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<br />COIJDI'l'IONS OB' PE!\Ml'l' l\FFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" Hhlch
<br />may be 1II0re t'estrictive than City regulations. The undersigned assumes responsibility for
<br />compl.iance with any applicable deed rest:rictions.
<br />B. UNLICENSED CON'l'RACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or con.tractors to undertake Hark, they may be required
<br />t:o b~ licensed in accordance with state and local regulat:ions. If the contractor is not
<br />licensed as required by law, both the owner and contractor may be cited for a misdemeanor
<br />violation under state law. If the mmer or intended contr:actor are uncertain as to what
<br />Licensing requirement.s may apply for the intended Hork, l~hey are advised to contact the
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />F.'urthermore, if the owner has hired a contractor o.t' contractors, he 1s advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application for which they
<br />NLU be responsible. I f you, as the owner signs as the contractor, you are i.ndicating that
<br />you, rather than the contractor, are responsible for the Nork. If the contractor Nishes
<br />YOII 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 Z~phyrhills.
<br />C. 'l'RANSPOR'l'A'rION IMPACT FEES AND UTILI'ry CONNECTION FEES
<br />D. CONS'rRUC'l'UION I,IEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, 11ave been provided with a copy of "Florida's Construction
<br />lien IJaw - Homeowner's Protection Guide" prepared by the Florida Department of Agricul ture
<br />and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that 1
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "ONlJer" prior to cOIJunencement.
<br />E. CONTRAC'l'OR' S/OWNER' S AFFIDAVIT
<br />I certify that all the information in this application is accurate and that all work 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 permit to do Nork and installation as indicated. I
<br />certify that no work or installation has commenced prior to issuance of a permit: and that
<br />all work will be performed to meet standards of all laNs regulating construction, City
<br />codes, zoning regulations, and land development r'egulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended \>-Iork, and that it is my responsibility to identify what actions I must take to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/WasteNater 'l'reatment
<br />*SoutllNest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"Army Corps of Engineers-Seawalls, Docks, Navigable \vatenlays
<br />"Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*11.S. EnvironInental 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 />unde.Lstood that a drainage plan addressing a "compensating volume" will be submitted which
<br />is prepared ~y a professional engineer registered in the state of Florida prior to permit
<br />issuance.
<br />A permit issued sllall be construed to be a license to proceed with the work and not as
<br />authority to violat.e, cancel, alter, or set aside any provisions of the technical codes,
<br />nor .lla11 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 beoome invalid unless the work authorized by such permit is commenced wlthin
<br />slx !\Ionths of issuance, or if work authorized by the permlt is suspended or abandoned for a
<br />period of six months after the time the work is commenced. One 90 day extension of time
<br />may be alJoVled for the pennit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspection must be logged during each SiK
<br />month perlod, or the project will be considered abandoned.
<br />WARNING '!'O OWNE',R: YOUR FAILURE '1'0 RECORD A NOTICE OF COMl1ENCEMEN'l' MAY RI!lSUI.'I' IN YOUR
<br />PAYING TWICE l!'OR IMPROVEMENTS '1'0 YOUR PROPERTY. IF YOU INTEND 'l'0 OBTAIN FINANCING, CONSUL'!'
<br />WI'I'lI YOUR LENDER OR AN AT'l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />
<br />
<br />:~~~~~'''~~~"O REell"n MID PllST A "NOTICE llF CO~ENCEMENT~
<br />
<br />
<br />STATE OF l!'LORIDA-U
<br />COUN'l'Y OF. I Qd<'.U
<br />The foregoing instrument was acknowledged
<br />Before me this 5-C!::- day of ---'~~. __, ;J.8Ll
<br />by___~ud'j :':xho/-Rr
<br />(name of person acknowledged)
<br />g-who is personally known to me, or
<br />
<br />STATE OF nORIDA --:J
<br />COUNTY OF -'O~O__._
<br />The foregoing instrument was acknowledged
<br />Before me this St:*- day of---~.--, ~?..:.3...
<br />by ~....l.f--Schrf r- ___
<br />(name of person acknowledged)
<br />D.+ro-'is personally known to me, or
<br />
<br />[] who
<br />
<br />
<br />
<br />[J who ha s produced ____________________
<br />(type of identlficatlon)
<br />[~d not take an oath
<br />
<br />~ -------
<br />Sign person taking acknowledgment
<br />~.,.., ~ Suzanne Doug'8S--Allen
<br />Name typ~d' ~~Qm~~.~lf~I~J~H! -------
<br />, ,. ~~~s~~~. 2~2~3
<br />
<br />has produced
<br />(type of identification)
<br />._~d no~n oath.
<br />
<br />
<br />on taking acknowledgement
<br />
<br />___._________________~:Z~:~:::,'~;~::08
<br />l'lallle typed, pr E.QL.sar"IJID2e
<br />- .." ~pne uClOl:iet; 5, 2003
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