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<br />CONDI'l'IONS OF PERMI'!' AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The unde~signed unde~stands thijt this p~rmit may be subject to "deed restriotionsU whiell
<br />may be mOI:e restri eli ve than City regulations. The undersigned assumes responsibility for
<br />compli~nce with any applicable deed restrictions.
<br />B. UNI4ICENSED (~ONTRACTORS AND CON'l'RACTOR RESPONSIBII.I'I'IES
<br />If the owner has hi~ed a contractor or contractors to undertake Hark, they lllay be required
<br />to be licellsed in accordance with state and local regulations. If Lhe contractor is not
<br />Ii censed as requi red by law, both the ovmer and contractor may be cited for a misdemeanor
<br />violation under state la\!. If the owner- or intended contractor are uncertain as to vlhat
<br />licensing rr::quirementl:l lIlay apply for the intended work, they are advised to contact the
<br />City of Zephyrhills Building Department, 813-766-6611.
<br />lfurtherlliol:e, if the Ovmer has hired a contractor or contractors, he 1.05 advised to have the
<br />contractor (s) sign portions of the "Contractor Sections" of this app1i.cation for whi eh they
<br />.1111 be responsible. If you, as the owner signs as the contractor, you are indicating that
<br />you, lather than the contractor, are responsible for the work. If the contr'actor' Idshes
<br />you to sign as uontractor that may be an indication that he 1s not pI:operly licensed and is
<br />nol enl:itled to permitting pdvi.leges in the City of Zephyr-hUls.
<br />c;. 'l'RANSPOR'l'ATION IMPACT IfEES AND UTILITY CONNECTION lfEES
<br />D. CONS'!'RlJC'rUION LIEN LM~ (CllAP'I'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />r certify that I, the applicant, have been provided with a copy of "Flori.da's Construction
<br />lien Law .- Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that: the "o.mer", 1 cerify that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "ownerU prior to coumencement.
<br />E. CON'rRAc'roR' S/OWNER' S AFFIDAVI'l'
<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 constl'uction, zoning, and land
<br />development.
<br />Applioation is hereby made to obtain a permit to do work and installation as indicated. I
<br />cEq:tify that no vwrk or installati.on 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 />certify that I understand that the regulations of other governmental agendes may apply to
<br />the intended work, and that it is my responsibility to identify what act.i.ons I mllst take to
<br />be in compliauce. Such agencies include but are not limited to: "'Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensj.tive
<br />Lands, Water/WasteHater rrreatlllent
<br />"'Southwest Florida Water Manag~nent District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"Army Corps of Engineers-Seawa l.ls, Docks, Navigable Watenlays
<br />"'Department of Health Ii Rehabilitative Services, Envir'onmental Health Unit-Wells,
<br />Wal:llewater Treatment, Sept1.c Tanks
<br />*U.S. Environmental Protection Agency-Asbestos abatement
<br />I 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 i'lhic:h
<br />is prepared by a professional engineer registered in the State of florida prior to permit
<br />issuance.
<br />A permit: issued shall be constn~ed to be a license to proceed Hith the work and riot as
<br />authority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a pennit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any oode. Every permit
<br />issued shall become invalid unleas the work authorized by such permit is cOllunenced Hlthin
<br />six months of issuance, or if work authorized by the permlt is suspended or abandoqed for a
<br />period of slIt months after the time the work 1s 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 Build.i.ng Official. An approved inspection must be logged during each' six
<br />month period, or the project v-l111 be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR FAILURE 'I'D RECORD A NOTICE DE' COMMENCEMEN'J' MAY REBUI/I' IN YDUR
<br />PAYING TWICE li'OR IMPROVEMENTS 'l'O YOUR PROPERTY. IF YOU IN'I'END TO OB'I'AIN b'INANC:;INC1, ~qNIi\UI:I'
<br />WITH YOUR LENDER OR AN A'!"rORNEY BEFORE RECORDING YOUR NO'l'ICE OF COMMENCEMEN'!'. .JOBS UNfJER
<br />$2,500 IN VALUE DO NO'l' NEED '1'0 RECORD AND POS'l' A "NO'l'ICE OF COMMENCENEN'11fl.
<br />
<br />SIGHA'l'URE: OWNER OR AGENT
<br />
<br />SIGNA'!'URE: CONTRACTOR
<br />
<br />S'l'A'l'E OF FLORI DA
<br />COUN'rY OF
<br />'l'he foregoing instrument Has ackno~,lledged
<br />Bt:lfore me this ___ day of _____, 19--"-
<br />by__
<br />(name of person acknOWledged)
<br />Owho is peraonally known to me, or
<br />
<br />STA'l'E OF IfLORIDA
<br />COUNTY OF ___
<br />The foregoing instrument w~s aoknowledged
<br />Before me this .__........rlay of.----, 19
<br />by _'__
<br />(name of person acknowledged)
<br />Qho is personally known to me, or
<br />
<br />o who haa produced
<br />(type
<br />and whoO did 0 did not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o who has produced_.__.____________
<br />(type of identification)
<br />and v~ho Ddid DUd not tala: all Oi:lth
<br />
<br />Signature of person taking acknmdedgement
<br />
<br />Signature of person taking acknowl edgllll:nt
<br />
<br />Name typed, printed or stamped
<br />
<br />_.~--'----_._-----~-----.-._~-.._-_.._~._._.__.~-~..-
<br />
<br />Name typed, printed or stampt:ld
<br />
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