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<br />CONDI'l'IONS OF PERNI'l' AE'FIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands thijt this permit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. The under'signed assumes responsibility for
<br />compliance with any applicable deed restricti,ons.
<br />B. UlnrCENSED (~ONTRAC'I'ORS AND CON'PRACTOR RESPONSIBII,I'l'IES
<br />I f the Ol'iner has hired a contractor or contractors to undertake work, they Illay be required
<br />to be licensed in accordance with state and local regulatiorls. If the contractor is not
<br />Ii cellsed as required by law, both the oymer and contract~:Jt' may be cited for a misdemeanor
<br />violation under state law. If the owner or intended contractor are uncertain as to y~lat
<br />licensing requirementl:l may apply for the intended work, they are advlsed to contact the
<br />City of Zephyrhills Bulldlng Department, 813-766-6611.
<br />Furthermor:e, if the ovmer has hired a contractor or contractors, he 1s advised to have the
<br />contractor (s) 51gn pOl'tions of the "Contractor Sectlons" of thls appl1cation for which they
<br />wlll be responsible. If you, as the owner signs as the contractor, YQij are indicating that
<br />you, rather than the contractor, are responsible for the work. I f the contractor \'iiahes
<br />you to sign as contractor that may be an indication that he is not properly llcenaed and is
<br />not entitled to permitti.ng priv1.leges in the C1ty of ZephyrhUls.
<br />C. 'I'RANSPOR'l'ATION lMPAC'l' )fEES AND UTILITY CONNECTION FEES
<br />D. CONS'rRUc'rUION I,TEN LAH (CHAP'rER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certlfy that I, tile applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection GuideU prepared by the Florida Department of Agriculture
<br />and Consumer Affa1.t's. If the appllcant is someone other that the "owner", I cerify that I
<br />Ilave obtalned a copy of the above descrlbed document and promise in good faith to deliver
<br />j t to the "owneru prior to C01TUl1encement.
<br />El. CON'I'RAC'rOR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the information in this application 1s accurate and tllat all work will
<br />be done in compllance with all applj,cable laws regul ating construction, zoning, and land
<br />development.
<br />Application is hereby made to obta1.n a permit to do work and installation as indicated. 1
<br />ce~tify that no ylOrk or installation has conunenced prior to lssuance of a permit and that
<br />all work w111 be performed to meet standards of all laws regulatlng construction, Clty
<br />codes, zonlng regulations, and land development regulations in the jurisdiotion. I also
<br />certify that I understand that the regulations of other governmental agenoles lnay apply to
<br />the intended work, and that it is my responsibility to ldentify what actions I must take Lo
<br />be in compliance. Such agencies inolude but are not limited tOI *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and l!:nvironmentally 8ens,i,tive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Alter1ng Watercourses
<br />'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*lJepartment of Health & Rehabilitative Servlces, Envlronmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />'U.S. Environmental Protection Agency-Asbestos abatement
<br />1 also uertify that, if fill material is to be used 1n Flood Zone ~A" or "A,etc.", it is
<br />unde,tstood that a drainage plan addressing a "compensating volume" 'will be SUbl!)i tted \-/h1ch
<br />16 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 provisions of the technlcal codes,
<br />nor shall issuallce of a permlt prevent the Bullding Official from thereafter requiring a
<br />correction of errors in plans, con~truction, or violCltions of any oode. Every permit
<br />iSliued shall become invalid unless the work authorized by such permit is cOllunenced within
<br />six months of issuance, or If work authorlzed by the perm1.t ls suspended or abandorled for a
<br />period of s1.x months after the time the work is conunenced. One 90 day extension of tillle
<br />may be allowed for the permit with fee charge of $15.00.. The extellsion shall be~equeated
<br />in writing to the Build1.ng Official. An approved 1.nspection must be logged during each dx
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNERI YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMEN'I' MAY RESUIl1' IN YOUR
<br />PAYING TWICE E'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'rEND TO OB'I'AIN Jj'INAN'1lNq, cqN~uIlr
<br />WITH YOUR LENDER OR AN A'l'TORNEY BEE'ORE RECORDING YOUR NO'I'ICE OF COMMENCEMEN'I'. ,JOBS UNDER
<br />$~2' 50n IN. VAL~E_D[)-"~~~5'ORn AND PO",' A "NO'HCE OF COMMENCEMEN''''.
<br />
<br />_.'/""-'~ ~~\J'I~
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<br />-- . /'- ~ SIGNA'I'UREI CON'I'RACTOR --'---
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<br />S'rATE OE' FLORIDA //' BTA'I'E OF nORIDA r-')", ,,0
<br />COUN'I'Y OF _~'S~n COUNTY OF -.:i........
<br />'l'he foregolng instrument was acknowledged The foregoing lnst,ljtiment Wa~tlledged ~
<br />Btlfore me thisa1~ d'W of ~A?/l .., 'Jt!f~t'P3 Before me this ~ay of. ~,MO,_
<br />by~~t.eH#e~ ? g,t!'~~ _A by
<br />(name of person acknowledged) ;}('. (name of person acknowledged)
<br />~o 1.s personally known to me, or .A'~ is personally kno\'into me, or
<br />
<br />
<br />Name
<br />
<br />[J who has produced~,__._____,__
<br />(type of idellLi ficatlonl
<br />and who_Odld ~ld ~ an oath
<br />
<br />~, ...
<br />~~~:r.
<br />
<br />Harne typ
<br />
<br />
<br />dgment
<br />
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