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<br />CONDI'l'IONS OF PERMI'r AE'FIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands th~t this permit may be subject to "deed restrictions" Wllich
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />con~liance with any applicable deed restrictions.
<br />B. UNLICENSED CON'I'RAC'I'ORS AND CON'l'AACTOR RESPONSIBII,I'rIES
<br />If the oHner has hired a contractor or contractors to undertake work, they nlay be required
<br />to b~ licensed in accordance with state and local regulations. If the contractor is noL
<br />Ii censed as requJred by law, both the ovmer and cont.r-aclor may be cJ ted for a misdemeanor
<br />violation under state law. If the oWller or intended contractor are uncerlain as to vlhat
<br />licensing requirementl:l may apply for the intended work, they are advised to contact the
<br />City of ZephydlJ1ls Building Department, 81.3-768-6611.
<br />Furthennot:e, .i t the ovmer has hir~d a contractor or contractors, he is advised to have the
<br />contl.actor(s) sign portions of the "Contractor Sections" of this application for Hhich t.hey
<br />will be responsible. If you, as the owner signs ~s tIle contractor, YQ4 are indicating that
<br />you, rather than the contractor, are responsible for the Ho_rk. If the contractor \.lishes
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />Ilot entitled to permitting privil~ges in the City of Zephyrhills.
<br />C. 'I'RANSPOR'l'ATION IMPAC'l' !fEES AND UTILITY CONNECTION h~EES
<br />il. CONB'l'RllC'l'UION LIEN LMJ (CHAP'l'ER '713, FLORIDA STATUTES, AS AMENDED)
<br />I certify tllat I, the applioant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guide" prepared by the Florida Depar-tment of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
<br />have obti:lined a copy of the above descd.bed document and promise in good faith to deliver
<br />it to the "owner" prior to COlTUllencement.
<br />E. CON'rRAC'l'oR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the information in this application is accurate and that all Hark will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />developmeut.
<br />Application is hereby made to obtain a permjt to do work and installation as indicated. I
<br />certi fy that no vwrk or installation has corrunenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laHs regulating construction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiction. I <ilao
<br />certify that I undel:stand that the regulations of other governmental agencies may apply to
<br />the intended work, <ind that it is my responsibility to identify what actions T must tal,e to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Environmental Regul<it.ion-Cypress Bayheads, Wetland Areas and Environmentally Sensj.tive
<br />Lands, Water/Waste~vater Treatment
<br />*Soutllwest flo~ida Water Management District-Wells, Cypress 8ayheads, Wetland Areas,
<br />Altering Watercourses
<br />'Anuy Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Vepal:tment of Health lie Rehabil.itative 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.", it is
<br />understood that a drainage plan addressing a "compensating volume"'will be submitted Hhicb
<br />is prepared by a professional engineer registered in tile State of Florida prior to permit
<br />j,tlsuance.
<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 vio~ations of any oode. Every permit
<br />is!',iued shall become invalid unless the Hork- authorized by such permit is cOlluuenced Hithin
<br />six months of issuance, or if \vork authorized by the permit is suspended or abandoqect for a
<br />period of si4! months after the time the work is corrunenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Buildlng Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNERI YOUR E'AILlJRE 'fO RECORD A NOTICE OF COMMENCEMENT MAY RESUIil' IN YOUR
<br />PAYING TWICE FOR IMPROVEiMENTS '1'0 YOUR PROPER'ry. IF YOU IN'l'END TO OB'rAIN FINANC;IH~I .(.::qN~UL'l'
<br />WI'rH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOnCE OF COMMENCEMEN'I'. . JOBS Ul~fJER
<br />$2,500 IN VALUE; DO NOT NEED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCENEN'r".
<br />
<br />
<br />SIGNA'l'URE: OWNER OR AGENT
<br />
<br />STA'rE OF E'LORIDA
<br />COUNTY OF -----
<br />The foregoing instrument was
<br />Before me this __ day of
<br />by_
<br />
<br />acknowledged
<br />, 19_
<br />
<br />STA'rE OF Ii'LORIDA P
<br />CO\JN'l'Y 0J:r~ a..SC 0
<br />The forego.ing instrnment w~.a.....Pokno~lled~so <...
<br />Before me this ~ia.y of~r}U(J..rY, ?J:__,-__
<br />by ~.o~a.5 ~. \:) ,'/'of""\
<br />~ne of person acknow.ledged)
<br />. o.is personally known tome, or
<br />
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and who[] did Odid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Owho has produced
<br />(type of identifioation)
<br />and Hho Ddid DUd not take all oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />-
<br />Name typed, printed or stamped
<br />
<br />Hallie typed, prlnted or stamped
<br />
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