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<br />COJ-lDI':!'IO)jS OF P~Hlv[IT AFFIDAVIT
<br />
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undet:signed understands that lhi:, pel:mi t may be sub:j cct to "deed restt:ictions" which
<br />may be more restrictive than City r'equlations. 'l'he undersigned assumes responsibllity for
<br />compliance with any, applicable deed restrictions.
<br />B. UNLICENSED CONTRAC'l'ORS AND CONTRACTOR RESPOI'-lSIBILI'l'H.:S
<br />If the o~nler has hired a contractor 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 a.s required by laVi, both the o,mer and contractor" Inay be cited for a misdemeanor
<br />violation under state lavl. If the olmer or intended contractor are unco;:rtain af:l to \~hat
<br />licensing requirements may apply for the intended work, they are advised to contact t:hb
<br />City of ZephYl'hills Building Department, tll3-'788-66ll,
<br />Furthermore, if the owner has llired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application for Vihicll they
<br />will be responsible. If you, as the OViner 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 Zephyrhills.
<br />C. 'fRAl'lSPOR'l'ATION H1PACT Ii'EES AND IJ'rILI'l'Y CONNEC'I'ION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAP'fER '713, FLORIDA STA'fUTES, AS AMENDE:D)
<br />I certify that I, the applicant, have been provided witll a copy of "Florida's Construction
<br />lien LaH - Homeowner's Protection Guide" prepared by the v'lorida Department of Agriclllture
<br />and Consumer Affairs. If the applicant is someone other that the "owner", 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 commencemen t .
<br />E:. CON'fRAC'l'OR' S/OWNER' S AE'FIDAVIT
<br />I certify that all the information in this application is accurate and that all Viork Viill
<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 \vork and installation as indicated. I
<br />certify that no work or: installation has commenced prior to issuance of a permit and that
<br />all Viork will bb performed to meet standards of all laws regulating construction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiction. ] also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended vwr:k, and that it is my r:esponsibility to identify what actions I must take to
<br />be in compliance. Such agencies include but are not limited to: -i,"Depar-tment of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Envirornnentally Sensitive
<br />Lands, Water:/Wastewater 'l'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 />klJepartment of Health & Rehabilitative Service::;, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U. S. E:nvironrnental 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 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 F~orida prior to permit
<br />is:>uance.
<br />A permit issued shall be construed to be a license to proceed with tho;: work and not a:>
<br />authority to violate, cancel, alter, or set aside any provisions of tIle technical codes,
<br />nor shall issuance of a perndt 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 invalid unless the work authorized by such permit is cOllunenced within
<br />six montlls of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of six months after the time the Viork is corrunenced. One 90 day extensi on of time
<br />may be allowed for the permit Viith fee charge of $15.00. 'l'he extension shall be requef:lb::d
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHMENCEMEN'l' MAY RESUW' IN YOUR
<br />PAYING 'l'WICE FOR IMPROVEMEN'!,S 'fO YOUR PROPERTY. IF YOU INTEND 'ro OB'l'AIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO'I'ICE Ov~ COl'1MENCEMEN'l'. ,JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCENEN'r".
<br />
<br />SIGNATURE: OWNER OR AGEN'I'
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />s'rATE OE' FLORIDA
<br />COUNTY OF-
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by
<br />
<br />acknowledged
<br />, 19_
<br />
<br />STATE OF FLORIDA
<br />COUN'fY Of'
<br />The foregoing instrument was
<br />Before me this __day of
<br />by
<br />
<br />acknowledged
<br />., 19
<br />
<br />(name of person acknowledged)
<br />o who is personally knoVin to me, or
<br />
<br />o who has produced
<br />(type
<br />and ~JhoD did Ddid not
<br />
<br />(name of person acknowledged)
<br />OJho is personally known to me, or
<br />
<br />Dwho has produced
<br />(type of identification)
<br />and vJho Ddid [}Jid not take an oath
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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