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<br />CONDI'l'IONS OF PERMIT AFFIDAVIT
<br />A. NO'1'ICE OF DEED RES'l'RIC'rroNS
<br />The undersigned understands thqt this pennit may be subject to "deed restrictions" which
<br />mdY be more restrictive than City regulations. 'J'lle und'=J:signed assumes responsibility for
<br />complicwce with any applicable deed restrictions.
<br />B. UNIJICENSED CON'l'RAC'l'ORS AND CON'l'R<\CTOR RESPONSIBILI'l'IES
<br />If the D\-Iner- has Idred a contracto!: or contractCJl:s to under-take Hork, they illay be required
<br />to be 1i censed in accordance ~d.th state and local regulations. If the contractor is not:
<br />1i censed as required lJy la\...., both the owner and contractor Illay be c1 ted far a mLedemeanar
<br />vi olati on under state la\J. I f the owner or- intended contractor are uncer'lain as to vihat
<br />lioensil19 requirements may apply for the intended work, tlley are advised to contact the
<br />Ci ty of Zephyrhills Building Department, 813-788-6611.
<br />Furthermou::, if the owner has hired a contractor or contractors, he is advised to have the
<br />ooutractol:(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, ar.-e responsible for the vwrk. I f the contractor wishes
<br />you to sign as contractor that may be an indication tllat he is not properly lioensed and is
<br />llot elltitled to permitting privlleges in the City of Zephyrhills.
<br />C. 'l'RANSPOR'l'A'I'ION IMPAC'l' IfEES AND UTILITY CONNECTION FEES
<br />D. c.:ONS'I'RUC'rUION LIEN LAW (CliAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />r certify that I, the applioant, have been provided with a copy of "Florlda's Constrllction
<br />lien Law - Homeowner's Protection Gulde" 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 document and promise in good faith to deli.ver
<br />it to the "owner" pri.or to commencement.
<br />E. CON'rRAC'l'OR' S/OWNER' S AFFIDAVI'I'
<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, zonill<1, and land
<br />development.
<br />Applioation is hereby made to obtain a permit to do work and installation as indioated. I
<br />ce-l=tify that no Hork or installation has commenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laHs regulating construction, City
<br />codes, zoning regulations, and land development regulations in the jllrisdictjon. I also
<br />certify that I understand that the regulations of other governmental agencies IDay apply to
<br />the intended work, and that it is my responsibility to identify what aotioue I must take to
<br />be in compliallce. such agencies include but are not limited tal "Department of
<br />EnvirolUDental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensltive
<br />Lands, Water/Wastewater 'freatment
<br />"Southwest Il'lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable WaterHays
<br />"LJepartment of Health & Rehabilitative Services, Environmental Health UnJt-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*u.S. Environmental I?rotection 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 />undeJ::stood that a drai.nage plan addressing a "compensating volume" 'will be submitted v/hich
<br />is prepared by a professional engineer registered in tile state of florida prior to permit
<br />issuance.
<br />A penDit issued shall be construed to be a license to proceed with the Hork and not as
<br />authority to violate, cancel, alter, or set aside any provisions of tbe technical codes,
<br />nor allall issuance of a permit prevent the Building Official from thereafter requiring a
<br />oorrection of errors in plans, con~truationr or viOlations of any code. Every permit
<br />iSrJued shall beoome invalid unless the wOJ:k authot'ized by such permit ia oOllulIenoed Hithin
<br />sil( months of issuance, or' if \-mrk authorized by the permlt is suspended or abandol1ed for a
<br />period of S11t months after the tilDe the work is commenced. One 90 day eKtenslon of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be ~equested
<br />in Hriting to the Buildlng Official. An approved inspectlon must be logged during each alK
<br />month periOd, or the project Hill be considered abandoned.
<br />WARNING '1'0 OWNERI YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN'l' MAY RESUL'l' IN YOUR
<br />PAYING TWICE E'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'rEND TO OB'I'AIN E'INANqINC~, \.X?N@UL'f
<br />WITH YOUR L~IWER DR AN A'l"!'oRNEY BEFORE RECORDING YOUR NO'l'!CE OF COMMENCEMEN'I'. JOBS UNDER
<br />$2,500 IN VALUE: DO NO'l' NEED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCEMEN'llll.
<br />
<br />..~.._.,---~~-"...~--_._--~--
<br />
<br />SIGNA'l'URE: OWNER OR AGENT
<br />
<br />SIGNNfURE: CONTRACTOR
<br />
<br />STA'l'E OF FLORIDA
<br />COUNTY OF
<br />'1'he foregoing instrument was acknowledged
<br />Before me this ..............-1ay of----, 19 _:..-
<br />by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />'l'he foregoing instrument Has acknoHledged
<br />Before me this __ day of _______, 19_
<br />by
<br />(name of person acknawl,dged)
<br />OHho is personally knoHn to me, or
<br />
<br />o who has produoed
<br />(type
<br />and who[] did []did not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />(name of person acknoHledged)
<br />Gho is personally knovin to me, or
<br />
<br />o v~ho has produced _____
<br />(type of identifioation)
<br />and VJho rJdid [}Ud not t.ake all oath
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Signature of person taking acknowledgement
<br />
<br />-~_._----_..._-~.._.-_...---._-_._-~------._-.------_._-----
<br />
<br />Name typed, lJrinted or stamped
<br />
<br />Name typed, printed or stamped
<br />
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