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<br />CUNIH'l'lONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands t"at this permit may be subjeot "to "deed restriotions" whioh
<br />may be more restrictive than City regulations. 'rhe undersIgned assumes resporisibility for
<br />complianoe with any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS ANV CONTRACTOR RESPONSIBIJ.l1'IES
<br />If the owner has hired a contractor or contractors to undertake work, they nlay 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 />violation under state law. If the owner or lntended contractor are uncertain as to what
<br />licensIng requirements may apply for the lntended work, they are advised to contact the
<br />City ~f Zephyrhills BUilding Department, 813-788-6611.
<br />Furthermore" 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 which they
<br />will be responsible. If you, as the oWher signs as the contractor, you are indicating that
<br />you, rather 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. TRANSPORTATION IMPACT FEES AND UTII.ITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, F~ORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy 6f "Florida's Construction
<br />lien Law - Homeowner's Protectlon Guide" prepared by the Florida Department of Agrlculture
<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 commencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certIfy that all the informatlon in this application is accurate Bnd 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 indicated. I
<br />certify that no work or installation 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, and land development regulations in the jurisdiction. I also
<br />certify that '1 understand that the regulations of other governmental agencies may apply to
<br />the intended work, 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 />Environmental RegUlation-Cypress Bayheads, Wetland Areas and EnVironmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Bouthwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of EngineerS-Seawalls, Docks, NaVigable Waterways
<br />*Department of Health , Rehabilitative Services, Enviromnental 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 "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 reglstered 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 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 invalid unless the work authorized by such permit is commenced within
<br />six months of issuance, or if work authorized by the permit is SUspended or abandoned for a
<br />period of six months after the time the work is commenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extenslon shall be requested
<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 OWNERz YOUR FAIIMRE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUI~ IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE D NOT NEED TO RECORD AND POST A "NOTICE OF COMMENC ENT".
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<br />
<br />'..
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<br />STATE OF FLORIDA R i)
<br />COUNTY OF ~c
<br />The foregoinu in"trument nas ackllowledyed
<br />Before me this 5 day of ~ ' alIlI
<br />by ~1"'o1 Cl,odU-
<br />V.
<br />_ Jname of person acknotfledged),
<br />~o is personally known to me, or
<br />
<br />o who has produced
<br />(ty~
<br />and whoO did Bd1d n
<br />
<br />STATE OF FI.ORIDA ~
<br />COUNTY OF ,rqJC 0
<br />'l'he foregoing instrument was acknowledged
<br />Before me 1jis ~ay o~ ~ , nu..-L
<br />by v.cA~ ~~..e
<br />(name of person acknowledged)
<br />~ is personally knowll to me, or
<br />
<br />Owho
<br />
<br />Signature of.. · Ilf.4Ii ~f!lcnowledgement
<br />*~ *My Commission CC874208
<br />...~..'~ Expires October 25, 2003
<br />-."1\
<br />Name typed, prInted or stamped
<br />
<br />
<br />
<br />pe of identification)
<br />not take an oath
<br />
<br />Signature 0 person taking acknowledgment
<br />,"6"~ Suzanne DouglaS-Allen
<br />*Jiif*My Commission CC874208
<br />Name t it=? E~if!IRf.li!lllr ~,#O<iJltamped
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