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<br />CONDrrEIONS OF PERMIT AFFIDAVl'r
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that thiti permit Hlay be subject to "deed restrictions" which
<br />way Le more l:estricliv,= than City regulations. The undersigned a:;;Sllmes re::;ponsibiU.t:y for
<br />compliance .Ii th any applicabl e deed .cestl:ictions.
<br />B. UNLICENSED COi-lTRAC'l'ORS AIm CONTRAcrOR RESPONSIBILITIES
<br />If the a.mer lidS hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accordance with state and local regulations. If the contractor is not
<br />licensed a:; required by la./, both the owner and contractor may be cited for a misdellleclllor
<br />violation under state la./. If the o.mer or intended contractor are lUlct:::l:tain as to .~hat
<br />licensing requirements may apply for the intended work, they are advi:;ed to contact tIle
<br />City of Zephydlills Building Department, 813-788-6611.
<br />Furthermore, if the o.mer has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of t:he "Contractor Sections" of this application for which they
<br />will be responsible. If you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor wislles
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />not entitled to permitting privileges in the City of <'.ephyrhills.
<br />C. II'RAHSPOR"l'A'rION IMPAC'l' J.1'EES AND UTILI'I'Y CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAP'rER 713, InORIDA STA'1'UTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner' oS Protection Guide" prepared by the b'lorida Depax:tmellt of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "ownel:", I ceri fythat I
<br />have obtc:lined a copy of the above described document and promise in good faith to dellver
<br />it to the "ol'>/ner" prior to corrunencement.
<br />E. CONTRACTOR' S/OWNER' S AlfFIDAVI"r
<br />I certify that all the information in this applicati.on is accurate and that all work Hill
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />developmellt.
<br />Application is hereby made to obtain a permit to do work and installation as lndicated. I
<br />certify that no vlOrk OL in:;tallation 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 />cod<:s, zoning regulations, and land development regulations 1.n tbe jurisdictioll. 1 also
<br />c<:rtify that I understand that the regulations of other governmental agencies lllay apply to
<br />the intended .JOLk, and that it is my responsibility to identify what actions I must talit:: to
<br />be in compliance. Such agencies include but are not limited to: -A'Depal:tment of
<br />~nvironmental Regulation-Cypress Bayheads, Wetland Areas and Environn~lltally S~nsitive
<br />Lands, Water/WasteHater 'rrealment
<br />*Southwe:;t Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />-AArmy Corps of Engineers-Sea\lalls, 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 "A" or "A,etc.", it is
<br />und""rstood that a dl:ainage plan addressing a "compensating volume" will be ::iublllitled which
<br />i::i prepared by a profetisional engineer reg1.stered in the State of Florida pLior to permit
<br />issuance.
<br />A permit is::iued 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 thereafter requiring a
<br />correction of errors in plans, construction, or violations of any code. Every permit
<br />issued shall become invalid unless the work authorized by such peL'mi t is cOllunenced within
<br />six month::> of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />peLiod of six months after the time the work is corrunenced. One 90 day extension of time
<br />may be allowed for the penni t wi. th fee charge of $15.00. 'I'he extension shall be requt::sted
<br />i.n .niting to the Building Official. An approved inspection must be logged during each six
<br />month period, or the pLoject will be considered abandoned.
<br />WARNING "ro OWNER: YOUR Ii'AILUR!!: TO RECORD A NOTICE OF COMMENCEMEN'l' MAY RESUW' IN YOUR
<br />PAYING TWICE FOR IMPROVEMEN'l'S '1'0 YOUR PROPERTY. n' YOU INTEND '1'0 OB"rAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN AT'l'ORNEY BEl!'ORE RECORDING YOUR NOTICE Ob~ COMMENCEMENT. ,JOBS UNDER
<br />$2,500 IN VALUE DO NO'l' NEED TO RECORD AND POST A "NO'rICE OF COMMENCEMEN"I'''.
<br />
<br />SIGNATURE: OWNER OR AGEN'r
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUN'l'Y OF
<br />The foregoing instrument was acknowledged
<br />Before me this _ day of , 19_
<br />by.___~
<br />(name of person acknowledged)
<br />o who is personally known to mt:, or
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF'
<br />The foregoing i.nstrument Was
<br />Before me this _day of
<br />by
<br />
<br />acknoHl.edged
<br />19
<br />
<br />(name of person acknowledged)
<br />[1ho is personally known to me, or
<br />
<br />of identification)
<br />take an oath.
<br />
<br />[Jwho has produced
<br />(type of id<:ntificatJon)
<br />and Hho Odid DUd not take cHi oath
<br />
<br />Owho has produced
<br />(type
<br />and .lhoO did [Jdid not
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of pertlon taki.ng acknowlt:dgment.:
<br />
<br />Name typed, pri nted 0.1.- stamped
<br />
<br />Name type.d, printed or stamped
<br />
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