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<br />COIWI'rIONS OF PERM!'!' AFlfIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'he undeJ.:signed understands thqt this p~uni t may be subject to "deed restrictions" Hhich
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable dcE:d restrictions.
<br />B. UNLIC!!:NSED 'CONTRAC'l'ORS AND CONTRACTOR RESPONSIBIJ.I'I'IES
<br />If the CHner has hired a contractor or contractors to undertake Hark, they nlay be required
<br />to pe licensed in accordance Hith st<ite and local regulations. If the contractor is not:
<br />licensed as required by laH, both the owner and oontractor IlIay be cited for a misdemeanor
<br />violation under state law. If the owner- or intended contractor ar-e uncer-tain as to vlhat
<br />licensing requirements may apply for the intended Hark, they are advised to oantapt the
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />ffurthermor-e, it the OHner has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor SectionsU of this application for whiell they
<br />wiJl be responsible, If you, as the owner signs as the contractor, YQl,! are indicating that
<br />YOll, rather than the contractor, are responsible for the work. If the contractor wishes
<br />you to sign al:l contractor that may be an indication that he is not properly lioensed aud ie
<br />lIot ellti tled to permitting privi.leges in the City of Zephyrhi.lls.
<br />c. 'IIRAN:JI:!OR'I'ATION IMPACT fEES AND U'I'ILI'I'Y CONNECTION !fEES
<br />D. CONS'fRlJC'l'UION LIEN LAW (CHAP'I'ER 713, FLORIDA S'I'ATUTES, AS AM!!:ND!!:D)
<br />i certify that I, the applicant, have been provided with a copy of "Florida's Conf:itruction
<br />lien Law - HomeoHner's Protection Guideu prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the appl.icant is someone other that the \\OH!leru, I cerify that I
<br />have obtcd.ned a copy of the above described document and promise in good faith to deliver
<br />it to the "oHneru prior to commencement.
<br />E. CON'rRAC'I'OR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the information in this application is accurate alld that all work will
<br />be done in compliance with all applicable laHs regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indioated. I
<br />ce~tify that no Hork 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 construction, City
<br />codes, zoning regulations, and land development regulations in tile jurisdiction. I also
<br />certify that 'I under'stand that the regulations of other governmental agenaiel:l may apply to
<br />the intended work, and that it is my responsibility to identify Hhat actions I IlIIlst Lake to
<br />be in oompliance. Such agencies include but are not limited tOI *Department of
<br />Environmelltal RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Bensttive
<br />Lands, Water/Wastewater 'rreatment
<br />*SouthHest Wlorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />'Army Corps of Engineers-SeaHalls, Docks, Navigable Waterways
<br />*lJepartment of Health & Rehabilitative Services, Environmental Health Unit-Wel.ls,
<br />Wastewater Treatn~nt, Septic Tanks
<br />*U. S. Environmental Pr-etection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone "AU or "A, etc.", it is
<br />understood that a dralnage plan addressing a "compen.sating volumeu 'Hill be submitted Vlhich
<br />hi prepared by a professional engineer registered in the, State of Florida pdor to penni t
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed wlth 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 />cor~ection of errors ill plans, construction, or vio~ations of any code. Every permit
<br />is~ued shall become invalid unless the Hork authorized by .such permit is oOllunenced Hlthin
<br />.slx months of issuance, or if Hark authorlzed by the permlt is suspeuded or abandol!lild f~r a
<br />period of six months after the time the work is commenced. One 90 day extension of time
<br />may be allowed for tile permit Hith fee charge of $15.00. The extension shall be requested
<br />ill writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project vl111 be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR FAIWRE '1'0 RECORD A NO'nC!!: OF COMMENCEMENT MAY RESUL'!' IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROI?ER'l'Y. IIf YOU IWl'END TO OB'fAIN i!'INANqn'lq, _~9N~UIJI'
<br />WlTH YOUR LENDER OR AN A'l"l'ORNEY BEFORE RECORDING YOUR NO'l'ICE OF COMMENCEMENII'. JOBS UNDER
<br />$2,500 IN VALUE DO NOT Nf:ED '1'0 RECORD AND POS'l1 A "NO'neE OF COMMENCEMEN'!''',
<br />
<br />SlGHA'l'URE: OWNElR OR AGEN'l'
<br />
<br />S I GNA'I'URE: CON'I'RACTOR
<br />
<br />S'l'A'l'lJJ OF !fLORI DA
<br />COUNTY OIi' --_____
<br />The foregoing instrument Has acknowledged
<br />Before me this ____ day of ______, 19_
<br />by
<br />(name of person acknowl~dged)
<br />Owho is personally known to me, or
<br />
<br />[] who has produced
<br />(type
<br />and who[] did 0 did not
<br />
<br />STA'l'E OF FLORIDA
<br />COUWI'Y OF
<br />The foregolng instrument Wii\S aokuovdedged
<br />Before me this _---.Jiay of---, 19 _:__
<br />by
<br />(name of person acknowledged)
<br />C1ho is peu:sonally knoHn to me, or
<br />
<br />o who has produced ___
<br />(type of identification)
<br />and v,ho Odid [}Ud not t,ake all oath
<br />
<br />of ldentiflcation)
<br />take an oath.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of, person taking acknowledgment
<br />
<br />N-;;I~{;-typ;-i~--prD;ted o~- stamped--~----
<br />
<br />Name typed, printed or' starnpdd
<br />
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