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<br />CUIW1'1'lONS OF PERMI'f AFIi'IDAVI'l'
<br />- A. ~OTICE OF DEED RESTRICTIoNS
<br />The undersigned understands th~t thi5 p~rmit may be subject to "deed restrictionsU which
<br />m~y be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CON'l'RAC'l'ORS AND CONTRACTOR RESPONSIBIJ.I'I'IES
<br />If the ol'mer has hit"ed a contractor: or contractors to undertake work, they may be required
<br />to bi:! licensed in accordallce with state and local regulations. If the contractor is not
<br />licensed afi required by law, both the ovmer and contractor may be cited for a miademeanor
<br />violation under fitate law, If the owner' or intended contractor are uncertain as to Vihat
<br />licensill9 requirements may apply for the intended work, they are advlsed to contact the
<br />City of Zephyrhills Building Department, 813-768-6611.
<br />Ifurthe.t:ll1o:re, if the ovmer has hired a contractor or contractors, he ia adviaed to have the
<br />contractor(s) sign portions of the "Contractor SectionsU of this application tor which they
<br />will be responsible. If you, as the owner signs as the contractor, YQ4 are indicating that
<br />you, lather than the contractor, are responsible for the wor'k. I f the contractor l^lishes
<br />you to sign as oontractor that may be an indication that he is not properly licensed and is
<br />not entitled to permitting privileges 1n the City of Zephyrhills.
<br />C. 'I'RANSPOR'I'ATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONs'rRUC'l'lJION LIEN LAW (CHAPTER '713, FLORIDA STATUTES, AS AMENDED)
<br />1 certify that I, the applicant, have been provided with a copy of "Florida's Constrllction
<br />lien Law - Homeowner's Protection Guideu 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 obtained a copy of the above described document and promise in good fa1th to deliver
<br />it to the "owner" prior to conunencement.
<br />E. CONTRAC'I'OR' S/OWNER' S AFFIDAVI'I'
<br />r certify that all the information 1n this appl1cation 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 indiaatsd. 1
<br />cert1fy that no work 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 />codefi, zoning regulations, and land development regulations in the jllrisdiction. 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 responaibility to identlfy what actions I must tal,e to
<br />be in compliance. Such agencies include but are not limited to: *Department Df
<br />Env1ronmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sens!tive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypresa Bayheads, Wetland Are~s,
<br />Altering Watercourses
<br />*Arlny Corpa of Engineers-Seawalls, Docks, Navigable Waterways
<br />*lJepartment of Health & Rehabilitative Services, Environmental Health Unit-Wella,
<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 ~Au or "A,etc.u, it is
<br />understood that a drainage plan addressing a "compensating volume"'will be submitted whioh
<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 thereafter requiring a
<br />correotion of errors in plans, construc~lon, or violations of any oode. Every permit
<br />is/.iued ahall become invalid unless the work authorized by such permit is cOllunenced within
<br />slx months of issuance, or if work authorized by the permlt i8 suspended or abandoqed 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 ttle permit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved in:>pection mu:>t be logged during each six
<br />month period, or the project Hill be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR FAIWRE '1'0 RECORD A NO'rrCE OF COMMENCEMENT MAY RESUL'!' IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO os'rAIN r'INANqINq, C9N~UL'I'
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'!'. JOBS UNDER
<br />$2,500 IN VALlJ&: DO NO'l' NEED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCEMEN'I'''.
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />S'rA'l'E OF FLORI DA
<br />COUNTY OF-
<br />The foregoing instrument was
<br />Before me this __ day of
<br />by
<br />
<br />acknowledged
<br />19_
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing 1natrument w~s
<br />Before me this ------.J.iay of
<br />by
<br />
<br />aoknowledged
<br />19
<br />
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />Qho is personally known to me, or
<br />
<br />Owho has produced
<br />(type
<br />and whoD did [J did not
<br />
<br />Dwho has produced
<br />(type of identifiQation)
<br />and who Ddid OUd not t,ake an oath
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />N-~-I~; ty"p";ci:---prlnted ~~-stamped
<br />
<br />Hame typed, printed or stamped
<br />
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