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<br />CONDITIONS OF PE:RlvlIT AFFIDAVI'r
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'he undero;igned understands that tI,i::; pe:nllit may be subject to "deed restrictions" which
<br />way be mort:! restrictive than City r:egulationo;. The undersign.;d a:.-;:.-;umes re:.-;pon:.-;ibility tor
<br />compliance with any applicabl e deed L'<=str:ict.ions.
<br />B. UNLICENSED cOj"TRACTORS AND CONTkAC'l'OR RESPONSIBILITIES
<br />I f the Oviner has hired a contractor or contractors to undertake work, they may be x:equirt::d
<br />to be licensed in accordallce with state and local regulations. If the contractor is not
<br />licensed as required by lavl, both the OvfrlE::r and contx:actor may be cited for a misdellleanor
<br />violati.on under state lay/. If the ovmer or intended contractor are uncertain as to vihat
<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 ovmer has hired a contractor or contractors, he is advise::d to I,ave the:.
<br />contractor(s) sign portions of the "Contractor Sections" of this application tor 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 re:.sponsible for the Hark. If the contractor wisht:ls
<br />you to sign ao; contractor that may be an indication that he is not properly licellsed and 1s
<br />not entitled to permitting privileges in the City of ~ephyrhi.lls.
<br />C. 'l'RANSPOR'l'A'rlON IHPACT fEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAP'rER 713, FLORIDA S'l'A'l'UTES, AS AMENDE:D)
<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 t:he l!'lorida Department: of AgriculturE::
<br />and Consumer Affairs. If the applicant is Someone other that the "ovmer", I ce:.rify that J
<br />have:. obtained a copy of the above described document and promise in good faitll to deliver
<br />it to the "owner'" prior to conunencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI'r
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance Hith 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 lndlcated. I
<br />certity that no vlOrk or in:.-;tallation has conunenced prior to issuance of a permi t and that
<br />all work will be performed to meet standards of all laws regulating construction, City
<br />codes, zoning regulations, and land development re::gulations in the jurisdictioll. 1 also
<br />certify that I understand that the regulations of other gove::rmnental agencies may apply to
<br />the intended work, and that it is my responsibility to i.dentify what action::. I must take to
<br />be in compliance. Such agencies include but are not limited to: A'Departme::nt of
<br />~nvironmental Regulation-Cypress Bayheads, Wetland Areas and Environmelltally Sensitiv~
<br />Lands, Wate::r/Wastcvlater Treatment
<br />*Southwe~t Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*AnIlY Corps of Engineers-SeaHalls, Docks, Navigable WatervJays
<br />*Department of Health & Rehabilitative Services, Environm~ntal Healtll Unit-Wells,
<br />Wastewater Trcatme:.nt, Septic Tanks
<br />*U.8. Environmental Protection Agency-Asbe:.stos abatement
<br />I also certify that, if fill material is to be used in Flood Zone "A" or "A,etc.", it is
<br />undi:::;rstood that a dr-ainage plan addressing a "compensating volume" Hill be submitted Hhich
<br />io; pre:.pare:.d by a professional e:.ngineer registe:.red in the State of Florida prior to pe:.nnit
<br />issuance.
<br />A permit issued shall bi:::; construe:.d to be a license to proceed with the work and not as
<br />authority to violate, cancel, alter, or Se::t aside any provisions of the technical codes,
<br />nor I>ball issuance of a permi t prevent the Building Official from the:.reafter re::qlliring a
<br />correction of errors in plans, construct~on, or violations of any code. Every permit
<br />i::.sued shall become invalid unless the work authorized by such permit is cOllunenced within
<br />six montlls of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />pbriod ot six months after t:he time the work is conunenced. One:. 90 day extension of time:.
<br />may be al10Hed for the permit with fee charge of $15.00. 'l'he exte:.nsion shall be reque::s1:e:d
<br />in vni ting to the Bui Iding Official. An approved inspection must be logged dllLing e::ach sii!
<br />month period, or the project Hill be:. considered abandoned.
<br />WARNING '1'0 OWNER: YOlJk E'AlLURE TO RECORD A NOTICE OF COHMENCEMENT I'1AY RESUr.'r IN YOUR
<br />PAYING TWICE fj'OR IMPROVEMEN'l'S '1'0 YOUR PROPER'ry. n' YOU INTEND '1'0 OB'fAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN AT'l'ORNEY BEfORE RECORDING YOUR NOnCE Ol!~ COJ:v1MENCElvlEN'I'. ,JOBS UNDER
<br />$2,500 IN ALliE DO NO'l' NEED '1'0 R~CORD AND POST A "NO'rICE OF COJ:v1MENCEl'1EN'r".
<br />
<br />
<br />~ }jt Cf7VJK
<br />
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<br />
<br />N/A
<br />
<br />SIGNATURE:
<br />
<br />CONTRACTOR
<br />
<br />OWNER OR AGENT
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing in::.trument was
<br />Befure me Lhis __ day of
<br />by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF'
<br />The foregoing instrument was
<br />Before me this _day of
<br />by
<br />
<br />acknoVlledged
<br />19_
<br />
<br />a<;knowle::dged
<br />19
<br />
<br />(name of person acknowledged)
<br />o who is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />[Lho is personally known to me, or
<br />
<br />Dwho has produced
<br />(type
<br />and \<lhoO did Odid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o viho has produced
<br />(type of identificatioll)
<br />and \<Iho Ddid [}Hd not take dll oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature ot per~on taking acknowledgment:
<br />
<br />Name typed, pri nted or .:>tamped
<br />
<br />Name typed, printed or stamped
<br />
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