of----, 19 _~,_
<br />by
<br />(name of person acknowledged)
<br />[1ho is personally knovm to me, or
<br />
<br />S'fA'l'El OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before llIe this______. day of
<br />by
<br />
<br />(name of person acknowl~dged)
<br />Owho is personally known to me, or
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o Hha l-ias produced_.___
<br />(type of identification)
<br />and Hllo Ddid DUd not t.ake all oath
<br />
<br />o who has produced
<br />(type
<br />and who[] did [] did not
<br />
<br />Signatur.e of person taking acknowledgement
<br />
<br />Signature of person taking ackuowledgmellt
<br />
<br />ilc.-;;;--typ'~~-C-P r T;~~d 0--;"- s t ampeci------'--
<br />
<br />Name typed, printed or stampt:ld
<br />
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