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<br />CONDITIONS OF PERl\lIT AFFIDAVI'l'
<br />A. NOTICE OF DEED RES'l'RIC'l'IONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. The undersigned a~sumes responsibility for
<br />compliance with any, applicable deed restr:i.cti.ons.
<br />B. UNLICE.NSED CONTRAC'l'ORS AND CONTRACTOR RESPONSIBILITIES
<br />If the o~mer has hired a cOlltractor or contractors 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 lavl, both the o~mer and contractor may be cited for a misdemeanor
<br />violation under state la~l. If the o~mer or intended contractor are lUlc""rtain as to what
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />City of Zephy.chills Building Department, 813-788-6611.
<br />Furthermore, if the owner has Iii red a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sectionsll 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, ratller 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 ~ephyrhills.
<br />C. 'l'RAl-..JSPOR'l'ATION U1PAC'I' Ii'EES AND lJ'l'lLI'I'Y CONNEC'I'ION FEES
<br />D. CONSTRUCTllION LIEN LAW (CHAP'rER 713, FLORIDA STA'l'UTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien LaVJ - Homeowner's Protection Guide" prepared by the b'lorida Department of Agriclllture
<br />and Consumer Affairs. If the applicant is someone other that the "ownel:", I cerify that 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 conmlencement.
<br />E. CONTRAC'l'OR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance vdth 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 indicated. I
<br />certify that no \tmrk Or in:::;tallation 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, alld land development regulations in the juri:::;diction. J also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended wor'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: "'Depar-tment of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water-lWastewater 'l'reatment
<br />"Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"Army Corps of E.ngineers-Seal'laIls, Docks, Nav1gable Waterways
<br />kDepartment of Health & Rehabilitative Service:::;, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U. S. Environmental Protection Agency'-Asbestos abatement
<br />I al~o certify that, if fill material is to be used in Flood Zone "A" or "A, etc.", it 1s
<br />understood that a dr'ainage 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 />iSl:iuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />author1ty to violate, cancel, alter, or iet aside any provisions of tIle 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 become 1nvalid unless the work authorized by slIch permit is cOllulIenced within
<br />six months of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />pt::riod of six months after the time the work is conunenced. One 90 day extension of time
<br />lnay be allowed for the permit with fee charge of $15.00. The extension shall be requested
<br />in VJri ting to the Bui lding Official. An approved inspection must be logged dllring each six
<br />month period, Or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUH FAILURE TO RECORD A NO'l'ICE OF COI"lMENCEMEN'l' MAY RESUW' IN YOUH
<br />PAYING 'l'WICE FOR IMPROVEMEN'l'S 'fO YOUR PROPERTY. IF YOU INTEND '1'0 OB'l'AIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN AT'l'ORNEY BEFORE RECORDING YOUR NOTICE Ol!~ COMMENCEMEN'I'. JOBS UNDER
<br />$2,500 IN VALUE DO NO'l' NEED '1'0 RECORD AND POST A "NOTICE OF COMMENCElIIJEN'rll.
<br />
<br />SIGNATURE: OWNER OR AGEN'I'
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _ 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 />acknowledged
<br />, 19
<br />
<br />(name of person acknowledged)
<br />o who is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />Olho is personally known to me, or
<br />
<br />o who has produced___
<br />(type of identification)
<br />and ~JhoO did Ddid not take an oath.
<br />
<br />Owho has produced
<br />(type of idenlificati ou)
<br />and Hho Odid [J:iid noL take an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />-
<br />Naml:: typed, printed or stalllped
<br />
<br />Name typbd, printed or ::ltamped
<br />
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