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<br />CONDl'rIONS OF PERMIT AFFIDAVIT
<br />.A. NO'rICE OF DEED RES'l'RIC'rIONS
<br />The ulldersigned understands thqt this 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 re,strictions.
<br />B. UNLICENSED C;ON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they may he required
<br />to be licensed in accordance with state and local reglllations. If the contractor is not
<br />licensed as required by law, both the owner and contractor may be cited for a misdemeanor
<br />violation under state law. If the owner or intended contractor are uncertai.n as to vlhat
<br />licensing requirementfl may apply for the intended work, they are advised to cantact the
<br />city of Zephyrhills Building Department, 813-788-6611.
<br />Furthennore, it the owner has hired a contractor or contractors, he is advised to have the
<br />contractor(sl sign portions of the "Contractor Sections" of this application for which they
<br />will be responsible. If you, as the owner signs as tile contractor, YQ4 ate indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor l'iishes
<br />you to sign as contractor that may~be an indication that he is not properly licensed alld is
<br />llot entitled to permitting privil~ges in the City of Zephyrhills.
<br />C. 'l'RANSPOR'l'ATION IMPAC'l' FEES AND UTILITY CONNECTION FEES
<br />D. CONS'l'RUC'l'UION LIEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guide" prepared by the Florida Depa.r:tment of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to commencement.
<br />El. CONTRAC'l'OR' S/OWNER' S AFff'IDAVI'l'
<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 />devl?lopment.
<br />Applioation is hereby made to obtain a -permjt to do work and installation as indioated. I
<br />ce.!=tify that no .wrk 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 regul.ations, and land development regulat10ns in the jurisdictlon. J also
<br />certify that I understand that the regulations of otller governmental agencies m~y apply to
<br />the intended work, and that it is my responsibility to identify what aotion.. I lllU..t Lalie to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Enviroml)ental Regul~tjpn-Cypress Bayheads, Wetland Areas and Environment.ally Bens.jtive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest ~lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watereourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*llepartment of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, septic Tanks
<br />*U.S. Environmental Protection Agency-Asbestos abatement
<br />I also eert1fy that, if fill material is to be used in Flood Zone qA" or "A, etc.", it is
<br />undenstood that a drainage plan addressing a "compensating volume" 'will be submitted Vlhich
<br />is prepared by a professional engineer registered in the State of ff'lorida 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 />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 requiring a
<br />correction pf errors in plans, oon~tructionr or violations of any code. Every permit
<br />iSfjued shall beoome invalid unless the work authorized by such permit is cOllunemced ~dthin
<br />six months of issuance, or if work authorized by the permit is suspended or abandoqed for a
<br />period of six months after the tillle 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 />1n writing to the Building Official. An approved inspection must be logged during each ajx
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER; YOUR FAILURE TO RECORD A No'rICE OE' COMMENCEMENT MAY RESUL'l' IN YOUR
<br />PAYING 'rWICE FOR IMPROVEMEN'I'S TO YOUR PROPERTY. IE' YOU IN'rEND TO OBTAIN IfINANqIl'iq, ~X)N~Uljr
<br />WITH YOUR LENDER OR AN A'fTORNEY BEFORE RECORDING YOUR NOTICE Off' COMMENCEMEN'I'. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMEN'l'''.
<br />
<br />S I GNA'l'URE: OWNER OR AGENT
<br />
<br />SIGNA'l'URE: CONTRACTOR
<br />
<br />acknowledged
<br />, 1 !i..-
<br />
<br />STA'I'E OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument w~s
<br />Before me this ------Pay of
<br />by
<br />
<br />STA'l'E Qff' FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this ____ day of
<br />by
<br />
<br />acklloHledged
<br />, 19 _~_
<br />
<br />(name of person acknowl~dged)
<br />Dwho is peraonally known to me, or
<br />
<br />(name of person aoknowledged)
<br />C1ho is personally known to me, or
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Dwho has produced
<br />(type of identifioation)
<br />and Hha Ddid DUd not talie an oath
<br />
<br />Signatur.e of person taking acknowledgement
<br />
<br />Signature of person taking aoknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or. stamped
<br />
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