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<br />CONDI'l'IONS OF PERJ"1I'I' AE'FIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'he undersigned understands thqt thi:3 p;=rmi t may be subj eet to "deed restrictions" wid ch
<br />IlI<tY be more restrictive than City re<;rulations. Tile undel.si911ed assumes responsibility for
<br />compliance with any applicable de<::d restrict.ions.
<br />B. UNI,ICENSED CON'l'RAC'l'ORS AND CONTRACTOR RESPONS lBILI'l'IES
<br />If the owner Ilas hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accordaIlce with state and local regulations. If the contractor is not
<br />licensed as rc:quired by law, both the o~mer and contractor may be cited for a llIisdc:meanor
<br />violation under state la\L If thCi owner or intended contractor are uncCil.'lain as to ~Ihat
<br />licensing requirement::! may apply for the intended work, thCiY are advised to contaot the
<br />City of Zephyr-hills Building Department, 813-788-6611.
<br />FurtherU10l.-e, if the owner has llir'ed a contractor or contractors, he is advlsed to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application for whicll they
<br />HiLL be l:esponsibl.e. If you, as the o"mer signs as the contractor, you are indicating that
<br />YOll, rather than the contractor, are responsible for the "lark. I f the contractor wishes
<br />you to sign as contractor that may be an indication that he is not properly licensed alld is
<br />not entitled to permitting priv.i.leges in the City of Zephyrh.i.lls.
<br />C. 'I'RANI::lPOR'I'A'rION IMPAC'I' If'EEI::l AND UTILITY CONNECTION FEES
<br />D, CONS'I'RUC'rUION LIEN LM~ (CIlAP1'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />J certify tllat 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 appl.icant 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 deliver
<br />it to the "owner" pri.or to conu-nencement.
<br />E. CON'rRAC1'OR' S/OWNER' S AF'FIDAVI'r
<br />I certify that all the information in this application is accurate and tllat. all work will
<br />be done in compliance with all appl:l.cable laws regulat:l.ng construction, zoniny, and land
<br />d~velopment.
<br />Applioation is hereby made to obtain a permit to do work and installation as indicated. I
<br />ce~tify that no work or installaU.on has commenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regulating construotion, City
<br />codes, zoning regulations, and land development regul a tJons In the j u:d sdictJon. I aLso
<br />certify that I understand that the regulation::! of other governmental agencies lnay apply to
<br />the intended work, and that it is my responsibility to identify what actions I lIlU.!lt take to
<br />be in compliance. Such agencies include but are not limited tal *Department of
<br />EnVironmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Bensttive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Wateroourses
<br />*Army Corps of Engineers-.SeaVlalls, Docks, Navigable WatenJays
<br />*LJepartment of Health & Rehabilitative Services, EnvJronmentaJ. Health UnJt-Wells,
<br />Wal:ltewater 'l'reatment, Septic 'l'anks
<br />"u.s. Environmental Protection Agency-Asbestos abatement
<br />1 also certify that, if fill material is to be used in Flood Zone ~A" or "A, etc.", Jt is
<br />understood that a drai.nage plan addressing a "compensating volume" 'will be submJtted Hhich
<br />is prepal.-ed by a professional engineer registered in tht:\ State of F'Jorida pdor to penni t
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not a::!
<br />authority to vlolate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a permit prevent the Building Official from tllereafter requi.ring a
<br />correction of errors ill plans, con~truction, or violations of any code. Every permit
<br />issu~d shall become invalid unless the work authorized by such permit is cOllulIenced within
<br />six months of issuance, or if Hork authorized by the permit is suspended 01' abandoqed for a
<br />period of silt 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 Buildlng Official. An approved lnspectlon must be logged durlng each' six
<br />month period, or the project will be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN'l' MAY RESUl/l' IN YOUR
<br />PAYING TWiCE li'OR IMPROVEMEN1'S TO YOUR PROPERTY. IF ):'OU IN'l'END TO OB'I'AIN l"INANqINq, .~qIHjUI/I'
<br />WITH YOUR LENDER OR AH ATTORNEY BEFORE RECORDING YOUR N01'ICE OF COMMENCEMENT. ,JOBS UNDER
<br />$2,500 IN VALUE: DO NOT NEED '1'0 RECORD AND POS'!' A "NOTICE OF COMMENCEMEN'l'''.
<br />
<br />SIGNA'l'URE: OWNER OR AGENT
<br />
<br />SIGNA'I'URE: CONTRACTOR
<br />
<br />STA'l'E OF FLORIDA
<br />COUNTY OF ----______
<br />The foregoing instrument Was acknowledged
<br />Before me this _----S-iay of---, 19
<br />by
<br />(name of person acknowledged)
<br />[1ho is personally kno\'1Il to me, or
<br />
<br />S'fATE OF FLORIDA
<br />COUN'I'Y OF -----.
<br />'!'be foregoing instrument was acknowledged
<br />Before me this __.._ day of , 19_
<br />
<br />by._________
<br />(name of person acknowl,dged)
<br />Owho is personally known to me, or
<br />
<br />of identification)
<br />t.ake an oath.
<br />
<br />[J \'Jho has produced_____. __.___
<br />(type of identifioation)
<br />and who Ddid DUd not t.ake an o<lth
<br />
<br />o who has produced
<br />(type
<br />awi whol] did []did not
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, pri.nted or stamped
<br />
<br />-
<br />Name typed, printed or stamped
<br />
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