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<br />COlHll'rIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands thqt lhis permit may be subject to "deed restrictions" \^lllich
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B, UNIJICENSED 'CON'l'RAC'l'ORS AND CONTMCTOR RESI?ONSIBnr'l'IES
<br />If the rmner has hired a contractor or contractors to undertake work, they 1I1ay be required
<br />to I:H:l U ct:llsed in accordance Hith state and local regulations. If the contractor is not
<br />licell13ed as required lJy law, both the o~mer and contractor may be cited for a misdemeanor
<br />violati on under state laH. I f the owner or intended contractor are ullcertain as to ~Ihat
<br />licensing requirement.s may apply for lhe intended work, they are advised to contact the
<br />City of Zephyrhilh Building Department, 813-788-6611.
<br />Furtheunol::e, it the owner has hired a contractor or contractors, he is advised to have the
<br />contractor (s) sign portions of the "Contractor Sections" of this appli.cation for which they
<br />will b~ responsible, If you, as the owner signs as the contractor, yay are indicating tlla.t
<br />you, rather than the oontractor, are responsible for the work, If the contractor wislles
<br />you to sign as contractor that me,y be an indication that he is not properly lioensed and is
<br />Ilot entitled to permitting privil~ges in the City of Zephyrhills,
<br />c. 'I'MNSl'CJk'l'A'rroN IMPAC'l' If'EES AND U'l'ILI'I'Y CONNECTION Ii'EES
<br />lJ, CONsrrRllc'rUlON LIEN LAv~ (CIiAP'I'ER 'Jl3, FLORIDA S'I'A'l'UTES, AS AMENDED)
<br />1 certify that I, the appli.cant, have been provided \^lith a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and Consumer Affa.irs, If the appli.cant is someone other that the "owner", I cerify that I
<br />have obti:l1ned a copy of the above deacribed document and promi.se in good faith to deliver
<br />it to the "owner" prior to commencement.
<br />E. COH'rAAC'l'OR' SimmER' S AFFIDAVl'l'
<br />I certify that all thb information in this application is accurate and that all work will
<br />IJe done in compliance with all applicable laws regulating constl:ucti.on, zoning, and land
<br />development.
<br />Appliuation is hereIJy made to obtain a permit to do work and installation as indicated. I
<br />ce~tify that no work or installation has comnenced prior to issuance 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 jllrisdiction, I also
<br />certify that I undel:stand that the regulations of other governmental agencies may apply to
<br />the intended work, and that it is my responsibility to identify what aCltions I must take to
<br />be in compliance, Such agencies include but are not limited to I *Department D.f
<br />Envirollmental Regulation-Cypress Bayheads, Wetland Areas and Bnvironmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />'Southwest IJ'lodda Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Envi.ronmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />-Au,S, Environmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone "A" or "A,eta.", it is
<br />understood that a drainage plan addressing a "compensating volume" 'will be submitted which
<br />is prepared by a professional engineer registered in tl.. 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 />authod ty to violate, cancel, alter, or set aside any provisions of the teclmioal codes,
<br />nor shall issuance of a permit prevent the Building Of{icial from tllereafter requiring ~
<br />correction of errors in plans, oonstruction, or violations of any code, Every permit
<br />is~u~d shall beaome invalid unless the Hork authodzed by such permit i6 oOllunenced within
<br />alx months of issuance, or if ~vork authorized by the permlt 1s suapended or abandoqed for a
<br />period of slx months after the tilne the work is commenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15,00, The extension shall be reques~ed
<br />ill writing to the Building Official. An approved inspeotion muat be logged during each aix
<br />month period, or the pr'oj ect Hill be considered abandoned,
<br />WARlHNG TO OWNER: YOUR FAILUREJ TO RECORD A NOTICE OF COMMENCEMEN'l' MAY RESUL'l' IN YOUR
<br />PAYING 'l'W1CE FOR IMPROVEMEN'l'S TO YOUR PROPERTY, IF YOU INTEND TO OB'rAIN E'INANGIl'lq,~9N~UL'!'
<br />WITH YOUR LENDER OR AN A'I"!'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT, JOBS UNIJER
<br />92,500 IN VALUE DO NOT NEED '1'0 RECORD AND POST A "NOnCE OF COMMENCEMEN'l'''.
<br />
<br />S H-iNA'l'lJRE : OWN ER OR AGEN'l'
<br />
<br />SIGNA'I'URE: CONTRAC'l'OR
<br />
<br />a clmowl edged
<br />, 19_
<br />
<br />STA'I'E OF FLORIDA
<br />COUN'ry OF --------_
<br />'l'he foregoing instrument w~s acknowledged
<br />Before me this ----Slay of----, 19 _..:_..
<br />by
<br />(name of person acknowledged)
<br />Qho is personally known to me, or
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF ---
<br />The foregoing instrument was
<br />Bt:fore Ine this __ day of
<br />by
<br />
<br />(name of person acknowledged)
<br />Owho is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and who[] did Ddid not
<br />
<br />o Hha has produced____
<br />(type of identification)
<br />and Hha Ddid DUd not t,ake all oath
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Signatur'e of person taking acknowledgerrient
<br />
<br />Signature of person takiug aoknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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