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<br />CONDI'l'IONS OF PERM!'!' AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />, 'l'he undeJ.:signed understands th~t this permit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. The undersigned assumes responsibility fo~
<br />complicmce with any applicable deed restrictions.
<br />B. UNLICENSED (~ON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBILI'l'IES
<br />If the owner has hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accordallce with state and local regulations. If the contractor is not
<br />licellsed as required by law, both the owner and contractor Illay be cited for a misdemeanor
<br />violation under ::;tate laH. If the owner or intended contractor are uncertain as to Hhat
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills BuUding Dflpartment, 813-788-6611.
<br />Furthenl1or-e, if the ovmer 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 whicll they
<br />will be responsible. If you, as the owner signs as the contractor, you are indicating that
<br />you, rathel' than the contractor, are responsible for the work. I f the contractor Hishes
<br />you to sign a/:1 contractor that may be an indication that he i.s not properly licensed and is
<br />not ellLitled to permitting privileges in the City of Zephyrhi.lls.
<br />C. 'I'RANSl-'OR'1'ATION IMPACT FEES AND UTILI'I'Y CONNECTION FEES
<br />D. CONS'I'RIIC'1'UION LIEN LAvJ (CHAP'I1ER '713, FLORIDA S'l'ATUTES, AS AMENDED)
<br />J certify tllat I, the 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 appl.icant is someone other that the "owner", I cerify thcat I
<br />have obtained a copy of the above described document and promi.se in good faith to deliver
<br />it to the "oHner" prior to conunencement.
<br />E, CON'!'AAC'1'OR' SIOWNER' S AFFIDAVI'l'
<br />I certify that all the information in this application is accurate arid that all Hork will
<br />be done in compliance with all applicable .laws regul ating construction, zoning, and land
<br />development.
<br />Applioation is hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no vwrk or installation has commenced pri.or to issuance of a permit and that
<br />all work v/ill be performed to meet standards of all laws regulati.ng oonstruction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br />oertify that I ullderstand that the regulations of other governmental agencies may apply to
<br />the intended work, and that it is my responsibility to identi.ty what aotions T must take Lo
<br />be in eompliallce. Such agencies include but are not limited tOI *Department ot
<br />Environn\ental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensltive
<br />Lands, Water/WasteHater Treatment
<br />*Soutllwest ilorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterway::;
<br />*Department of Health Ii Rehabilitative Services, Environmental Health UnJt-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.8. Environmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone ~A" or "A,ete.N, it is
<br />unde.t:stood that a drai.nage plan addressing a "compensating volume" 'Hill be submitted v/hic: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 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 shall issuance of a permit prevent the Building Official from thereatter requiring a
<br />correction of errors in plans, construction, or violations of any oode. Every permit
<br />iSliu~d shall beaome invalid unless th~ Hark authorized by such permit is aOllunenced within
<br />six months of issuance, or if work authorized by the permit is suspended or abandoqed for a
<br />period of sbt months after the time the work is commenced. One 90 day extension of time
<br />may be allowed for the permit Hith fee charge of $15.00. The extension shall be requested
<br />il\ writing to the Buildlng Offici.al. An approved inepection muet be logged during each silt
<br />1II0nt1l period, or the project will be considered abandoned.
<br />WAfUHNG '1'0 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN'll MAY RESULT IN YOUR
<br />PAYING TWICE FOR H1PROVEMEN'l'S TO YOUR PROPERTY. IF YOU IN'I'END TO oa'1'AIN FINANC;ING, .(::QN~UI/I'
<br />WITH YOUR LENDER OR AN A'l"!'ORNEY BEFORE RECORDING YOUR NO'llICE OF COMMENCEMEN'1'. 'JOBS UNDER
<br />$2,50D IN VALUE DO l'lO'r.~~~lJ:p'_.:.:.~O .~~~~RD AND POS'!' A "NOnCE OF COMMENCEMEN'l'''.
<br />
<br />81 ..-~//-._=:=:;~~ 8~~-=~3:>-;--~
<br />
<br />
<br />S'l'A'rEl OF FLORI DAjJfi 11,('J
<br />COUN'I'Y OF - ,.,..::?
<br />'l'he foreaoing .instrument was acknoHledged
<br />Bdore ~ this -:;S- day of /?J/'I/2..t!.# , ~..2C1tl3
<br />by . qL ~~€/,q
<br />~(name of pereon aaknowl~dged)
<br />~ho is personally known to me, or
<br />
<br />STA'I'E OF FLORIDA L?
<br />COUNTY OF rA..st!..c.
<br />ThE3 for'ego.ing instrument w~s acknoHledged.
<br />Befor, e me~lis o?~y of.-,&l/9..~fl4- , oW 2~3
<br />by , ',,!Jv L... 'A'!/e,.c:; / /i-
<br />{name of person acknowledged)
<br />~is per:sonally kno\'Jn to me, or
<br />
<br />Owho has produced
<br />(type of identification)
<br />an~ Ddid not take an oath.
<br />
<br />c-r'" ~crfd ~
<br />
<br />"Signatur'e of person taking acknowledgement
<br />
<br />o who has produced________~_______
<br />(type of identification)
<br />
<br />a,ndt.Odid ~Z~ an oath
<br />~ ~~ t -----
<br />S gnature of person taking acknowledglllt:nt
<br />
<br />Hame typed
<br />
<br />1>I'l~~ed ~ccmo
<br />~~"::1 MY COMMISSION t CC 949169
<br />~\ . ~ EXPIRES: June 26, 2004
<br />'1~R";":l . Bonded Thru Notary Public Undorwrltors
<br />, Ht'"
<br />
<br />
<br />SHlRDEN K. DEL cono
<br />
<br />&; p. P
<br />Bonded Thlu NoIary NIle Undonn1laII
<br />
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