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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE Of DEED RESTRICTIONS
<br />The undersigned understands th~t this p~rmit may be subject to "deed restriotionsH whiGh
<br />may be more ,restrictive than City regulations. 'l'he undel:signed assumes responsibility for
<br />complianoe with any applicable deed re5trictiontl.
<br />B. UNLICENSED 'CONTRAC'l'ORS AND CONTRACTOR RESPONSIBILI'l'IES
<br />If the OH1Ier has hired a contractor or contractors to undertake work, they may be required
<br />to b~ Ii censed in accordance ~~i.th f:ltate and local regulations. If the contractor is not
<br />licensed as required by la~", both the o~mer and contractor lIlay be cited far a misdemeanor
<br />violation under state law. If the owner or intended contractor are uncertain as to v~lat
<br />licensing requirements may apply for the intended work, they are advised to oontapt the
<br />city of Zephyrhills Building Department, 813-768-6611.
<br />Furthermol:e, if the owner has hil:ed a contractor or contractors, he is advised to havlil the
<br />contractor(s) sign portions of the "Contractor sectionsU of this application for which they
<br />will be responsible. If you, as t11e owner signs as the contractor, YQ4 are indicating that
<br />you, l.ather than the contractor, are responsible for the wor'k. If the contractor wishes
<br />you to sign as COlltractor that may be an indication that he is not properly licensed and is
<br />not entitled to permitting privileges in the city of Zephyrhll1s.
<br />c. 'rRANSl?OR'l'A'nON IMI?AC'l' IfEES AND UTILITY CONNECTION FEES
<br />D. CONS'fRUC'rUION LIEN LA~J (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />r certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection GuideH prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "owneru, I cerify that I
<br />have obtained a copy of the above described document and promise in good falth to dellver
<br />it to the "owneru prior to commencement.
<br />E. CONTRAc'roR' a/OWNER' 6 AFFIDAVI'r
<br />I certify that all the information in this application is accurate and tllat all Hork will
<br />be done in compliance with all applicable laws regulating constnlCtion, zoning, and land
<br />devfi?lopment.
<br />Applioation is hereby made to obtain a permit to do work and installation as indioated. I
<br />ce~tify that no ~mrk 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 th~ regulations of other governmental agencies llIay apply to
<br />the intended work, and that it is my responsibility to identify what aationa 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 Sens1tive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest florida Water Management Di5triat-Wells, cypress Bayheads) Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Departrnent of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic 'l'an~s
<br />;!.u.s. Environmental I?rotection Agency-Asbeatos abatement
<br />1 also certify that, if fill material is to be used in Iflood Zone ~Au or "A,eto.#, it is
<br />understood that a dralnage plan addressing a "compensating volume"'will be submitted which
<br />is prepared by a professional engineer registered in tile State of florida prior to permit
<br />iaauance.
<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 teohnical codes,
<br />nor allal1 issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of erron in plana, construction! or violations of any oode. Every pliilrmit
<br />iSriu~d ahall become invalid unless the work authorized by such permit is cOlllmencedwithin
<br />SlK months of issuance, or if work authorized by the perm1t 1s suspended or abandoijetd f9! a
<br />period of six months after the time the work is commenced. One 90 day eKtenslon of tillle
<br />may be allowed for the permit with fee charge of $15.00. The eKtension shall be requ@s~ed
<br />in writing to the Buildlng Official. An approved inspection muat be logged during each SiK
<br />month period, or the project will be considered abandoned. .
<br />WARNING TO OWNHlR: YOUR H'AlLURE '1'0 RECORD A NO'rICE OE' COMMENCEMENT MAY RESUW' IN YOUR
<br />I?AYING 'rWICE FOR IMFROVEMEN'l'S TO YOUR l?ROI?ER'fY. IE' YOU IN'fEND TO OB'fAIN E'INANGIWG, _~qNiuL'f
<br />Wl'I'H YOUR LENnER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE Olf COMMENCEMEN'I'. . JOBS UNnER
<br />$2,500 IN VALUE DO NO'l' NEED '1'0 REGORD AND POS'l1 A "NOTICE OF COMMENCEMEN'l'''.
<br />
<br />SIGNA'l'URE: OWNER OR AGENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />acknowledged
<br />,19_
<br />
<br />STA'l'E OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument WClS acknowledged
<br />Before me this -------Pay of--, 19 ~
<br />by
<br />(name of person acknowledged)
<br />[1ho is peraonally known to me, or
<br />
<br />S'l'A'rE Oli' FLORIDA
<br />COUN'I'V OF
<br />The foregoing instrument was
<br />Before me this ___ day of
<br />by
<br />
<br />(name of person acknoWl~dged)
<br />Owho is personally known to me, or
<br />
<br />o who has produoed
<br />(type
<br />and what] did Ddid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o who has produced_
<br />(type of identifioation
<br />and ~"ho Odid DUd not t.ake an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknOWledgment
<br />
<br />._,,_.._-._~-.--_.__.
<br />Hame typed, printed or stamped
<br />
<br />llame typed, printed or stamped
<br />
<br />"-
<br />
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