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<br />COIWI'l'IONS OF PERMI'r AFE'IDAVIT
<br />A. NOnCE OIl' DEED RES'l'lUC'rIONS
<br />The undersigned understands thqt this permit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />oompliance with any applicable deed restrictions.
<br />B. UNI,ICENSED !CON'I'RAC'I'ORS AND CONTRACTOR RESPONSIBII,I'I'IES
<br />If the o\'/ner has hired a contractor or contractors to undertake work, they may be required
<br />to be Ucensed in accordance vdth state and loca.l regulations. If the contractor is not
<br />lioensed as required by law, both the OhIner and contractor may be cited for a ndsdellleanor
<br />vio.lation under state lahI. If the owner or intended contractor are lHlcerLodn as to Vihat
<br />licensillg requirements may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills Building Dt:;partment, 813-788-6611.
<br />Furthermol:e, 1 t 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, YQ~ are indioating that
<br />you, lather than the contractor, are responsible for the work. If the contractor wishes
<br />you to sign as contractor that mCiY be an indication that he is not properly .licensed and is
<br />not entitled to permitting privil~ges in the City of Zephyrhills.
<br />c. 'I'RANSPOk'l'ATION IMPAC'l' IrEES AND U'I'HI'I'Y CONNECTION FEES
<br />D. CONS'rkllcrrUION LIEN LAvJ (CHAprl'ER '713, FLORIDA s'rATUTES, AS AMENDED)
<br />1 certify that I, Lhe applicant, have been provided with a copy of "Florida's Constrllction
<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 "ovmeru, I cerify that I
<br />Ilave obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owneru prior to commencement.
<br />g. CON'I'RAC'l'OR' S/OWNER' S AFFIDAVI'r
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />development.
<br />Applioation is hereby made to obtain a permi t to do work and installation as indicated. I
<br />certify that no work or installation has corrunenced prior to iSlOuance 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 regu.latJons .in the jm:isdicUon. I also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended work, and that it is my responsibility to identity what actions I must take to
<br />be in compliance. Such agencies include but are not limited to; *Department of
<br />Environn!ental RegUlation-Cypress Bayheads, Wetland Areas and Environment.ally Sensjtive
<br />Lands, Water/Waste\-later Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Baybeads, WeLl and Areas,
<br />AJtering Watercourses
<br />*AnnX' Corps of Engineers-Seawalls, Docks, Navigable WaterVlays
<br />*Department of Hea.lth & Rehabilitative Services, Environmental Health Unit-Wells,
<br />WasteViater Treatment, Se~tic Tanks .
<br />*u.S. Environmental Protection Agency-Asbestos abatement
<br />I also oertify 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 Hh.ich
<br />it; prepared by a professional engineer registered in thE! State of Florida pdor to penult
<br />j ssuance.
<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 sha.l.l issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, con~truction, or violations of any code. Every permit
<br />issued shall become invalid unless the Hark authorized by such permit is COlluuenced Hlthin
<br />slx months at issuance, or it work authorized by the permi.t is suspended or abandoqed tor a
<br />period of sLx months after the time the work is conunenced. One gO day extension of time
<br />may be allowed tor the permit with fee charge of $15.00. The extension sha.ll be ~eques~ed
<br />in wri ting to the Buildi.ng Official. An approved inspection must be logged during each I:lix
<br />lIIonth periOd, or the pr'oject Hill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAIWRE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL'r IN YOUR
<br />PAYING '!'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB'I'AIN It'INANqlNq, ~qNI?UL'l'
<br />WITH YOUR LENDER OR AN A'l"fORNEY BEFORE RECORDING YOUR NOTICE Olr COMMENCEMENT. ,JOBS UNDER
<br />$2,500 IN VALUE DO NO'!' NEED '1'0 RECORD AND POS'}' A "NOTICE OF COMMENCEMEN'l'''.
<br />
<br />SIGHA'l'URE: OWNER OR AGENT
<br />
<br />S I GNA'I'URE: CONTRACTOR
<br />
<br />S'I'A'rE OF FLORIDA
<br />COUN'ry OF
<br />'J'be foregoing instrument was acknowledged
<br />Before me this ___._ day of __, 19-,-
<br />by ____
<br />(name of person acknowl,dged)
<br />Owho is personally known to me, or
<br />
<br />STA'fE OF nORIDA
<br />COUNTY OF
<br />The foregoing instrument H~S
<br />Before me this ---------Pay of
<br />by
<br />
<br />a oknovJl edged
<br />, 19~_
<br />
<br />(name of person aoknowledged)
<br />Qho .is personally kno\'m to me, or
<br />
<br />o who has produced
<br />(type
<br />and who[] did []did not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Ll Hho has produced________._______
<br />(type of identification)
<br />and Hho Odid []Jid not t.ake all oath
<br />
<br />Signature of person taking acknohIledgement
<br />
<br />Signature of person taking acknowl edgmt:mt
<br />
<br />I'lame typed, fJrinted or stamped
<br />
<br />-
<br />Nan~ typed, printed or
<br />
<br />stamfJed
<br />
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