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<br />CONDIIfIONS OF PERl'1IT AE'~'IDAVIT
<br />A. NO~ICE OF DEED RESTRICTIONS
<br />The undersigned understands th,t this permit may be subject to "deed restrictions" ~l~ch
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNIJICENSED CON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBII,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 vd_th state and local regulations. If the contractor is not
<br />licensed as ~equired by law, both the owner and contractor may be cited for a misdemeanor
<br />violation under state law. If the owner or intended CO!ltractor are uncertain as to what
<br />Ucensing requirements may apply for the intended work, they are advlsed to oontact the
<br />City of Zephyrhills Buildlng Department, 813-788-6611.
<br />Furthermore, jf the ovmer has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application for whiell they
<br />Hill be l.esponsible. If you, as the ovmer signs ~s the contractor, YQlj are .indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor Hishes
<br />you to sign as contractor that may be an indication that he is not properly licensed arid is
<br />not entitled to permitting privil~ges in the Clty of Zephyrhl1ls.
<br />c. 'l'RANSPOR'l'A'I'ION IMI?AC'l' FEES AND U'l'UITY CONNECTION FEES
<br />D. CONS'l'RIICTUION I,IEN LAvl (CHAP'l'ER 713, FLORIDA STA'I'U'I'ES, AS AMENDED)
<br />1 certify tllat I, the appllcant, have been provided with a copy of "Florlda's Construction
<br />lien Law - Homeowner's Protection Guide" prepared by the Florlda Department of Agriculture
<br />and Consurner Affairs. If the applicant is someone other that: the "owner", 1 cerify that I
<br />llave obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" pri.or to COllUllencement.
<br />E:. CON'I'RAC'I'OR' S/m'lNER' S AFFIDAVI'I'
<br />I certify that all the information in this application is accurate and that all Hork will
<br />be done in compliance with all appli.cable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtai.n a permit to do work and installation as indlcated. I
<br />certify 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 constructlon, Clty
<br />codes, zoning regulations, and land development regulations in the jurisdiction. J alao
<br />certify that I understand that the regulations of other governmental agenciea may apply to
<br />the intended work, and that it is my responsibility to identify what actions I IlIlH:lt take to
<br />Le in compliance. Such agencies include but are not llmited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensttive
<br />Landa, Water/Wastewater Treatment
<br />*SouthHeat florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<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,atc.", it is
<br />understood that a drainage plan addresaing a "compensating volume"'will he submitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to pennit
<br />iasuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />authority to vi.olate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a permit prevent the Building Ofilcial from thereafter requiring a
<br />correction of errors In plans, oonstruction! or violCltions of any code. Every pennit
<br />is!fiu~d shall become invalid unless th~ worK authorized by such permit is cOlllmenced Hithin
<br />six months of issuance, or if vlCrk authorlzed by the permit is suspended or ahandol1ed for a
<br />period of slx months after the time the work is conunenced. One 90 day extension of time
<br />may be alloHed for the permlt with fee charge of $15.00. The extellsion ahall be tequeated
<br />ill writing to the Buildlng Official. An approved inspection must be logged during each six
<br />month period, or the project Hi.ll be considered abandoned.
<br />WARNING 'fO OWNER: 'lOUR FAILURE 'fO RECORD A NOTICE Of COMMENCEMENT MAY RESUL'l' IN YOUR
<br />PAYING 'l'WICE FOR IMPROVEMENTS TO YOUR l?ROPER'I'Y. H' YOU INTEND TO OB'fAIN InNANqrNG,~9N~UIlI'
<br />Wl'I'H YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'!'. ,JOBS UNDER
<br />$~, 500 IN VALUE DO NOT NEED '1'0 RECORD AND POST A \\ ENClilMEWllll .
<br />
<br />SHiNA'l'URE: OWNER OR AGENT
<br />
<br />SIG
<br />
<br />TRACTOR
<br />
<br />
<br />
<br />
<br />acknowledged
<br />, 19_
<br />
<br />STATE OF FLORIDA R
<br />COUN'fY OF 6..5 cO
<br />The foregoing instrument w~s aOknow~d~~03
<br />Before rne.....:t.bis ~ay of ~o.')\"c..r , ~:_:___
<br />by __ \ nCIY\.:\5 ~ . D.,. '0 ~_____
<br />.... ~e of person acknowledged)
<br />~ is personally known to me, or
<br />
<br />S'l'A~E Oli' FLORI DA
<br />COUNTY OE' -------
<br />The foregoing instrument was
<br />Before me this __ day of
<br />by _
<br />
<br />(name of person aoknoWledged)
<br />Dwho is personally known to me, or
<br />
<br />Dwho has pr.oduced
<br />(type
<br />and whoO dld 0 dld not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Dwho has produced
<br />(type of identification)
<br />and Hho Ddid [}Ud not take an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taki_ng acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed Or stamped
<br />
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