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<br />CONIlI'rIONS OF PERNI'r AF~""IDAVIT
<br />A. NO'!'rCE OF DEED RES'I'RIC'l'IONS
<br />'l'he undersigned understandl'l thqt this permit may be subject to "deed restrictions" which
<br />. .
<br />'may be more l.estd ati ve than City regulations. 'l'he undersigned assumes responsibiU ty tor
<br />complil;HlGe with any applicable deed restrictions.
<br />B. UNLICENSED 'CON'I'RAC'I'ORS AND CON'l'RAC'rOR RESPONSIBIJ,I'l'IES
<br />I f the oivner has hired a contractor or contractors to undertake work, they nlay be required
<br />to be licensed in accordance with st..te and local regulations. If the contractor is not
<br />I ioellsed as required by law, both the owner and contractor: IlIay be cited for a mifldellleanor
<br />violation under state law. If the owner or intended contractor are uncertain as to Hhat
<br />licensing requirements may apply for the intended work, they are advi.sed to Clonta.ot the
<br />City of Zephyrhills Bui.lding Department, 813-7B8-6611.
<br />Furthermore, if the owner has hired a contractor or contractors, he is advised to havtl the
<br />contractor (s) sign pOl:tions of the "Contractor Secti.ons" of this application for which they
<br />vlill be l.esponsible. If you, as the owner .signs as the contractor, YOL! are indicating that
<br />you, rather than the oontractor, are responsi.ble for the work. If the contractol: wishes
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />not ent:ltled to permitting privileges in the City of Zephyrhi.lls.
<br />C. 'I'RANSPOR'l'ATION IMPAc'r FEES AND U'I'ILI'I'Y CONNECTION )j....EES
<br />D. CONS'l'RllC'l'UlON LIEN LAW (CHAP'I'ER 713, FLORIDA S'l'A'l'UTES, AS AMENDED)
<br />T certify that I, the applicant, have been provi.ded with a copy of "Florida's Constrllcti.on
<br />lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agri.culture
<br />and Consumer Affairs. If the appl.i.cant i.s someone other that the "owner", 1 cerity thi:lt I
<br />have obtdned a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to COIlunencement.
<br />E. CONTRAC'POR' S/OWNER' S AFFIDAVI'P
<br />I certify that all the information in this appl.ication is accurate and tllat all work will
<br />be done in compliance with all appUcable laws regu1 ating consti'l\etion, zoning, and hnd
<br />devijllopment.
<br />Appli.oation is hereby made to obtain a permit to do work and installation as indioated. 1
<br />ce~tify that no Hork or installation has cOITUnenced prior to isauance 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. J 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 lI111st take to
<br />be in compliance. Such agencies include but are not lirnited tOI *Department of
<br />Environrljental Regulation-Cypress Bayheads, Wetland Areas and Envi.ronment:al1y Sens}.ti.ve
<br />Lands, Water/Wastewater Treatment
<br />*Soutllwest Wlorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Alteri.ng Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabi1i.tative Services, Environmental Health Unit-WeLls,
<br />Wastewater Treatment, Septic Tanks
<br />*U.8. Environmental Protection Agency-Asbestos abatement
<br />1 also certify that, if fill material is to be used in Flood Zone "AN or "A,etc.H, it is
<br />ullderstood that a drainage plan addressing a "compensating volumelf'will be submitted which
<br />is prepared by a professiollal engineer registered in th~ State of Florida pri.or to permit
<br />issuance.
<br />A permit issued shall be construed to ~e a license to proceed with the work and not as
<br />authority to violate, cancel, alter, or set aside any provisions of t1le technical codel:l,
<br />nor allall issuance of a permit prevent the Building Ofticial from thereafter requiring a
<br />co~~ection of errore i.n plans, cDn~truction, or violations of any code. Every p~'mit
<br />iSl:iued r:lhall become invalid unless the work authorized by such permit is oOllunencad within
<br />aix months of issuance, or if work authorized by the permi. t is suspended or abandolled for a
<br />period of si.x months after the tillle the work is commenced. One 90 day extensi.on of time
<br />may be allowed for the permi.t with fee charge of $15.00. 'rhe extensi.on shall be reguel:l~ed
<br />ill writing to the Building Official. An approved inspection must be logged during each aix
<br />month period, or the project v/111 be consi.dered abandoned.
<br />WARNING '1'0 OWNERI YOUR FAILURE TO RECORD A NonCE OF COMMENCEMENT MAY RESUL'l' IN YOUR
<br />PAYING 'l'WICE FOR IMPROVEMENTS TO YOUR PROPER'PY. IF YOU IN'l'END TO OBTAIN FINANqINq, ~'tN'UL'!'
<br />W!'1'H YOUR LENDER OR AN A'l"I'ORNEY BEfORE RECORDING YOUR NO'l'ICE OF COMMENCEMEN'l'. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED 'I'D RECORD AND POS'I' A "NO'!'ICE OF COMMENCEMEN'l"'.
<br />
<br />S I GNA'l'URE: OWNER OR AGENT
<br />
<br />S I GNA'!'URE I CONTRACTOR
<br />
<br />S'fA'l'E OF FLORIDA
<br />COUNTY OE'
<br />The foregoing instrument was
<br />Before llIe this _ day of
<br />by_
<br />
<br />acknowledged
<br />,19_
<br />
<br />STA'I'E OF FLORIDA
<br />COUN'rY OF
<br />The foregoing instrument WqS
<br />Before me this --J-iay of
<br />by
<br />
<br />acknowledged
<br />, 1 9 _...:.__
<br />
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />o who haa produced
<br />(type
<br />and who[] did []did not
<br />
<br />(name of person acknowledged)
<br />Diho is personally known to me, or
<br />
<br />o who hal3 produced ,___
<br />(type of identificati.onl
<br />and v,ho Ddid [}Hd not t.ake all oClth
<br />
<br />of i.dentification)
<br />take an oath.
<br />
<br />Signature of person taking acknowledgelllent
<br />
<br />Signature of person taki.ng aoknowledgment
<br />
<br />Name typed, printed or stan~ed
<br />
<br />Name typed, printed or stamped
<br />
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