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<br />CO~\~!~)lrJ.lIONS OF PER~Irr AFB'IDAVIT
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<br />A. NOTICE OF DEED RESTRICTIONS
<br />'rhe ~under<!3igned understands th~t t.h:L:;1 pennit m~y IH= :;,lb:}ect to "deed restd.ctions" wldeh
<br />may be more restrictive than City r.:qulations. The und,n'signed assumes respollsibil'ity for
<br />compliiHlce with any applicable dee:d .cestrictions.
<br />B. UNl~ICENSEDc'ON'l'AAC'l'ORS AND CON'l'HAC'I'OR RESPO''1SII3IJ,I'l'II!:S
<br />If the owner has hired a contractor or contracl:()rs to undertake work, they may be required
<br />to lJtl lictlnsed in accordance with state and 108al 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 th~ owner or intended contractor are uncertain as to V~lat
<br />licensing requirements may apply for the intended work, tIley are advised to contact the
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />Furthennor-e, if the owner has hired a contractor or contractors, he is advised to have the
<br />oontractor(s) sign portions of the "Contractor Sections" of this applioation for which they
<br />will be responsible. If you, as the owner signs as tile contractor, YQij are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor wislles
<br />you to sign ae contractor that may be an indication that he 1s not properly licensed alld is
<br />llot entitled to permitting privil~ges in the City of Zephyrhills.
<br />c. 'rRANSpOR'l'ATION IMPAC'!, fEES AND UTILITY CONNECTION FEES
<br />D. CONS'l'RlJC'l'UION LIEN LAW (CHAP'l'ER '713, FLORIDA S'l'ATUTES, AS AMENDED)
<br />I certify that I, tile applicant, have been provided with a copy of "Florida's Construction
<br />lien L~w - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "owller", I cerify that I
<br />have obtained a copy of the above described document and promise in good faitll to deliver
<br />it to the "owner" prior to COlTUllenCement.
<br />E. CON'l'RAC'l'OR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the information in this application is accurate and that all Hork will
<br />be done in compliance with all applicable laws regulating construction, zonillg, and land
<br />development.
<br />Applioation is hereby made to obtain a perml.t to do work and installation as indicated. I
<br />c.q:ti fy that no work or installation has corrunenced 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 regulations in the jurisdiction. I also
<br />certify that 1 understand that the regulations of other governmental agencies Inay apply to
<br />the intended work, and that it is my responsibility to identify what aotions I must take to
<br />be in compliance. Such agencies include but are not. limited to: *Department of
<br />Environmental Regulati.on-Cypress Bayheads, Wetland Areas and Environment.ally Sensltive
<br />Lands, Water/Wast.eHaLer Treatment
<br />*Southwest Wlarida Water Management District-Wells, Cypress Bayheads,-Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waten/ays
<br />*Uepartn~nt af Health , Rehabilitative Services, Environmental Healtll 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 qA" or "A, etc.", it is
<br />understood that a dralnage plan addressing a "compensating volume" 'will be submitted which
<br />is prepared by a professional engineer regist.ered in the St.ate of florida prior to permit
<br />j ssuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />autllority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall lssuance of a permit prevent the Building Ofricial from thereafter requiring a
<br />correction of errors in plans, oon~truotion, or violations of any oode. Every permit
<br />issued shall beoome invalid unless the wo.rk authorh:ed by such permit is oOllunenced within
<br />six months of issuance, or if work authorized by the permit is suspended or abandoQed for a
<br />period of six months after the time the work is commenced. One 90 day extension of tillle
<br />may be allowed for the permit with fee'charge of $15.00. The extension shall be ~eque6~ed
<br />in writing to the Building Official. An approved inspection must be Jogged durinCJ eacb six
<br />Inonth period, or the project will be considered aban~oned.
<br />WARNING TO OWNER I YOUR FAILURE '1'0 RECORD A NO'l'ICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
<br />PAYING TWICE E'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB'l'AIN FINANC:;INq.~')N@UI1L'
<br />WI'l'H YOUR LENDER OR AN A'l'TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'r. JOBS UNflER
<br />,2,500 IN ~ Nmo NEEIl '1'0 RECORD AND PO"" A "N""'~OMMEN("'MENT" , _____
<br />
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<br />
<br />SIGHA'l'lJRE: OWNER OR AGENT SIGNA'l'URE: CONTRAC'l'OR
<br />
<br />Signatur
<br />
<br />edgement
<br />
<br />STA'l'E OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument w~ ~oknovJle.9g~t.Js
<br />Before me this ~D Ilay O~~-, 4<4~_
<br />by
<br />(name of person acknowledged)
<br />7*ho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and whi. tt]QAB8ER OUd not t.ake all oath
<br />
<br />.~~.St~~~.~:.I= _
<br />SiglOb\Tlhf~tQMt16*1 taking acknowledgment
<br />._.__.__ :::J ~ Co ~ ~ .~ ~ .- ______________.______
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<br />
<br />
<br />f(~~ t)
<br />
<br />and
<br />
<br />II">
<br />
<br />,.
<br />
<br />Hame typed, printed or stampbd
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