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<br />
<br />CONDI'l'IONS OF PERNI'l' AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands thqt this pl'lrmit may be subject to "deed restrictions'; '~:\'J'ch
<br />may be mure reatriative than City regulations, The ~ndersigned assumes responsibility for
<br />complicwce wi t'h any applicable deefi restrictions.
<br />B. U1nIcENSED (~ON'l'RAC'l'ORS AND CON'fiAC'I'OR RESPONSIBIlJI'l'IES
<br />I f the o\vner- has hired a contracto'J: or contractors to undertake work, they may be required
<br />to bl:'l U censed in accordance Hith state and local regulations. If the contractor is not
<br />licensed as requiLed by law, 'both the ovmer and contractor may be cited for a mLsdemeaoo.t:
<br />violation under statl:'l IcnL If the owner' or intended contractor are uncertain as to Vlhat
<br />licensing requirements may apply for the intended work, they are advJsed to contact the
<br />city of Zephyrhills Building Department, 813'-788-6611.
<br />Furtheuliol:e, j f the OHner has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application tor which they
<br />will be responsible. If you, as the owner signs as the contractor, YQY are indicating that
<br />you, rather than the contractor, aie responsible for the work. If the contractor wisll6s
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />not elltitled to permitting privJl~ges in the City of Zephyrhills.
<br />C, 'fRANSPOR'l'ATION IMPAC'!' FEES AND UTUITY CONNECTION nlES
<br />D. CONS'l'RllCTUION MEN LA~J (CHAP'PER 713, FLORIDA STATUTES, AS AMENDED)
<br />J certify that I, the appli.cant, have been provided with a copy of "Florida's Constructlon
<br />lien Law - Homeowner's Protection Guide" prepared by the Florlda Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that: the "owner", I cerify that I
<br />llave obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to conm1encement,
<br />E. CONTRACTOR' a/OWNER'S AFFIDAVI'r
<br />I certify that all the information in this application is accurate alld that all work will
<br />be done in compliance \-"dth all appllcable laws regulating constnlCtion, zoning, and land
<br />development.
<br />Applloation is hereby made to obtain a permit to do work and installation as illdicated. 1
<br />certify that no vwrk or installation has commenced prior to issuance ot a permit and that
<br />all work Hill be performed to meet standards of all laws regulating construction, City
<br />codes, zoning regulations, and land development regulations in the jllrisdiction, I also
<br />certify that I understand that the regulations of other governmental agellcies may apply to
<br />the intended work, and that it is my responsibility to identify vlhat actions I Hlllst take to
<br />be in compliance. Such agencies include but are not l.imited to: *Depar-tment of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Bensttive
<br />Lands, Water/Wastewater Treatment
<br />'Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />AlterJng Watercourses
<br />'Ar-my Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health Ii Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environmental Protection Agency-Aabea~Gs 8batement
<br />I also certify that, if fill material is to be used in Flood Zone ~A" or "A,ete.H, it is
<br />understood that a drainage plan addressing a "cornpen~ating volume" 'will be submitted whic)!
<br />is prepared by a professional engineer registered in the State of Florida prlor to permit
<br />issuance,
<br />A permit issued shall be construed to be a license to proceed Hith the work and not as
<br />authority to violate, cancel, alteL, or set aside any provis1ons of the technical codes,
<br />nor shall 1ssuance of a permit prevent the Building Official from thereafter requJring a
<br />correction of errors in plans, con~truction, or viol&tions of any oode. Every permit
<br />iSliued .shall become invalid unless th~ work authorized by such permit is oOllunenced within
<br />six months of issuance, or if work authorized by the permlt is suspended or abandoqed for a
<br />period of aLII month5 after the time the work is commenced. One 90 day extension of time
<br />may be alloVled tor the permit with fee charge of $15.00. The extension shall be requested
<br />i n ~vri ting to the Buildi.ng Offioial, An approved inspection must be Jogged during each. alx
<br />month peri.od, or the proj ect will be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR FAILURE 'I'O RECORD A NO'l'ICE OJ!' COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE B'OR IMPROVEMEN'l'S '1'0 YOUR PROPER'n. IE' YOU INTEND TO OB'PAIN li'INANqNq, ~qN~UI!!'
<br />WITH YOUR LENDER OR AN A'l"rORNEY BEB'ORE RECORDING YOUR NOnCE OF COMMENCEMEN'I'. ,JOBS UNDER
<br />$2,500 IN VALUE: DO NO'I' NEED '1'0 RECORD AND POS'l1 A "NWrICE OF COMMENCEMEN'I'It,
<br />
<br />e /52L ~ _____
<br />OWNER O{~~
<br />
<br />SIGNA'l'URE:
<br />
<br />CONTRACTOR
<br />
<br />S'l'A'PE OF F1O~DA
<br />COUN'I'Y OF C\. ~_O
<br />'I'he foregoing in~frllment WEed${~d-
<br />Befor~ \lIIe this ~~ ~y ~.~ a _ ' ~...3
<br />by _ \:.,:\ -e~ '" N-..:-\- " \
<br />_ ~ame of person aoknowledged)
<br />L~10 is personally known to me, or
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument WqS acknowledged
<br />Before me this _~ay of.---, 19 __:...._
<br />by
<br />(name of person aoknowledged)
<br />Qho is personC:llly knQ~m to me, or
<br />
<br />
<br />of identifi~ffl~hRn~
<br />take an ~~ R. PE.,lj!~ and Hha Ddid
<br />/" '* o..() ........ '/M.~
<br />~~<<,v..~~\SSION ~~..;'[p ~
<br />:'11IIO. ~.. ~ ~ . ' ~ _____"
<br />Signature of person taking ack~w{~~me'nt.. 't>\ ~signature of person taking acknowledgment
<br />. -*- .... .*=
<br />
<br />~~_to..l..~ffK j' r\~ \~.. ~.962~80 t? .~ii-.----~---
<br />Hame t\1ped printed or stamped ~"P'",.~'t>I,p1'~onded:x'~~~";:$l~ Name typed, prlnted or stamped
<br />:t , ~?r'... "'UblicU",.,e;...<..~ *'
<br />~'" ,oUS........"-o'\ ,::S
<br />'o'11t. ZlC 51 [1.\" \\,.....
<br />IIIIII/i" "'''\\\
<br />
<br />o Hho has produced____ ____
<br />(type of identification)
<br />CJJid not t.ake ,UI oath
<br />
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