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<br />l;UNU1'1'lONS OF PERMIT AF'FIDAVIT
<br />A. NOflCE OF DEED RESTRICfIONS
<br />The undersigned understands thqt thios permit may be subject to "deed restrictions" which
<br />iliay b~ mure reaLrictive than City regul,tions. The undersigned assumes responsibility for
<br />oonvliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRAC'l'ORS AND CON'l'RAC'rOR RESPONSIBILI'fIES
<br />If the O\VIHH has hired a contractor or contractors to undertake work, they may be required
<br />to bi:: licensed in accordance with state and local regulations. If Lhe contractor is not
<br />licensed as required by law, both the OyJner and contractor may be cited far a misdemeanor
<br />violation under state lal" If the owner or intended contractor are uncertid.n as to v.,rhat
<br />licensing requirem=nts may apply for the intE:nded work, they are advised to contact: the
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />Furthe1:ll1or-e, j t the oymer has hired a contractor or contractors, he is advised to have the
<br />oontractor(s) sign portions of the "Contraotor Sections" of this application for which they
<br />v.,rill be responsible. If you, as the owner signs as the contractor, YQ4 are indicating that
<br />you, rather than the oontractor, are responsible for the work. If the contractor wishes
<br />you to sign as contractor that may be an indication that he is not properly liaellsed and is
<br />Il0t entitled to permitting privil~ges in the City of Zephyrhills.
<br />C. 'rRANSPOR'l'ATION IMPAc'r FEES AND UTILITY CONNECTION FEES
<br />D. CONS'rRUC'l'U10N LIEN LAW (CHAP'l'ER '713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applioant, have been provided v.,rith a copy of "Florida's Constrllction
<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 "oymer", I cerify that I
<br />Ilave obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to COlTunencement.
<br />E, CONTHAC'l'OR' a/OWNER'S AFFIDAVI'r
<br />I certify that all the information in this application is accurate and tllat all work will
<br />be dOlle in complianoe with all applicable laws regulating construction, zoning, and land
<br />development.
<br />Applioation is hereby made to obtain a permit to do work and installation as indiaatliid. I
<br />certify that no ywrk or installation has commenced prior to is:suance of a permit and that
<br />all work will be performed to meet standards of all laws regulating con:struction, 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 lnay apply to
<br />the intended v.,rork, and that it is my responsibility to identify v.,rhat actiona T lllllst take to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Envirollmental RegUlation-Cypress Bayheads, Wetland Area:s and Environmentally 8ensttive
<br />Lands, Water/Wastewater Treatment
<br />*Boutllwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />.Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Uepartn~nt of Health & Rehabilitative Services, Environmental Healtll Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />.U.S. Environmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material i:s to be used in Flood Zone ~A" or "A, etc.", it is
<br />understood that a drainage plan addressing a "compensating volume" 'will be :submitted which
<br />is pr-epared by a proftlssional engineer registered in the State of Florida prJor to permH
<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 provi.sions of t.he technical codes,
<br />nor allal1 issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, constructi.on, or violations of any oode. Every permit
<br />iSIiUed shall become invalid unless the Hark authorized by such permit is conunenced Hithin
<br />slx months of issuance, or if work authorized by the permlt is suspended or abandoqed for a
<br />period of S11. months after the time the v.,rork is conunenced. One 90 day extension of time
<br />may be allo",ed tor the permit with fee charge of $15.00. 'rhe extension shall be !:IiHlu@ated
<br />in writing to the Build1ng Official. An approved inspeotion must be logged during each six
<br />month period, or the project ",ill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMEN'I' MAY RESUW' IN YOUR
<br />PAYING 'l'WICE li'OR IMPROVEMENTS TO YOUR PROPER'ry, IF YOU INTEND TO OB'rAIN Ji'INANqrNq,~qN!l.UL'I'
<br />WITH YOUR LENDER OR AN A'l'TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED 'I'O RECORD AND POS'l' A "NOTICE OF COMMENCEMEN'r".
<br />
<br />SIGNATURE: OWNER OR AGEN'l'
<br />
<br />SIGNA'l'URE: CONTRACTOR
<br />
<br />S'!'A'rE OF FLORI DA
<br />COUNTY OF-
<br />The foregoing instrument was
<br />Before me this __ day of
<br />by
<br />
<br />STA'rE OF If'LORIDA
<br />COUN'I'Y OF
<br />The foregoing instrument W~1:l
<br />Before me this ----"pay of
<br />by
<br />
<br />acknowledged
<br />, lL-
<br />
<br />aoknowledged
<br />19
<br />
<br />(name of person acknowl~dged)
<br />Dwho is personally knov.,rn to me, or
<br />
<br />o v.,rho has produced
<br />(type
<br />and who[] did []did not
<br />
<br />(name of person acknowledged)
<br />[1ho is personally kllOYIn to me, or
<br />
<br />o v.,rho has produced____
<br />(type of identifioation)
<br />and v.,rho Ddid D-iid not take 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 />Name typed, pri.nted or stamped
<br />
<br />Nallle typed, printed or stamped
<br />
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