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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. ' NO'l'Il::E OF DEED RES'l'RICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" ,'lh1ch
<br />may be more restrictive than City regulations. '1'l1e undersi.gned assumes responsibi.li.ty for
<br />compLi.ance w~th any applicabl.e deed restrictions.
<br />B. UNLICENSED CON'l'RACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the ovmer has hired a contractor or con.tractors to undertake work, they may be required
<br />to be l.icensed in accordance with state and local regulations. If the contractor is not
<br />licensed as requi.red by law, both the owner and contractor may be cited for a misdemeanor
<br />violation under state law. If the OHner or intended contr.actor are uncertaln as to what
<br />Licenstng requirements may apply for the intended work, they are advised to contact the
<br />City of Zepbyrhills Building Department, 813-788-6611.
<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 Sectlons" of this appllcation for whlcll they
<br />wilt be responsible. If you, as the owner signs as the contractor, you are indicating that
<br />YOll, rather than the contractor, are responsible for the work. If the contractor wishes
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />not: entitled to permitting privileges in the City of Zl'lphyrhiU.B.
<br />c. 'l'RANSPOR'l'A'rION IMPAC'l' FEES AND UTILITY CONNECTION FEES
<br />D. CONS'!'RUc.:'l'UION I,IEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I cert1fy that I, the applicant, llave been provided with a copy of "Florida's Construction
<br />lien LaH - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and ConS\lmer Affairs. If the applicant is someone other. that the "owner", I cerity that I
<br />have obL:ained a copy of the above descd.bed document and promise in good faith to deli.ver
<br />it to t.he "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 />development.
<br />1\ppl icati.on is hereby made to obtain a permit to do work and installation as ind1.cated. I
<br />certify that no work or installation has commenced prior to issuance of a permit and that
<br />atl work will be performed to meet standards of all laws regulating constrllction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br />certify tllatI understand that the regulations of other governmental agencies may apply to
<br />the 1ntended wor'k, and that it is my responsibility to identify Hhat actions 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 Sens;itive
<br />Lands, Water/Wastewater 'l'reatment
<br />*southvlest ITJ.orida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />'Army Corps of E',ng1.neet:s-Seawalls, Docks, Navigable Waterways
<br />*UeparLmelll: of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*\1. S. E:nvJ r:onlllental Protection Agency-Asbestos abatement
<br />I aJso 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 submitt.ed which
<br />1s prepared by a professional engineer registered in the state of Florida prior to permit
<br />ias\lance.
<br />1\ permit issued sllall 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 shall i.ssuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any code. Every permit
<br />issued shall becom!!l invalid unless the work authorized by such permit is cOlTunenced within
<br />six months of issuance, or if work authorized by the permlt is suspended or abandoned for a
<br />period of slx months afte.t:: the time the work is commenced. One 90 day extension of t.ime
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be requested
<br />in writ1ng to the Buil.ding Official. An approved inspection must be logged during each six
<br />n~llth perlod, or the project will be considered abandoned.
<br />WARNING TO OWNE,Rl YOUR FAILURE '!'O RECORD A NOTICE OF COMMENCEMENT MAY RESUL'I' IN YOUR
<br />E'AYHlG 'I'W1CE I!'OH IMI?ROVEMENTS TO YOUR PROPERTY. IF YOU INTEND '1'0 OBTAIN FINANCING, CONSULT
<br />W ['I'll YOUR LI!:NDER OR 1\N ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ,TOBS UNDER
<br />$2,500 HI VALUE DO NOT NEED 'PO RECORD AND POS'!' 1\ "NOTICE OF COMMENCEMEW!'''.
<br />
<br />
<br />---61--/UdJ-.~ ~~<f?
<br />
<br />S IGII}\'l'lJRE:J OWNER OR AGENT
<br />
<br />~ .13~
<br />
<br />s I GNATUR~ON'l'RACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />'l'he foregoing instrument was acknowiedged
<br />Before me this ~pay of TANvtt!!::L, /J82PrJ5
<br />by t, (ZP"C? I] ~I:-:(jl::
<br />~~(name of person acknowledged)
<br />~ho is personally known to me, or
<br />
<br />P A s<- 0
<br />
<br />S'l'A'l'E OF li'LORTDA "DA-S
<br />COUN'I'Y OF ____......L-. (. C
<br />The foregoing instrument was acknowledged
<br />Before me tlds -LS- day of -S-1tN//f/Ut , "f!I!J-7t)D?
<br />by _-CUtL. ~fJ::~F
<br />(name of person acknowledged)
<br />~o is personally known to me, or
<br />
<br />and
<br />
<br />~ho has produced .---
<br />(type of Jdelltification)
<br />DUd not take an oath
<br />
<br />tl~Mf/
<br />
<br />Signature of per.son taking acknoHledgment
<br />
<br />wh 0 [3'did
<br />B-.. -'l,
<br />
<br />[] who has produced
<br />. (type of identification)
<br />all<i wllO[~d rJdid not. take an oath.
<br />
<br />____.__._._~JJ, ~
<br />
<br />S.lgnal:ure of person taking acknowledgement
<br />
<br />~lLlJe,f' I:). , A 51)[" L-
<br />----..- ,_..._-~---------~----_.------_.--
<br />HaJt\e typed, printed or stamped
<br />. i,a.~ '" Bruce A Asbel
<br />
<br />:~ ~ .: My Commission 00116710
<br />~o,..',;II Expires June 22. 2006
<br />
<br />__~(l-v'C E A /~ 5BF:L
<br />
<br />Name typed, printed or stamped
<br />
<br />J'~' Bruce A Asbel
<br />;,~ .: My Commission 00116710
<br />~C/f...df Expires June 22. 2000
<br />
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