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<br />CONDI'rIONS OF PERNI'I' AFFIDAVIT
<br />A. NO!rICE Oli' DEED RESTRIc'l'IONS
<br />The undersigned understands thijt this permit may be subject to "deed restrlotionsu which
<br />may be more re~trictive than City regulations, The undersigned assumes responsibility for
<br />compliance with any applicable deed re5trictions,
<br />B. UlnlCENSElD t:ONTRAC'l'ORS AND CONTRACTOR RESPONSIBIJ.I'l'IES
<br />If the owner lias hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accordance with state and local regulations, If the contraotor is not
<br />licensed as required by law, both the ovmer and contraotor may be cited for a miademeanor
<br />violation under state lav/. If the owner or intended contractor are uncertain as to vlhat
<br />li oensing requirements may apply for the intended work, they are advised to contaot the
<br />City of Zephyrhills Building Department, 613-788-6611.
<br />Furthermol.:e, if the owner has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor SectionsU of this application for which they
<br />will be responsible. If you,. as the owner signs as the contractor, YQ4 are indicating that
<br />you, rather than the contractor, are responsible for the work, If the contractor wislles
<br />you to sign as contractor that may be an indication that he is not properly lioensed and ia
<br />not entitled to permitting privileges in the City of Zephyrhills,
<br />C. 'rRANSI?OR'!'ATION IMPAG'r rEElS AND UTILITY OONNECTION IfEES
<br />D. CONSTRuc'rUION LIEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />I oertify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guideu prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that: the "owneru, 1 aerify that I
<br />have obtaineci a oopy of the above described Qocument and promise in good faith to deliver
<br />it to the "owneru prior to COllUllencement.
<br />E. CON'rRAC'l'OR' S/OWNER' S AFFIDAVI'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 applicable laws regulating construction, zoning, and land
<br />devi;1llopment.
<br />Application is hereby made to obtain a permit to do work and .tnstallation as indicated, I
<br />ce+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 laws regulating construction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br />certifYrthat I understand that th~ regulations of other governmental agencies lRay apply to
<br />the intended work, and that it is my responsibility to identify what actions I "mat take to
<br />Le in compliance, Such agencies include but are not limited tOI *Department of
<br />Environlllental Regulation-Cypress Bayheads, Wetland Areae and Environmentally SensJ.tive
<br />Lands, Water/Wastewater 'rreatment
<br />*Soutllwest li'lorida Water Management District-Wells, Cypress Bayheadsl Wetland Areas,
<br />Altering Watercourses
<br />"Army Corps of Engineers-Sea\'lalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmental Health Unit-Wel.ls,
<br />Wastewater Treafment, 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 ~Au or "A,etc,U, it is
<br />understood that a drainage plan addressing a "compensating volume"'will be submitted whioh
<br />is prepared by a profesaional engineer registered in the State of Florida prior to permit
<br />is ,!:lUance .
<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 issuance of a permit prevent the Building Ofticial from thereafter requiring a
<br />cor~ection of errors ill plans, oon~tructio1}! or vio~apions of any oode. Every P\iI.ril\it
<br />issu~d shall beoome invalid unless th~ W01:K authorized by such permit is oommenoed within
<br />six rnontlls of issuance, or if work authorized by the permit is suspended or abandoq~d f9r a
<br />period of six 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 requeated
<br />in writing to the BuildJ.ng Official, An approved inspection must be logged during each'alx
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNERI YOUR li'AILURE TO RECORD A No'rrCE OF COMMENCEMENT MAY REBUl/l' IN YOUR
<br />PAYING 'l'WlCE FOR IMPROVEMENTS TO YOUR PROPERTY, Ilf YOU INTEND TO OB'rAIN FINANqn~q, .c'JUtUI/l'
<br />WI'fH YOUR LENDER OR AN A'rTORNEY BEIi'ORE RECORDING YOUR NOTICE Oli' COMMENCEMEN'I', JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POS'l' A "NO'!'ICE OF COJ.1J.1ENCEMEN'r".
<br />
<br />SIGNA'l'URElI OWNER OR AGENT
<br />
<br />SIGNATURE I CONTRACTOR
<br />
<br />STATE QJj' FLORIDA
<br />COUNTY OE'
<br />The foregoing instrument was
<br />Before me thia ___ day of
<br />by
<br />
<br />ackno\'lledged
<br />, 19_
<br />
<br />STA'l'E OF 1fL0RIDA
<br />COUN'ry OF
<br />The foregoing instrument w~s
<br />Before me this ------Jiay of-
<br />by
<br />
<br />acknowledged
<br />, HI......:._
<br />
<br />(name of person aokno"l~dged)
<br />Dwho is personally known to me, or
<br />
<br />of identification)
<br />take an oath,
<br />
<br />(name of person aaknowledg~d)
<br />aha is personally known to me, or
<br />
<br />DHho has produced
<br />(type of identif1cat~on)
<br />and Vlha Ddid DUd not t.ake an oath
<br />
<br />o who ha", produced
<br />(type
<br />and who[] did 0 did not
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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