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<br />I.;U1Wl'!'10NS OF PERlI1Irf AE'E'IllAVIT
<br />A. NO'rICE OF DEED RES'l'RIC'rIONS
<br />.'rhe u.ndersigned understands thqt thie pl'lrmi t may be subj ect to "deed restrictions" which
<br />may be more restrictive than City regulations. The undersigned aseumes responsibility for
<br />oonv1iance with any applicable deed restrictions.
<br />B. UNLICENSED CON'I'RAC'I'ORS AND CONTRACTOR RESPONSIBILI'I'IES
<br />If the o\"mer has hired a contractor or contractors to undertake work, they may be requix:ed
<br />to bl:l licellsed in accordance with state and local regulations. If the contractor is nol
<br />licensed as requiLed by law, both the ovmer and contractor may be cited tor a mlsdemeallor
<br />violation under state laH. If the owner or intended contractor are uncertain as to vlhat
<br />licensing requirement.s may apply for the intended work, they are advised to contact the
<br />Ci ty of Zephyrhills Building Department, 813-788-6611.
<br />Furthenllor-e, j t the ovlller has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application for which they
<br />will b~ responsible. If you, as the owner signs as the contractor, YQ4 are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor \.lishes
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />!lol elltitled to permitting privileges in the City of Zephyrhi.lls.
<br />C;. 'PRANI:lPOR'!'ATION IMPACT FEES AND UTILI'l'Y CONNECTION ~~EES
<br />D. CONS'PRUCTUION I,IEN LAW (CHAP'l'ER 713, FLORIDA S'l'ATUTES, AS AMENDED)
<br />I certify that I, Lhe applicant, have been provided with a copy of "Florida'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 "owner", I cerify that I
<br />have obtai.ned a copy of the above described document and prond.se in good faith to deliver
<br />it to tbe "owner" prior to commencement.
<br />E, CONTRAC'l'OR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the information in this appJ.ication is accurate and tllat all work will
<br />be done in compliance with all applicable laws regulating constr-uction, zoning, and land
<br />development.
<br />Application is hereby made to obtai.n a permit to do work and i.nstallation as indicated. I
<br />ce~tify that no work or installation 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 agencies may apply to
<br />the intended work, and that it is my responsibility to identify what actions I /IIust take to
<br />be in compliance. Such agencies include but are not li.mited to: *Department of
<br />Envirollmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensttive
<br />Lands, Wat:er/WasteHater Treatment
<br />*Soutllwest Florida Water Management District-Wells, Cypress Bayheads. Wetland Areas,
<br />Altering Watercourses
<br />'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Envir:onmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone qA" or "A, etc.", it i.s
<br />under'stood that a dralnage plan addressing a "compensating volume" 'will be suumi tted Ylhich
<br />is prepared by a professional engineer registered in the State of florida pri.or to permit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />autllority to violate, cancel, alter, or set aside any provisions of the teohnical codes,
<br />nor shall issuance of a permit prevent the Buildi.ng Official from thereafter- requlri.ng a
<br />correction of errors in plans, construction, or violations of any oode. Every permi.t
<br />issued shall become invalid unless the work authorized by such permit is cOllunenced within
<br />six montlls of issuance, or if work authorized by the permit is suspended or abandor~ed for a
<br />period of six months after the time the work is comnenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be ~equested
<br />in writing to the Building Official. An approved inspection must be logged during eacb I:lix
<br />month period, or the pr:oject Hill be considered abandoned.
<br />WARNING TO OW1UlR: YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
<br />PAYING TWICE FOR IMPROVEMEN'l'S TO YOUR PROPER'l'Y. IF YOU INTEND TO OBTAIN b'INANqINq,~qNt.;lUL'l'
<br />WI'fH YOUR LENDER OR AN A'fTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
<br />$2,50D IN VALUE DO NOT NEED '1'0 RECORD ~D POST A "NOTICE OF COMMENCEMEN'I'".
<br />
<br />SIGHA'l'URE: OWNER OR AGEN'l'
<br />
<br />S I GNA'I'URE : CONTRACTOR
<br />
<br />acknowledged
<br />,19_
<br />
<br />STA'rE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />Before me this -------Jjay of---, 19
<br />by
<br />(name of person acknowledged)
<br />Qho is personally known to me, or
<br />
<br />S'fA'rE OF FLORI DA
<br />COUNTY OF-
<br />Th@ foregning instrument was
<br />Before me this __ day of
<br />by
<br />
<br />(name of person acknowledged)
<br />Owho is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and who[] di.d Ddid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Owho has produced
<br />(type of identificati.onl
<br />and who Odid DUd not t,ake all oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or. stamped
<br />
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