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<br />COHDI'l'IONS OF PERlI1I'I' AFE'IDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands th~t this perrrdt may be subject to "deed restrictionsU which
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNIJICENSED 'CON'I'RAC'I'ORS AND CON'l'RACTOR RESPONSIBII,I'I'IE:S
<br />If the mvner- has hil'ed a contractor or. contractors to undertake work, they nlay be required
<br />to be licensed 1n accordallce wi.th state and loca.l regulations. If the contractor ls not:
<br />licensed as required by laH, both the ovmer and contractor may be c.ited for a Illiadellleanor
<br />violation under state law. If the owner or 1ntended contractor are uncertain as to vlhat
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills Bullding Department, 813-768-6611.
<br />E'urthermon:, :1. f the ovlller bas hit'ed a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application for Hhich they
<br />vilLi b<:i responsible. If you, as the owner signs as the contractor, you are indicating that
<br />YOll, lather than the contractor, are responsible for the work. If the contractor wishes
<br />you to sign as contractor that may be an indication that he 1s not properly lioensed and 1s
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C. 'l'RANSI:'OR'l'ATION IMPACT fEES AND U'l'ILI'l'Y CONNECTION FEES
<br />D. CONS'PRlIC'l'UION LIEN LAW (CliAP'l'ER 713, FLORIDA S'l'ATUTES, AS AMENDED)
<br />1 certify that I, the applicant, have been provided with a copy of "Florida's Constr\lctlon
<br />lien Law -- Homeowner's Protect1on Guide" prepared by the Florida Depat.tmellt of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "owner", 1 cerify that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />j t to the "owner" pr10r to corrunencement.
<br />~1. CON'l'RAC'I'OR' S/OWNER' S AFFIDAVl'r
<br />I certify that all the information in this applicat10n is accurate and tllat all work will
<br />be done in compliance with all applicable .laws regulating constt-uction, zoning, and land
<br />development.
<br />Application 1s hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no .wrk or installation has commenced prior to issuance of a permit and that
<br />ail work will be performed to meet standards of all laws regUlating construction, City
<br />codes, zoning regulations, and land development regulat.ions .in the jlll:isdictlon. 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 1dentify what actions I must take to
<br />be in compliance. Such agencies 1nclude but are not 11mited to: *Department of
<br />Environmental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Bensttive
<br />Lands, Water/Wastewater Treatment
<br />*Soutllwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"Anny Corps of Eng1neers-SeaHal.ls, Docks, Navigable WaterHays
<br />*lJepartment of Health & Rehabilitative Services, Env1r:onmental Health lJnl.t-WeUs,
<br />Wastewater 'l'reatmellt, Septic 'l'anks
<br />"u.s. Environmental Protection Agency-Asbestos abatement
<br />I a.lso certify that, if fill mater1al is to be used in Flood Zone ~A" or "A,etc.u, it is
<br />understood that a dra1nage plan addressing a "compensating volume" 'wiLL be :mblld tt:ed Hhich
<br />is prepared by a professional engineer registered in the. State of Flodda pdoI' 1:0 pel~lnJt
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />author1ty to violate, cancel, alter, or set aside any provis10ns of the techn1eal codes,
<br />nor shall 1ssuance of a permit prevent the Build1ng Official from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any code. Every ps!mit
<br />iermed shall become invalid unless the Hark authorized by such permit 16 oonuuenced Hithin
<br />six months of issuance, or if work authorized by the pernd.t 1.s suspended or abandoljeld for a
<br />period of Sill months after the t1.me the work is conunenced. One 90 day extens1.o11 of time
<br />may be alloHed for tire permit w1th fee charge of $15.00. The extellsion shall be requeated
<br />:1. n writing to the Buildi.ng Off1.cial. An approved inspection must be logged during eacb six
<br />month period, or the ptoject Hill be considered abandoned.
<br />WARlHNG TO OWNER: YOUR E'AIl,URE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
<br />PAYING 'l'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN E'INANqINq, .(.::qNl?UVI'
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO'l'ICE OF COMMENCEMEN'P. ,JOBS UNDER
<br />$2,500 IN VAWE DO N01' NEED '1'0 RECORD AND paS'l' A "NO'nCE OF COMMENCEMEN'l'''.
<br />
<br />----_._"~-_._-------------
<br />
<br />SIGNA'l'URE: OWNER OR AGEI'.J'l'
<br />
<br />-_._------~
<br />
<br />S I GNA'!'URE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF-
<br />The foregoing instrument was
<br />Before me this ___ day of
<br />by
<br />
<br />acknowledged
<br />.i 19~
<br />
<br />STA'l'E OF FLORIDA
<br />COUNTY OF
<br />The foregoing inetrument w~s aoknowledged
<br />Before me this .----J1ay of----, 19~_
<br />by _____
<br />(name of person acknowledged)
<br />[1ho .is personally knoHn to me, or
<br />
<br />(name of person acknowl~dged)
<br />Dwho ls personally known to me, or
<br />
<br />Owho has produced
<br />(type
<br />and who!] d1d [Jdid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o who has produced____ ____.____
<br />(type of 1dent:ification)
<br />and ~lbo Odid DUd not take an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of pereon taking acknowledgment
<br />
<br />._-_._--~--- -- -_.._~-~------_._-_._------~-._---
<br />
<br />Name typed, printed or stamped
<br />
<br />Harne typed, printed Ot stamped
<br />
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