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<br />CONDITIONS OF PERHIT AF'FIDAVI'f
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undeJ.:signed understands that tl1i::; permit lIlay be subject to "deed restriction::;" which
<br />may be more restrictive than City l:egulations - 'I'he undersigned assumes responsibility for
<br />compliance ~Jitb any applicabJ e deed restr:icU ons.
<br />B. UNLICENSED CONTRAC'l'ORS AIIJD CONTkAC'rOR RESPONSIBILI'l'IES
<br />If the OHnet has hil:ed a contractor or contractor::; to undertake work, they may be n:quirt::d
<br />to be licensed in accordance Hith state and local regulations. If the contractor is not
<br />licensed as r.::quired by lavl, both the o~mer and contractor may be cited for a misdemeanor
<br />violation undE::L :state lavJ. If the OHnElr or intended contractor are uncertain as to ~Jhat
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills 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 thE:: "Contractor Sections" of this application tor which they
<br />will be responsible. If you, as the OHner signs as the contractor, you are indicating that
<br />you, rather than the contractor, are responsible for the work. If t.he contractor vdshes
<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 ~ephyrllills.
<br />(;. 'l'RANSPOR'l'A'rION IMPACT Ii'EES AND UTILITY CONNECTION F'EES
<br />D. CONSTRUCTUION LIEN LAW (CHAP'fER 713, FLORIDA STA'fUTES, 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 f!'lorida Department of Agriculture
<br />and Consumer' Affairs. If the applicant is someone other that the "owner", I carify 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 corronencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />I certify that all the information in this application is accurate and that all wor'k will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permi t to do \wrk and installation a::; indicated. I
<br />certi fy that no work or intstallation has conunenced prior to issuance of a permi t aud that
<br />all work Hill be performed to meet standards of all laws regulating construction, City
<br />codes, zoning regulations, and land development regulations in tbe jurisdiction. 1 also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended ~wLk, ,md t.hat it is my responsibility to i.dentify what actions I must take to
<br />be in compliance. Such agencies include but are not limited to: -A'Depar.tment of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environn~lltally Sensitive
<br />Lands, Water/Waste~Jater 'I'reatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"'Army Corps of Engineers-SeaHalls, Docks, Navigable Waterway::;
<br />*Department of Health & Rehabilitative Service::;, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environmental Protection Agency-A::;bestos abatement
<br />I also certify that, if fill material i::; to be used ill Flood Zone "A" or "A, etc.", it is
<br />understood that a drainage plan addressing a "compensating volume" ~Jill be "mbmitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to permit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with t.he work and not as
<br />authority to violate, cancel, alter, or s..t a::;ide allY provisions of th.. technical codes,
<br />Ilor ~hall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construct~on, or violations of any code. Every permit
<br />L:isued oShaJ I become invalid unless the work authorized by such permit is cOllunenced within
<br />.:;ix month.::; of ioSsuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of six monthfl after the time the v/Ork i::; commenced. One gO day extension of time
<br />may be allowed for the permit with fee cliarge of $15.00. The extension shall be requested
<br />in \niting to the Buildi ng Official. An approved inspection must be Jogged during each six
<br />month period, or the project will be considered abandoned.
<br />~vARNING 'fO OWNER: YOUH E'AUURE: TO RECORD A NOTICE OF COI"lMENCEMEN'I' MAY RESUI/f IN YOUR
<br />PAYING TWICE ji'OR IMPROVEMEN'l'S TO YOUR PROPERTY. U' YOU INTEND TO OB'rAIN l!'INANCING, CONSULT
<br />WITH YOUR LENDER OR AN AT'l'ORNEY BEt"ORE RECORDING YOUR NOTICE OF COMMENCEHENT. JOBS UNDER
<br />$2,50 '1'1 VALU!!~ DO NO'!' NEED '1'0 RECORD AND POST A "NO'rICE OF C MMENCEIVlEN'ffl.
<br />
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<br />
<br />VV-'-./' __..<..../\
<br />OR AGEN'I'
<br />
<br />a cknovll edged
<br />19_
<br />
<br />"-
<br />
<br />SIGNATU~ONTRACTOR
<br />r//
<br />
<br />STA'l'E OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument Was
<br />BeforE< me this __day of
<br />by
<br />
<br />
<br />(
<br />
<br />STATE OF' IfLOR
<br />COUNTY OF'
<br />The foregoing instrument was
<br />Before me this _ day 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 />[1ho is personally known to me, or
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o who has produced
<br />(type of identification)
<br />and ~Jho Ddid DUd not take an oath
<br />
<br />o v/ho has produced
<br />(type
<br />and vJhoD did Ddid not
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of per.'::lon taking acknowledgment
<br />
<br />Name typed, pri nted or stamped
<br />
<br />Name typed, printed or stamped
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