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<br />COlIDI'rIONS OF' PEronT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The under-signed understands that t.his permit !nay be subject to "deed restrictions" \>lhJ.ch
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />comp.Llance w~ th any applicable deed res trictions.
<br />B. UNLICENSED CON'l'RACTORS AND CON'l'AAC'l'OR HESPONSIBILI1'IES
<br />If the owner has hired a contractor or con.tractors 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 as required by law, both the owner and contractor may be cited for a misdemeanor
<br />vio.lation under state law, If the owner or intended contl:actor are uncertain as to what
<br />licens.lng requirements may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills Building Department, 813-788-6611,
<br />FurtheaRore, 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 application for whicll 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 respons.ible for the Hork. 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 Z~phyrhills.
<br />c, 'l'RANBPOR'l'A'rION IMPACT FEES AND U'l'ILI'l'Y CONNECTION FEES
<br />D. CONS'l'RUC'l'U I ON LI EN LAW (CHAP'l'ER 713, FLORI DA STA'l'UTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided "iJth a copy of "Florida's Construction
<br />Ijen Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and Consumer AffaIrs. If the applicant is someone other that the "owner", I cerify t.hat 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 conunencement.
<br />E. CON'['RAC'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 work and installation as illdlcated. I
<br />cer.tify that no work or installation has commenced prior to issllance of a permit and that
<br />all. work will be performed to meet standards of all laws regulating construction, City
<br />codes, zonlng regulations, and land development regulations in the jurisd.ictjon. I also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended wOL-k, 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 />Envjronmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sellsitive
<br />l,ands, Water/Wastewater 'l'reatment
<br />*Sollthwest I!'lorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Al teL-iny Wa tel: COlll::ses
<br />kArmy Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*lJepartment of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />Io;U.8. 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 />understood that a drainage plan addressing a "compensating volume" 'will be submitted which
<br />is prepared by a professional engineer registered in tile state of Florida prjor to permit
<br />issuance.
<br />A permil: 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 provisions of the 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 beoome invalid unless the work authorized by such permit is commenced within
<br />six montlls of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of slx months after the time the work is conunenced. One 90 day extension of time
<br />may be allowed for the permit 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 six
<br />mOllth period, or the project will be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY HESUIiI' IN YOUR
<br />PAYING 'I'WICE FOR IMPROVEMENTS '1'0 YOUR PROPERTY. IF YOU INTEND '1'0 OB'l'AIN FINANCING, CONSULT
<br />WITH YOUR I,E:NDER OR AN AT'l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ,JOBS UNDER
<br />$2,500 IN VALUE DO 0'1' NEED '1'0 RECORD AND pos'r A "NCYrICE OF COMMEHCEMEN'l'''.
<br />
<br />~>j /i'/~"~
<br />
<br />SiGNATURE:,~CTOR .
<br />l..-
<br />STATE OF.FLORIDA '-:-J
<br />/1:b?Jt d
<br />COUNTY OF __.__
<br />The foregoing instrument was acknowledged
<br />Before me this. SeA- day of----t2~r_--, :R@tZ:L
<br />by ,~J..(:;,.1l SCheper-
<br />(name of person acknowledged)
<br />If:hrro 1s personally known to me, or
<br />
<br />
<br />S'l'A'I'E OF E'I,ORIDA. ,)
<br />COUN'l'Y OF ___ r(24t" d
<br />The foregoing instrument was acknowledged
<br />Before me this 5f7- day of hla--L , a9t'3
<br />by J udr--- Schcp-Rr 0
<br />(name of person acknowledged)
<br />~ is personally known to me, or
<br />
<br />
<br />[] Hho has produced
<br />(type of identification)
<br />11J-d'1CJ,,< · - Sul@ft EP~-Mft. h .
<br />* C mission CC874208
<br />." ober 25, 2003
<br />
<br />acknohlledgernent
<br />
<br />[] who has produced_______________
<br />(ty~e of identification)
<br />0d:;rd not take an oath
<br />
<br />
<br />Hallie l:yped, printed or stamped
<br />
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