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<br />CONDI'l'IONS OF PERlvtI'I' AE'E'IDAVIT
<br />A. NOTICE OF DEED RESTRICTIoNS
<br />The undersigned understande th~t this p!::rmit may be subject to "deed restrictions" wldch
<br />mC:lY be more restrictive than City regulations. '1'he undersigned assumes responsibility for
<br />compliance with any applicable deed restricti.ons.
<br />B. UNI,ICENSED c':ONTRAC'l'ORS AND CON'I'RACTOR RESPONSIBIT,I'l'IES
<br />If the owner lias hi.red a contractor or contractors to undertake work, they may be required
<br />to bl:> licensed in accordance with state and local regulations. If the contractor is nut
<br />11 cansed as required by la\'~, both the G\mer and contractor may be oi ted for a mlsdemeanor
<br />violation under state law. If the owner or intended contractor are uncertain as to \~lat
<br />licensing requirements may apply for the intended work, they are advised to oontact the
<br />City of Zephyrhills Building Department, 613-788-6611.
<br />Ifurtherll1or-e, if the owner has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this applioation for which they
<br />wiLl be rtlsponsibltl. If you, as the owner s.igns iSlS the contractor, you are indicating that
<br />YOll, rather than the contractor, are responsible for the Hark. If the contractor Hishes
<br />you to slyn at:! contractor that may be an indication that he ls not properly licensed and is
<br />not entitled to permitting privil~ges in the City of Zephyrhills.
<br />C. TRAN::;POR'1'ATION IMPAC'1' FEES AND U'l'II,I'1'Y CONNECTION !J~EES
<br />D. CONS'rRIIC'l'UION LIEN LAW (CllAP'I'ER 713, FLORIDA S'rATUTES, AS AMENDED)
<br />f cert1fy that I, the appli.cant, 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 applicant is someone other that the "owner", I cerify that I
<br />Ilave obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to conmencement.
<br />El, CONTRACTOR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the information in this applicat10n is accurate and tllat all work will
<br />be done in compliance wi th all applicable laws regu1 aU ng canstl-tlction, zoning, and land
<br />development.
<br />Applioation is hereby made to obtain a permit to do work and installation as indicated. I
<br />certi fy that no \wrk or installation has conunenced prior to issuance of a penni t 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. J also
<br />certify that I understand that the regulations of other governmental agencies Inay apply to
<br />the intended Hark, and that it is my responsibility to identify what actions I Illlltlt take to
<br />be in compliance. Such agencies include but are not limited to; *Department of
<br />EnvirollTl!ental Regulation-Cypress Bayheads, Wetland Areas and Environment.ally Sensj.tive
<br />Lands, Water/Wastewattlr Treatment
<br />*Southwel:>t Jj'lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"Arllry Corps of Engineers-Seawalls, Docks, Navigable WaterHays
<br />*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<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.N, it is
<br />understood that a drainage plan addressing a "compensating volume"'will be submitted Hhich
<br />is prepared by a professional engineer registered in the State of Florida pdor to permit
<br />issuance.
<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 technical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, con~truction, or violations of any code. Every permit
<br />issued shall become invalid unless the work authorized by such permit is cOllunenced Hithin
<br />six months of issuance, or lf work authorized by the permit is suspended or abandollect for a
<br />period of si.x months after the time the work is conunenced, One 90 day extension of time
<br />may be allowed for the permit Hith fee charge of $15.00. The extension shall be ~equested
<br />ill writing to the Build1.ng Official. An approved inspection must be Jogged during each'alx
<br />month period, or the project Hill be considered abandoned.
<br />WARNING '1'0 OWNERl YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUW' IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR 1'ROPER'ry. IF YOU IN'rEND TO oB'rAIN E'INANqINq, ~()Nl?UI:r
<br />WITH YOUR I,ENDER OR AN A'I"rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'r. ;JOBS UNDER
<br />$2,500 IN VALUE DO 1'10'1' NEED 'l'0 RECORD AND 1'08'1' A "NO'f'ICE OF COMMENCEMEN'l"'.
<br />
<br />SIGNA'l'UREl OWNER OR AGENT
<br />
<br />SIGNA'i'URE; CONTRACTOR
<br />
<br />acknowledged
<br />, 19_
<br />
<br />STA'I'E OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument WaS aokllowledged
<br />Before me this --slay of----, 19
<br />by
<br />(name of person acknowledged)
<br />Qho is personally kno~1l1 to me, or
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF ----
<br />'J'he foregoing instrument was
<br />Before me this _.___ day of
<br />by"
<br />
<br />(name of person acknOWledged)
<br />Dwho is personally knoHn to me, or
<br />
<br />of identification)
<br />take an oath.
<br />
<br />lJ Hha has produced_____________
<br />(type of identification)
<br />and who Ddid [).Ud not t.ake all oath
<br />
<br />o Hho has produced
<br />(type
<br />and who[] did Ddid not
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Hame typed, printed or stamped
<br />
<br />-
<br />Nan~ typed, printed
<br />
<br />Dr stamped
<br />
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