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<br />CONOI'fIONS OF PERMIT AFFIOAVIT
<br />A. NOTICE OF OEEO RESTRICTIONS
<br />The undersigned understand/3 thqt this permit may be subject to "deed restrictions" wliich
<br />m~y be more restrictive than City regulations. The undersigned assumes respon~ibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED (;ON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBILI'l'IES
<br />If the owner has hired a contractor OE contractors to undertake work, they IIIay be required
<br />to be Ii censed in accordance ,,~ith I:ltate and local regulations. If the contractor is not
<br />lioensed as requi.red by law, both the owner and contraotor may be cited for a misdemeanor
<br />violation under state law. I f the owner' or intended contractor are uncertain '-IS to vlhat
<br />licensing requirements may apply for the intended work, they are advised to oontact tlae
<br />city of Zephyrhills Building Department, 813-768-6611.
<br />Furtherll1on" 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 appli.cation for Hhich they
<br />will be responsible. If you, as the owner signs .s the contractor, YQY are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor' wishes
<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 Zephyrhl11s.
<br />c. 'l'RANSl'OR'l'ATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. cONs'rRlIc'rUION LIEN LAW (CllAprl'ER 713, FLORIDA S'l'ATUTES, AS AMENDED)
<br />f certify that I, tIle applicant, have been provided with a copy of "Florida's Construction
<br />lien I,aw - Homeowner's Protection Guide" prepared by the Florida Oepartment of Agriculture
<br />and Consumer Affait's. If the appllcant is someone other that the "owner", I cerity that I
<br />have obtained a copy of the above described document and promise in good talth to deliver
<br />it tC) the "owner" prior to commencement.
<br />E. CONTRAC'l'OR' a/OWNER'S AFlfIDAVI'f
<br />I certlfy that all the information in this application is accurate and that all work will
<br />be done in compllance with all applicable laws regulating constl-uction, zoning, and land
<br />development.
<br />AppLication 1s hereby made to obtain a permjt to do work and installation as indioated. I
<br />certi fy that no work or installaU_on 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 the j\lrisdiction. I also
<br />certify that I understand that the regulations of other governmental agencies lOay apply to
<br />the intended work, and that it is my reaponsibility to identify what actions I mllst take to
<br />be in compliance. Such agencies include but are not limited tal *Oepartment of
<br />Environme1ltal Regulation-Cypress Bayheads, Wetland Areas and Environmentally Bensttive
<br />Lands, Water/Wastewater 'I'reatment
<br />*Southwest florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmental Healtll Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*11.8. Environmental Protection Agency-Asb~stos abatemant
<br />I also certify that, if fill material is to be used in flood Zone ~A" or "A,ete.", 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 />issuance.
<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 provi.sions of the technical codes,
<br />nor shall 1ssuance of a perm1t prevent the Building Ofticial from thereafter requldng a
<br />correction of errors in plans, con~truction, or violations of any code. Every permit
<br />is~ued ahall become invalid unless the Hork authorized by such permit is aonu"enced within
<br />six months of issuance, or if work authorized by the permlt is suspended or abandoqed tor a
<br />period of si.Jt months after the time the work is cOfiUnenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be teques~ed
<br />in writing to the Build1.ng Official. An approved inspection must be logged during each six
<br />month period, or the project Vlill be considered abandoned.
<br />WARNING TO OWNER: YOUR Ii'AILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
<br />PAYING TWICE FOR IMPROVEMEN'rS TO YOUR PROPERTY. IIi' YOU INTEND TO OB'rAIN InNA1H1rNq,~QN~UIlr
<br />WITH YOUR LENDER OR AN A'I"rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
<br />$2,500 IN VAWE DO NO'1' NEEO TO RECORD AND POS'l' A "NOTICE OF COMMENCEMEN'r".
<br />
<br />__~Uit- ~44.i~
<br />
<br />SIGNA'l'URE: OWNER OR AGENT SIGNA'rURE: CONTRACTOR
<br />
<br />S'j'A'I'ID OF FLORIDA"Va-'~
<br />COUNTY OF--
<br />'l'he foregoing in - ument v'as ackro~dedged
<br />Befo ln~ this ay of J?p.j L , V~
<br />by. -.
<br />~ (name of person acknOWledged)
<br />~.Who is personally known to me, or
<br />
<br />Owho has produced
<br />(type of identification)
<br />an"tJl>o[J did ~di"rit take an oath, .
<br />
<br />- IfJm) In . ~bJA
<br />
<br />Signature of person taking acknowledgement
<br />
<br />STA'l'E OF FLORIDA 7 a,)t1j
<br />COUNTY OF .
<br />The foregoing in,~~~~ment w~Ovlledged ;
<br />Before me this ~ay of , 1/~,?a...
<br />by
<br />(name of person acknowledged)
<br />~hO is personally known to me, or
<br />
<br />o who has produced___ _~__
<br />(type of identifioation)
<br />~d not t,ake an oath
<br />
<br />
<br />----~-----'ri.""~~ Dono M. Word
<br />Harne t~p ,~:.J-MV~~~IOMt ~~~RES
<br />~". ~?: July 14, 2005
<br />-.11);... "00;.'- BONDED TH~U TROY FAIN INSURANCE. INC
<br />~/}/,9r.,~\\"
<br />
<br />Signature 0 taking aoknowledgment
<br />,.~!/'rif:.:... Dona M. Ward
<br />..~~<; MISSION' nnn~"R E~
<br />-. - .. ~~y COM .. __~_.__....,.___._
<br />Name ~. ~jprintedol'plJl.2Sf)5amped
<br />"'~iif.,t\<" - BONDED TH~U TIlOY FAIN INSU~ANCf.1NC.
<br />
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