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<br />CONDI'1.'IOl'JS OF PERMIT AFFIDAVIT
<br />
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understande thqt Chi:. p~al\it may be sub:ject to "deed restd.otions" w,hJch
<br />may be mure restrictive than City r.:gulations. 'I'he und,=rsigned assumes responsibility for
<br />oompliance with any applicable deed restriction~.
<br />B. UNLICENSEP 'CONTRAC'!'ORS AND CON1'HACTClR RE:SP~)NSIBILI'l'IES
<br />If the o\~ner has hired a contractor: or contractors to undertake work, they Illay be required
<br />to btl lIcensed in accordance wit.h state and local regulations. If the contractor is not
<br />1 I oens..d as required !Jy law, botb the m)ner and oontract:or may be cited for a mi.sdemeanor
<br />violation under ::;tate lal/. If the O\'iner or intended contractor are uncerlain as to "lhat
<br />Ii ct::!nsillg requirementl:l may apply for the intE'.lnded WaLk, they are advised to contaot the
<br />City of Zcphyrhills Building De:partmcnt, 81.3-788-6611.
<br />Furthermo!:e, 1 f the owner bas hil:ed a contractor or contractors, he ls advised to have the
<br />contractor(s} slgn portions of the "Contractor Sections" of this application for "dlich they
<br />will be: j.esponsible. If you, as the owner signs CIS the contractor, YQl,! are indicating that
<br />you, Lather than the contractor, at'e responsible for the work. I f the contractoj.' wishes
<br />you to siyn as contractor that may be an indlcation that he is not properly licellsed and ls
<br />not entitled to permitting priv1leges in the City of Zephyrhllls.
<br />C. 'I'RANSPOR'I'ATION lMPAC'l' FEES AND U'I'UI'I'Y CONNECTION h'EES
<br />D. CONS'rRlJC'fUION LIEN LAvJ (CHAP'l'ER '713, FLORIDA STA'rU'l'ES, AS AMENDED)
<br />1 certify that I, the applicant, have 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 oerify that I
<br />have obbdned a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to commencement.
<br />E. CONTRAC'l'OR' S/OWNER' S AFlfIDAVI'l'
<br />I oertify that all tile information in this application is accurate and that all work will
<br />be done in oompliance with all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a penuit to do \-<ark and installation as i ndiaated. I
<br />certify that no work or installation has con~enced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regulating construotion, City
<br />code::;, zoning regulations, and land development regulations in the jllrisdictlon. I also
<br />certify that I unde1:stand that the regulations of other governmental agencies may apply to
<br />the intended work, and that it is my .tesponsibility to identify what actions I IIIlHlt: take to
<br />be in compliance, Such agencies inolude but are not limited tOI *Department of
<br />EnviroluQental Regulation-Cypress Bayheads, Wetland Areas and Bnvironmentally Sens~tive
<br />Lands, Water/Wal:ltewater Treatment
<br />'" Southwest E'lodda Water Management District-Wells, Cypress Bayheads, Wetl and Areas,
<br />Altering Watercourses
<br />"Anny Corps of Engineerl:l-Seawalls, Docks, Navigable WaterHays
<br />*Department of Health & Rehabilitative Services, Environmental Health UnIt-Wella,
<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 "A" or "A, etc.", it is
<br />ullderetood that a drainage plan addressing a "compensating volume" 'wiLL be SUbllli tted VJhich
<br />is prepared by a professional engineer registered in the; state of Jj'lorida prJor to penllit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />authority to vlolate, cancel, aIte!., or set aside any provisions of the techllical codes,
<br />nor sllall issuallce of a permit prevent the Building Ofticial from thereafter requiring a
<br />correction of errors in plans, ~onstruction, or violations of any oode. Every permit
<br />iSl'Ju(;d shall beoome invalid unless the work authorized by such permit is cOllullenced Hithin
<br />six months of issuance, or if work authorized by the permi. t 105 suspended or abandorled f9r a
<br />period of si.x months after the time the work is conunenced. One 90 day extenei.on of tillle
<br />may ~e allowed for the permit with fee charge of $15.00. The extension shall be requea~ed
<br />ill wrItlng to the Building Official. An approved inspection must be logged during each six
<br />llIonth period, or the pr:oject Hill be considered abandoned.
<br />WARNING '1'0 OWNER; YOUR FAILURE '1'0 RElCORD A NO'fICE OF COMMENCEMENT MAY RESUW' IN YOUR
<br />PAYING TWICE FOR IMPROVEMEH'l'S TO YOUR PROPERTY. IF YOU INTEND TO OB'rAIN }:1INANqINq, ~{tN~UL'r
<br />WITH YOUR LENDER OR AN A'l"rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
<br />$~, 500 IN VAW&l DO NO'I' NEED TO RECORD AND POS'!' A "NOTICE OF COMMENCEMEN'l'''.
<br />
<br />_~~4--_u ~d-P-~ ~~;;~70?06
<br />
<br />SIGNA.~~~~~R AGENT SIGNA/i'URE: CONTRACTOR '
<br />
<br />S'I'ATID OF FLORIDA
<br />COUNTY OF
<br />'1'he foregoing instrument was
<br />Before me this ___ day of
<br />by~
<br />
<br />acknowledged
<br />,19_
<br />
<br />STA'l'E OF FLORIDA
<br />COUN'l'Y OF
<br />The foregoing instrument vla,S acknoVlledged
<br />Before me this ------S-iay of--, HI.......:-
<br />by
<br />(name of person acknowledged)
<br />[1ho .is pet'sonally known to me, or
<br />
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and who[J did [Jdid not
<br />
<br />of identi.fication)
<br />take an oath.
<br />
<br />o Hho has produced___. ~_____
<br />(type of i.dentificati.on)
<br />and IJho Ddid DHd not t.ake all oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, pri.nted or stamped
<br />
<br />Hame typed, printed or. stamped
<br />
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