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<br />COIWl'rIONS OF PERl'1I'I' AFE'IDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Yhe undersigned understands th~t this permit may be subject to "deed restrictionsU Wllich
<br />may b~ more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED 'CON'I'RAC'I'ORS AND CON'l'RAC'l'OR RESPONSIBILI'I'IES
<br />I f the o\-./ner has hired a contractor or contractors to undertake Hark, they IlIay be ragui red
<br />to bl: 11 censed 1n accordanoe \-li.th state and 10ea.1 regulations. If lhe cOl1traol:or is not
<br />licensed as requi:t:ed !Jy law, both the owner and contraoto:t:' may be cited for a miademeanor
<br />violation under state lalL If the owner or intended contractor one uncertain as to what
<br />li censing regui rements may apply for the intended wOl:k, they are advised to contact the
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />Flutherlnol:e, if the owner has hired a contractor or contraotors, he 1s advised to have the
<br />contractor(e) sign portions of the "Contractor SectionsU of this application for whiell they
<br />Hill be l.eeponsible. If you, as the owner signs as the oontractor, you are indicating that
<br />you, rather than the oontraotor, are responsible for the work. If the contractor l'Iishes
<br />you to siyn as contractor that may be an ind1cation that he is not properly llcensed and is
<br />not enUtled to permitting privileges in the City of ZephyrhUIs.
<br />C. 'I'RANSPOR'l'A'fION IMPACT FEES AND U'l'ILITY CONNECTION IfEES
<br />D. CONS'I'RIIC'l'UION LIEN LAW (CliAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />1 certify that I, Lhe applioant, have been provided wilh a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection GuideU prepared by the Florida Departmellt of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "ownerU, I cerify that I
<br />Ilava obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owneru prior to corrunencement.
<br />E. CON'I'RAC'l'OR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in oompliance with all appli.cable laws regulating construotion, zoning, and land
<br />development.
<br />Application is hereby made to obta1n a permit to do work and installation as indicated. 1
<br />certify that no Hork or installation has oorrunenced prior to issuance of a per'lfIlt and that
<br />all work will be performed to meet standards of all laws regulating oonstruotion, City
<br />eodes, zoning regulations, and land development regulat10ns in the jurisdiotion. I also
<br />certify that I understand that the regulations of other governmental agencies Inay apply to
<br />the intended wOl'k, and that it is my responsibility to identify what actions T must lake to
<br />be in compliance. Suoh agencies include but are not limited to: *Department of
<br />EnvirOlllljental Regulation-Cypress Bayheads, Wetland Areas and E:nviromnentally Sensj.l1ve
<br />Lands, Water/Wastewater Treatment
<br />*Southwest ~"lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"Army Corps of Engineers--Seawa1.1.s, Dooks, Navigable WaterHays
<br />*llepartment of Health & Rehabil1tative Servioes, Environmental Health Hnlt-Wells,
<br />Wastewater Treatment, Septio Tanks
<br />*H.8. Environmental Protection Agency-Asbestos abatement
<br />1 also certify that, if fill mater1al is to be used in Flood Zone "AU or "A,etc.u, it is
<br />understood that a drainage plan addressing a "compensating volumen'will be submitted which
<br />is prepared by a professional engineer registered in the; State of li'lodda pdor to pennit
<br />issuanoe.
<br />A permit issued shall be construed to be a license to prooeed with the work and not as
<br />autllOri ly to v1olate, canoel, alter, or set as1de any provi.sions of the tealmical codes,
<br />nor shall issuance of a permit prevent the Building Offioial from thereafter requir1ng a
<br />correction of errors in plans, con~truction, or violations of any oode. Every permit
<br />is!iu~d shall become inval1d unless the work authorized by auch permit is cOl\ulIenced Hithin
<br />s1.x months of issuance, or if \-./Ork authorized by the perm1.t 1.s suspended or abandoqed for a
<br />period of s1.:x months after the time the work ls conunenced. One 90 day extension of tillle
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />lIIonth period, or the project Hill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NO'rICE OF COMMIllNCEMENT MAY RESUW' IN YOUR
<br />PAYING 'I'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN li'INAN(1n"q,~qN@UI/r
<br />WITH YOUR LENDER OR AN A'l"I'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
<br />$2,500 IN VALUE DO NOrl' NEED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCEMEN'llll.
<br />
<br />SIGHA'1'URE; OWNER OR AGENT
<br />
<br />SIGNA'I'URE: CONTRACTOR
<br />
<br />S'I'A'l'E OE' FLORIDA
<br />COUN'ry OE'
<br />The foregoing instrument was acknowledged
<br />Before me this __.____ day of _._____________. 1~
<br />by _____
<br />(name of person acknowlo;dged)
<br />Dwho is personally known to me, or
<br />
<br />STA'I'E OF nORIDA
<br />COUN'l'Y OF
<br />'fhe foregoing instrument Wi3,S aokrlOwl edged
<br />Before me this .----J.iay of---, ] 9._...:._
<br />by __
<br />(name of person aoknowledged)
<br />C1ho is personally known to me, or
<br />
<br />o who has produoed
<br />(type
<br />and who[] did [J did not
<br />
<br />of identifioation)
<br />take an oath.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgn~nt
<br />
<br />'_'~'4'_"____.'__,__,___________.______________
<br />
<br />I'lame typed, pri.nted or stamped
<br />
<br />Name typed, printed or stalnpt:Hj
<br />
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