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<br />CONOI'rIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The.undersigned understands thqt thia 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. UNl,ICENSED C;ON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBII.I'rrES
<br />If the owne}.' has hired a contractor or contractors to undertake Hark, they may be required
<br />to be licensed in accordance with state and local regul~tions. If the contractor is not
<br />licensed as required by laH, both the ovmer and contractor may be cited for a misdemeanor
<br />violation under state lavl. I f the owner or intended contractor are tHlcertain as to vlhat
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />Furthennon:, if the owner has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections II of this application for whicll they
<br />v/ill be l.esponsibltl. If you, as the owner signs as the contractol:1 YQ4 are indicating that
<br />you, rather than the contractor, are responsible for the wOl.-k. If the contractor wishes
<br />you to sign as contractor that may be an indication that he is not properly lioensed alld is
<br />not enti tled to permitting privileges in the City of Zephyrhl11s.
<br />C. 'I'RANI:)POR'l'ATION IMPAC'l' FEES AND UTILITY CONNECTION FEES
<br />D. CONS'l'RUC'I'UION LIEN LAW (CliAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Constrllction
<br />lien Law - Homeowner's Protection Guidell prepared by the Florida Departmellt of Agl:iculture
<br />and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
<br />llave obtained a copy of the above described document and promise in good faith to deliver
<br />.it to the "ownerll prior to corrunencement.
<br />E. CON'l'RAC'I'OR' S/OWNER' S AFFIDAVI'I'
<br />I certify that all the information in this appl.ication 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 i.s hereby made to obtain a permit to do work and installation as indioated. I
<br />certify that no work or installation has commenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regulating construotion, 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 agencies may apply to
<br />the intended work, and that it is my responsibility to identify what actions I lIlust take to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensttive
<br />Lands, Water/Wastewater rl'reatment
<br />*Southwest Florida 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, Environmental 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 ~AII or "A,ete.lI, it is
<br />understood that a drainage plan addressing a "compensating volume"'wiI1 be submitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to permit
<br />jl:lsuance.
<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 requi.ring a
<br />correction of errors in plans, oon~truction! or vio~ations of any oode. Every pa~mit
<br />iSliued shall become invalid unlel3s the work authori~ed by such permit is oOllunenoed Hithin
<br />six months of issuance, or if work authorized by the permlt is suspended or abandollCld for a
<br />period of elx months after the tlme the work is commenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extellsion shall be requested
<br />in writing to the Building Offioial. An approved inspeotion must be logged during eaoh'six
<br />month period, or the pl.'oj ect Hill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE '1'0 RECORD A NO'I'ICEl OF COMMENCEMENT MAY RESUW' IN YOUR
<br />PAYING 'rWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'l'END TO OB'I'AIN l!'INANGING, CqN~UL'l'
<br />WI'i'H YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO'l'ICE OF COMMENCEMEN'I'. 'JOBS minER
<br />$2,500 IN VALUE DO NO'I' NEED TO RECORD AND POST A "NOTICE OF COMMENCEMEN'l"'.
<br />
<br />SlGHA'l'URE: OWNER OR AGENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />acknowledged
<br />_,19_
<br />
<br />STATE OF FLORIDA
<br />COUWl'Y OF
<br />The foregoing instrument w~s
<br />Before me Utie -----Pay of
<br />by
<br />
<br />STA'l'E OE' FLORIDA
<br />COUNTY OF ----
<br />The foregoing instrument was
<br />BE:lfore me this ____ day of
<br />by
<br />
<br />acklloV/ledgect
<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 />o who has produced
<br />(type
<br />and wholJ did IJdid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Dwho has produced
<br />(type of identifioation)
<br />and Hho Ddid DUd not t.ake an oath
<br />
<br />Signature of person taking acknoHledgement
<br />
<br />Signature of person taking aoknowledgment
<br />
<br />Name typed, prlnted or stamped
<br />
<br />Name typed, printed or stamped
<br />
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