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<br />CO~~ITIO~S O~ PERMIT AFF~DAVl~ <br />A. NOTICE OF DEED RESTRICTIONS <br />The undersigned understands th~t this pel:mi t may be subj eet 1:0 "deed restrictions'" which <br />may be more restrictive than City l'egulat:ion.s. 'l'he un.d'3l'siqned assumes responsibility for <br />compliance with any applicable deed restl:ictions. <br />B. UNLICENSED CONTRACTORS AND CON1'RACTOH RESPONSIBIIJIT rES <br />If the owner has 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 not <br />licensed as required by law, both the ovmer and contractor may be cited for a misdemeanor <br />violation under state law. If the owner or intended contractor are uncertain as to what <br />licensing requirements may apply for the intended work, they are advised to contact the <br />City of Zephyrhills Building Department, 813-766-6611. <br />Furthermore, 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 which they <br />will be responsible. If you" as the owner signs as the contractor, you are indicating that <br />you, rather than the contractor, are responsible for the work. If the contractor wishes <br />you to sign as contractor that ma~ be an indication that he is not properly licensed and is <br />not entitled to permitting privileges in the City of Zephyrhills. <br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES <br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) <br />I 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 cerify that I <br />have obtained a copy of the above described aocument and promise in good faith to deliver <br />it to the "owner" prior to conunencement. <br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT <br />I certify that all the information in this application is accurate and that all work will <br />be done in compliance with all applicable laws regulating construction, zoning, and land <br />devf?lopment. <br />Application is hereby made to obtain a permit to do work and installation as indicated. I <br />ce~tify that no work 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 construction, City <br />codes, zoning regulations, and land development regulations in the jurisdiction. I also <br />certify that I understand that the regulations of other g.overnmental agencies may apply to <br />the intended work, and that it is my responsibility to identify what actions I IUUSt 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 Sensitive <br />Lands, Water/Wastewater Treatment <br />*8outhwest 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 Unit-Wells, <br />Wastewater Treatment, Septic Tanks <br />*U.8. 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 />understood that a drainage plan addressing a "compensating volume"'will be submitted 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 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 ahall 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 permit <br />issued shall become invalid unless the work authorized by such permit is commenced within <br />six months of issuance, or if work authorized by the permit is suspended or abando~ed for a <br />period of six 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 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 TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR <br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANGINq, CQN~ULT <br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER <br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". <br /> <br />;W If fWP1 <br /> <br />, <br />SIGNATURE: CONTRACTOR <br /> <br />STATE OF FLORIDAO/?0.AJA I <br />COUNTY OF LWeu <br />The foregoing i?~+x~ent wasA~c~edged <br />Before me this . ay of I.JI!L(J. , 11 ~ <br />by <br />~. (name of person acknowledged) <br />~uo is personally known to me, or <br /> <br />Dwho has produced <br />(type of identification) <br />and who Ddid ~id not take an oath <br /> <br />~ 11} .l~J!lrd . <br /> <br />Signature of person taking acknowledgment <br /> <br />"..\,'I~f./'" Dana M. Ward <br />-(E" MY ,.nuutClc:ll'lN 1# 00038228 EXPlRfS <br /> <br />Name t:,' .J;i,rinted:l\ltf.t14'~E['k. <br />"'lW,"j,."<tt- IIONOEO MIU TROYfAlll '" <br /> <br />l1!!J{j., ~w~ <br /> <br /> <br />STATE OF FLORID~~ <br />COUNTY OF . <br />The foregoing i7~~Jument w~~a~Wled?~~NI\ <br />Before me this t!J day of 1J14 V), ~ <br />by. <br />(name of person acknowledged) <br />~ho is personally known to me, or <br /> <br />Dwho has produced <br />(type of identification) <br />and whoO did ~id not take an oath. <br /> <br />'j;)Q;y}Ct '-m ' Wnfld <br /> <br />Signature of person taking acknowledgement <br /> <br />Name <br /> <br />