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<br />CONDI'I'IONS OF PERJ.lIT AFFIDAVIT
<br />
<br />A. NO'l'ICE OF' DEED RES'l'RICTIONS
<br />'l'he underl:iigned understands that t.h:LI:i penni l IntlY be subj c:ct to "deed n::l:itrictiOlll:i" whi ch
<br />way be mort: restrictive than City n:<Jlll ationl:i. 'l'h,,, undersigned assumes rel:iponsibility tor
<br />complic:mce viith any applicabl e de~,d .c<:stx:iCLi::>l1s.
<br />B. UNLICENSED COI-JT'RAC'l'ORS AND CONTH/I,.C'rOR RE:Sl'DNBI13ILI'l'IES
<br />If the ovwer has hired a contractor or contract:::>r:::; to undertake work, they may be l:equired
<br />to be lict:nsed in accordance with state and local regulations. If the contractor is not
<br />lic..nsed ab required by lClvJ, both the ovmer and contcactor may be cited for a misdelllt=anor
<br />violation under state lavL If the olmer or intended contl:actor are IUlct=rtain Oil> to I.hat
<br />licensing requirements may apply for the intended work, they are advised to contact tile
<br />City of Zephydlill.s Building Department, 813-788-6611.
<br />Furthermore, if 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 application tor which thoe:y
<br />will be respon~ibl~. If you, a~ the owner signs as the contractor, you are indicating that
<br />you, rather than the contractor, are responsible for the ~ork. If the contractor wislles
<br />you to sign as contractor that may be an indication tllat he is not properly licensed and is
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C. 'l'RANSPOR'rA'frON H1PACT fEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUlON LIEN LAW (CHAP'rER 713, :nORIDA STA'rUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "florida's Construction
<br />lien LaH - Homeowner's Protection Guide" prepared by the })'lorida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "olmer", I cerify that I
<br />have obtained a copy of the above described document and promise in good faitll to deliver
<br />it to the \\ol',mer'" prior to conunencement.
<br />E. CON'fRACTOR' S/OWNER' S Ali'FIDAVl'f
<br />I certify that all the information in this applicati.on is accurate and that all work will
<br />be done in compliance vdth all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no work or in~tallation has con6enced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regulating constrllction, City
<br />codes, zoning regulations, and land development regulations in the juril>dictioll. 1 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 Inust take to
<br />be in compl iance. Such agencies include but are not limited to: A'Department of
<br />~nvironmental Regulation-Cypress Bayheads, Wetland Areas and Environmelltally Sensitive
<br />Lands, WC:lter/WasteIJater 'freatment
<br />*Southwest florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Anuy Corps of Engineerl>-SeaHalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmental Healtll Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />''''U..':i. ~nvironmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone "A" or "A,etc.", 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 the State of florida prior to permit
<br />is::iuance.
<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 tile technical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafte:r requiring a
<br />correction of errors in plans, construct~on, or violations of any code. Every permit
<br />issued shall become invalid unless the work authorized by such permit is coumenced within
<br />six month.:; of i.ssuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of six months after the time the work io::; commenced. One 90 day extension of time
<br />may be allowed tor the permit with fee cllarge of $15.00. The extension shall be requested
<br />in vniting to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOIJR E'AILURE TO RECORD A NOTICE OF COI'1MENCEMENT MAY RESUW' IN YOUR
<br />PAYING TWICE FOR IMPROVEMEN'l'S '1'0 YOUR PROPERTY. IE' YOU IN'l'END '1'0 OB'rAIN FINANCING, CONSUL'r
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
<br />$2, 5~.:;;? V~l~~ DO NO'!' .NEED '1'0 RECORD AND POS'" A "No'r:~.'f % ~f COMMENCEMEN'r" .
<br />
<br />(-/ ?~ ~/~~-
<br />
<br />SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
<br />
<br />S'l'ATE OF FLORIDA
<br />COUN'rY OF
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by
<br />
<br />acknovlledged
<br />, 19_
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this ~ay of
<br />by
<br />
<br />acknowledged
<br />19
<br />
<br />(name of person acknowledged)
<br />o who is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />OJho is personally known to me, or
<br />
<br />Dwho has produced
<br />(type
<br />and liJhoD did Ddid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Dwho has produced
<br />(type of identificatioll)
<br />and VJho Ddid DUd not take C:lll oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, pri nted 0,1: stamped
<br />
<br />Name typed, printed or. stamped
<br />
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