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<br />l;UIW1'1.'lONB OF PERlI1I'I' AFFIDAVIT
<br />"A. NUfICE OF DEED RES'l'RIC'rIONS
<br />The undersigned understands th~t this permit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. The underSigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED (~ON'I'RAC'l'ORS AND CON'l'RACTOR RESPONSIBnI'I'IES
<br />If the OHl1er has hired a contractor or contractors to undertake work, they may be required
<br />to bi: 1.1 censed in accordance ~d.th state and local regulations. If the contractor is not
<br />licensed as required by law, both the owner and contractor may be cited for a misdemeanor
<br />violation under state law. If the owner or intended contractor a.t:e uncertain as to .Ihat
<br />licensing requirements may apply for the intended work, they are advised to aonta6t the
<br />city of Zephyrhills -Building Department, 813-788-6611.
<br />Fur:therlllol:e, :1 f the owner has hired a contractor or contractor:s, 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, you are indicating that
<br />you, rather than the contractor, are responsible for the work. I f the contt'actor wishes
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />Ilot entitled to permitting privil~ges in the City of Zephyrhills.
<br />c. 'I'RANl:il'OR'l'ATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONS'l'RUC'l'UION LIEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />1 certify that 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 that I
<br />have obtcd.ned a copy of the above described document and promise in good faith to deliver
<br />it to the: "owner" prior to C01TUllencement.
<br />E. CONTRAC'fOR' S/OWNER' S AFFIDAVI'r
<br />I certify that all the infor:mation 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 />Application is hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no Hork or installation has commenced prior to issuance of a permit and that
<br />all work .Jill 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 agenciea may apply to
<br />the intended work, and that it is my responsibility to identify what actions I must tal.e to
<br />be in compliance. Such agencies include but are not limited to: "'Department Df
<br />Environmental ~egulation-Cypress Bayheads, Wetland Areas and Invironmentally Bensttive
<br />Lands, Water/Wastewater Treatment
<br />"'Southwest E'lorida Water Management Distr:ict-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />"'iJepartmenl of Health Ii Rehabilitative Services, Envi.ronmental 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 ~A" or "A,etc.", it is
<br />under:stood that a drainage plan addressing a "compensating volume"'will be submitted which
<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 tile technical codes,
<br />nor: shall issuance of a permit prevent the Building Official from thereafter r:equiring a
<br />correction of errors in plans, construction, or violations of any oode. Every p~'mit
<br />iSliued ahall beoome invalid unless the work authorized by such permit is COIIUlIl;lnCt:id within
<br />six months of isauance, or if work authorized by the permit is suspended or abandoij~d for a
<br />period of si~{ months after the time the work is commenced. One 90 day extension of time
<br />may be allowed for the permit with fee char:ge of $15.00. The extension shall be requelited
<br />in w!:iting to the Building Official. An approved inspection must be logged during each aix
<br />month period, or the proj ect .Jill be considered abandoned.
<br />WARNING '1'0 OWNER; YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMEN'I' MAY RESUL'I' IN YOUR
<br />PAYING TWICE Ii'OR IMPROVEMENTS TO YOUR PROPER'I'Y. IF YOU INTEND '1'0 OBTAIN )!'INANqINq, .~9NliIUL'I'
<br />WI'l'H YOUR LINDER OR AN A'rTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'f. JOBS UNDER
<br />$2,500 IN VALUE: DO NOT NEED 'I'O RECORD AND POS'l' A "NOTICE OF COMMENCEMENT".
<br />
<br />SIGNA'l'URE: CONTRACTOR
<br />
<br />S 1 GNA'l'lJRE: OWN ER OR AGENT
<br />
<br />S'l'A'rE OF FLORIDA
<br />COUN'I'Y OF__
<br />'l'he foregoing instrument was acknowledged
<br />Before me this _._,_ day of _.____, 19_
<br />by__
<br />(name of person acknowledged)
<br />Owho is personally known to me, or:
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument w~s
<br />Before me this -------S-iay of
<br />
<br />aoknowledged
<br />, 19.~_
<br />
<br />by
<br />
<br />(name of person acknowledged)
<br />C1ho is personally known to me, or
<br />
<br />Owho has produced
<br />(type:
<br />and who[] did Ddid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o who has produced .
<br />(type of identifioation)
<br />and Villa Ddid DUd not t,ake an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, pdnti:d or stamped
<br />
<br />Name typed, printed or stamped
<br />
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