<br />.Nov.]g, 2002 8:30AM CITY OF ZEPHYRHILLSOF PERM!T AFFIDAVIT No.2788 P.1/1
<br />P.., "V.I. .Lv.l:l ul!' U.lliI:i1J J{ESTk.l.l.:'l'lUNl:i
<br />The undersigned understands that this pern~t may be sUbject to "deed ~estrictions" which
<br />may be more restrictive th.n City regulations. The undersigned assumes ~esponsibil1ty for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CONT~CTOR5 AND.CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in &Ccordande with state and local regulations. If the contractor is not
<br />lioensed a~ requlrad by law, both the o~ner and contr~ctor may be cited for $ misdem8anor
<br />violation Under state law. If the owner or intended contractor are uncertain as to what
<br />licensing requirement~ may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills Suilding Department, 813-766-6611.
<br />FUrthe~~or_, if the OWner h.~ hired a contractor or contraoto~s, he is adv1.~d to have the
<br />contraotorls) sign portions of the "Contraetor Sect.1.ona" of this application for which they
<br />will be respohsible. rf you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the contractor, ar@ responsible for the work. If the contr~ctor wishes
<br />you to sign as contractor that may be an indication th.t he is .not properly licensed and is
<br />not entitled to petmittinq privilege. in the City of Zephyrhill~.
<br />C, TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FE!S
<br />D. CdNSTRUCTU!ON L!!N LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of ~Florida's Con~truction
<br />lien Law - Homeowner's Protection Guide" prepared hy the Florida Department of Agrioulture
<br />and Con'sumer Affairs. If the .pplicant is someone other that the "owner", I oerify that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to commencement.
<br />E. CONTRACTOR'S/OWNEA'S AFFIDAVIT
<br />I certify that all the info~mation in this applic.tion is accurate and that all work will
<br />b~ done in cornpli~noe with all applicable laws regulating construction, zoning, and land
<br />developmen t.
<br />Application is hereby m~de to dbtain a permit to do work and installation as indicated. I
<br />certify that no work or installation has commenced prior to issuance of a permit and that
<br />all work will be performed to meet standard. of all laws regulating construction, City
<br />codes, zoning regulations, and land development re9uiations in the jurisdiction. I alao
<br />certify that! understand that the regulations of other qovernmental agenoies may apply to
<br />the intended work, and that it is my re~ponsibility to identify what actions I Joust take to
<br />be in complianoe. SUch agencies include but are not limited tOI *Department of
<br />Environmental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />" *Scuthw@$t florida Water Man.gement Distriot-Wells, Cypress Bayhe.ds, Wetland Areas,
<br />Altering Watercourses .
<br />*Anny Corp~ of ~ngineers-Seaw.llst Docks, Naviqable Waterway~
<br />*D@p.rtment of Hea~th & Rehabilitative Service~, Environmental Health Unit-Wells,
<br />Wastewater Treatm~ht, Septic Tank.
<br />*U.S. Environmen~al Proteetion ~geneY-Asbestos abatement
<br />I also certify th~t, if fill ma.terial is to be used in rlood Zone "All or "A,ete.", it is
<br />understood that iii. drainage plan addressLng .. "cornpen..t1ng volumeH will be submitted which
<br />is pre~ared by a professional engineer registered in the State of Florida prior to permit
<br />issuance.
<br />A permit issued shall b@ construed to b. a license to proceed with the work a.nd not as
<br />authority to viOlate, canoel, alter, or set ~side any provi~ions of the technical cocles,
<br />nO~'8hall issuance of a permit prevent the BUilding Official from thereafter requiring a
<br />dorrec.tion df errors in plans, consttuotion; or violations of any code. ~very permit
<br />issu~d shall become invalid uniess the work authorized by euoh per,mit is commenced within
<br />six months of issuance, or if work authorized by the permit is suspended or abandoned far a
<br />period of six months after the time the work is commenced. One 90 d~y extension of tim_
<br />m~y be allowed for the permit with fee charge of ~15~oo. The extension ahall bs requested
<br />in writing to the Building Official. An approved in.pection must be logged during each six
<br />mc;mth period, or the pr:oj ect will b. considered abandoned.
<br />WARN!NG TO OWN~R; YOUR rAILUR~ TO RECORD A NOTICE or COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTy. IF yoU INTEND TO OBTAIN I!'INANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY B~FORE RECORDING YOUR NOTICE OF COMMENC!MENT, JOBS UNDEA
<br />$2 ~LUE DO T N TO ECORD AND POST A "NOTICE OF COMMENCEMENTH.
<br />
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />OF FLOJ:l.IDA ,..,.. STATE OF FLORIDA
<br />C Y OF Qn:.N\.~ COUNTY OF
<br />The foreq01ng instrument )ia~ acknowledged The foregoing instrument was
<br />Before ~ this ~\ ~ dl\Y of ..A.:Je"~\,~, ~OO2- Before me this _day of
<br />by _~) \::::"'~fOr~ by
<br />.~ ln~mm o. person acknowledged)
<br />[Jwho is pereonally known to me, or
<br />
<br />acknowledged
<br />, 19~
<br />
<br />(name of person acknowledged)
<br />C1ho is personally known to me, or
<br />
<br />
<br />of identification)
<br />ake an oath.
<br />
<br />Owhd has produced
<br />(type of identifioation)
<br />and who Odid D::Ud not take an oat,h
<br />
<br />acknowledgement
<br />
<br />Signature ot person ,taking acknowledgment
<br />
<br />Name typed, printed or: stamped
<br />
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