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<br />co:mITIONS OF PERNIT AFFIDAVIT <br />A. NOTICE OF DEED RESTRICTIONS <br />The undersigned understands that this pernrlt may be subject to "deed restrictionsU which <br />may be more restrictive than City regulations. The undersigned a~sumes responsibility for <br />compliance with any, applicable de,,,,d restr:ict:ions. <br />B. UNLICENSED CONTAAC'l'ORS AND CONTRACTOR RESJ:>ONSIBILI'l'IES <br />If the OHner has hired a contractor or contractor.:> to undertake Hork, 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~iner and contractor may be cited for a misdemeanor <br />violation under state laVl. If the owner or intended contractor are uncertain as to wllat <br />licensing requirements may apply for: the intended work, they are advised to contact the <br />City of Zephyrhills Building Department, 813-788-6611. <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 SectionsU of this application for whicll they <br />Hill be responsible. If you, as the OHner signs as the contractor, you are indicating that <br />you, rather than the contractor, are responsible 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 Zephyrhills, <br />C. 'rRANSPOR'l'ATION H1PACT r~EES AND lJ'rILI'I'Y CONNEC'I'ION FEES <br />D. CONSTRUCTUION LIEN LAW (CHAP'rER 713, FLORIDA STA'l'UTES, AS AMENDE:D) <br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction <br />lien Law - Homeowner's Protection Guide" prepared by the Inorida Department of Agrictllture <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 fai.th to deliver <br />it to the "owner" prior to commencement. <br />E. CON'fRAC'fOR' S/OWNER' S AFFIDAVIT <br />I certify th~t all the i.nformation in this application is accurate and that all Hark Vlill <br />be done in compliance Hith all applicable laHs regulating construction, zoning, and land <br />development. <br />Application is hereby made to obtain a permit to do Hork and installati.on as indicated. I <br />certify that no H01-k or in::otallalion has conunenced prior to issuance of a permit and that <br />all work will be performed to meet standards of all laHs regulating construction, City <br />codes, zoning regulations, alld land development regulations in the jurisdiction. J also <br />certify tllat I understand that the regulations of other governmental agencies may ~pply to <br />the intended Hork, and that it is my responsibility to identify wllat actions I >>mst 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'/Wastewater Treatment <br />*SouthHest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, <br />Altering Watercourses <br />*Army Corps of Engineers-Sea~.alls, Docks, Navigable Waterways <br />klJepartment of Health & Rehabilitative Services, Environmental Health Unit-Wells, <br />Wastewater Treatment, Septic Tanks <br />*U.,s. Environmental Protection Agency-Asbestos abatement <br />I also certify that, if fill material is to be used in Flood Zone "AU or "A,etc,U, it is <br />understood that a drainage plan addressing a "compensating volume" Hill be :>ubmitted which <br />is 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 Hox:k i'lnd not as <br />authority to violate, cancel, alt~r, or set aside any provisions of tile technical code:>, <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 invalid unless the work authorized by such permit is COllulIeuced within <br />six months of issuance, or if Hark authorized by the permit is suspended or abandoned for a <br />pbriod of six months after the time the Hork 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 reque~ted <br />in writing to the Building Official. An approved inspection must be logged dllring each six <br />month period, or the project Hill be considered abandoned. <br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NO'l'ICE OF COMMENCEMEN'l' MAY RESUL'l' IN YOUR <br />PAYING 'l'WICE FOR IMPROVEMEN'l'S TO YOUR PROPERTY, IF YOU INTEND TO OB'l'AIN FINANCING, CONSULT <br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER <br />$2,500 IN VALUE DO NOT NEED '1'0 RECORD ANV POST A "NOTICE O~' COMMENCEl"'iEN'r". <br /> <br />SIGNATURE; OWNER OR AGEN'I' <br /> <br />SIGNATURE: CONTRACTOR <br /> <br />STATE OF FLORIDA <br />COUNTY OF- <br />Th~ foregoing instrument Has <br />Before me this __ day of <br />by <br /> <br />STA'l'E OF FLORIDA <br />COUNTY OF' <br />The foregoing instrument Has <br />Before me this __day of <br />by <br /> <br />acknowledged <br />19_ <br /> <br />acknoHledged <br />19 <br /> <br />(name of person acknowledged) <br />o Vlho is personally knoHn to me, or <br /> <br />(name of person acknowledged) <br />Olho is personally known to me, or <br /> <br />Owho has produced <br />(type <br />and vlhoD did 0 did not <br /> <br />of identification) <br />take an oath. <br /> <br />Owho has produced <br />(type of idE::ntificatioul <br />and who Ddid []Jid not take an oath <br /> <br />Signature of person taking acknoHledgement <br /> <br />Signature 6f person taking acknoHl~dgment <br /> <br />- <br />Name typed, printed or stamped <br /> <br />Name typed, printed or ",tamped <br />