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<br />CONDI'rIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Th@ undersigned understands thq.t this permit may be subject to "deed restrictions" wbJch
<br />n~y be more restrictive than city regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED (;ON'l'RAC'l'ORS AND CON'l'RAC'rOR RESPONSIBILITIES
<br />If the olo/ner' has hired a contractor or contractors to undertake work"tney may be required
<br />to be lIcensed In accordance wIth state and local regulations. If the contractor is not
<br />licensed as required by la~J, both the o~mer and contractor may b'e cJt;;ed for a mIsdemeanor
<br />violation under state law. If the owner or intended contractor are uncertain as to v~lat
<br />]j censing requirements may apply for the intended work, they- are advlsed to contaot the
<br />city of Zephyrhills Building Department, 813-788-6611.
<br />Furthermore, it the owner has hired a contractor or contractors, he, is advised to have the
<br />contractor (s) s1 gn portions.. O;f the "Contra-pt6:r Sections" of t!hisilpplication for \Vhich they
<br />will be responsible. If you, as the owner signs as the contractor, YQ4 are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractol' Io/ishes
<br />you to sign as contractor that may be an indication that he Is not properly licellsed and is
<br />not entitled to permitting privil~ges in the City of Zephyrhills.
<br />C. 'I'RANSI?OR'l'A'rION IMPACT FEES AND U'l'UI'I'Y CONNECTION FEES
<br />D. CONS'l'RUc'rUION LIEN LAW (CHAP'l'ER 713, FLORIDA S'l'ATUTES, AS AMENDED)
<br />I certify that I, tile applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guide" prepared by the Florida Departmellt of Agriculture
<br />"md Consumer Affairs. If the applicant is someone other that the "owner", 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" pri.or to conunencement.
<br />E, CONTRAc'rOR' a/OWNER'S AFFIDAVI'r
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />development.
<br />Applloation is hereby made to obtaln a permit to do work and installation as indicated. I
<br />certify that no work or installation has conunenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regulating construction, City
<br />aode~, zoning regulations, and land development regulatIons in the jllrisdiction. I ~lso
<br />certify that I understand that th~ regulations of other governmental agencies In~y apply to
<br />the intended work, and that it is my responsibility to identify what actions I JOust t:a}(e to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Envil:Ollfnental Regulatlon-Cypress Bayheads, Wetland Areas and Environmentally Bensi_live
<br />Lands, Water/Wastewater Treatment
<br />*Souttlwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />.Army Corps of Englneers-Seawalls, Docks, Navigable Wat~rways
<br />*Department of Health & Rehabilitative Services, Envlronmental Health Unit-Wells,
<br />Wastewater Treatment, Septlc Tanks
<br />"U.S. Environmental Protection Agency-Asbestos abatement
<br />I also certify that, lf fill material is to be used in Flood Zone nA" or "A, eta.", it is
<br />understood that a drainage plan addressing a "compensating volume" 'will he submitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to pennit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />~uthorit:y to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a permit prevent the Building Of~icial from thereafter requiring a
<br />correction of errors in plans, oon~tructionr or violations of any oode. Every permit
<br />iSsUed shall become invalid unless the work authorized by such permit is oOllullenced wlthin
<br />six months of issuance, or if Hork authorized by the perm1t 1s suspended or abandolled for a
<br />period of sill months after the time the work is conunenced. One 90 day eKtension of time
<br />may be allowed for the permit with fee charge of $15.00. The eKtellsion shall be requested
<br />ill writing to the Buildi.ng Official. An approved inspection must be logged during each sIx
<br />month period, or the project vdll be considered abandoned.
<br />WARNING TO OWNER; YOUR FAILURE TO RECORD A NonCE OF COMMENCEMENT MAY RESUL'{' IN YOUR
<br />PAYING 'rWICE IWR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'l'END TO OB'l'AIN FINANqINq, ~{,mlaUlir
<br />WI'l'H YOUR LENDER OR AN A'I"l'ORNEY BEFORE RECORDING YOUR NonCE OF COMMENCEMH:N'}'. ,mas UNDER
<br />$2,50D IN VALUE DO NO'l' NEED '1'0 RECORD AND POS'l' A "NO'l'ICE OF COMMENCE'JvIEN'l'''.
<br />
<br />-A!vdL~
<br />
<br />SIGNA'l'lJRE; OWNER OR AGENT SIGNA'I'URE: CONTRACTOR
<br />
<br />"
<br />
<br />STA'rE OF FLORIDAA
<br />COUNTY OF SC 0
<br />The foregoing instrument was
<br />Before me this ___ day. of
<br />by
<br />
<br />acknowledged
<br />, 19_
<br />
<br />STATE OF FLORIDA
<br />COUN'l'Y OF
<br />The foregoing instrument w~s acknowledged
<br />Before me this ---ljay of---, 19
<br />by
<br />(name of person acknowledged)
<br />Gho is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and who[] did 0 did not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o who has produced ,___
<br />(type of identifioation)
<br />and Vlho Odid DUd not t.ake an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, pri.nted or' stalopl:ld
<br />
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