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<br />co~mITIONS 0): PE;RlV:IT AF'FIDAVIT
<br />A. NO'l'lCE OF DEED RES'l'RIC'l'IONS
<br />The undersigned understands that this perndt lnay be subj~ct to "deed restrictionsU which
<br />may be more restrictive than City l'eguh.tions. 'Phe lll1dersigned assumes responsibility' for
<br />compliance with any, applicable deed restrictions.
<br />B. UNLICENSED CONTRAC'l'ORS AND CONTRACTOR RE.:SPDNSIBILITU<:S
<br />If the ovfner has hired a contractor or contractJrs 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 owner and contractor may be cited for a misdemeanor
<br />violation under state law. If the owner or inte~~ed contractor are uncertain as to wllat
<br />licensing requirements Illay apply for the intended work, they are advised to contact the
<br />City of Zephyr'hills 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 SectionsU 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 licen~ed and is
<br />not entitled to permitting privileges in the City of Zaphyrhills.
<br />C. TRANSPOR'!'ATION U1PAC'I' IfEES AND UTILI'lIY CONNEC'I'ION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAP'rER 713, FLORIDA STA'rUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Con~truction
<br />lien LaH - Homeowner's Protection Guide" prepared by the t'lorida Departmt:nt of Agriculture
<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 cornmencemen t,
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I cert.ify that all the information in this application is 'accurate and that all wor.k will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />development,
<br />Application is hereby made to obtai,n a permit to do Hork and installation as indicated. I
<br />certify that no vwrk or inl::ltallalion has conunenced prior to issuance of a permit: and that
<br />all work will be performed to meet standards of all laws rt:gulating construction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended vlOr:k, and that it is my responsibility to identify what actions I llIust 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/Wastewater Treatment
<br />.Southwest Florida Water Management District-Wells, Cypress Bayhead~, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Uepartment of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Envirornnental 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" will be ::lubmitted which
<br />is prepared by a professional engineer registered in the State of Florida prior: to permit
<br />is~uance.
<br />A permit issued shall be construed to be a license to proceed Hith the Hork and not as
<br />authority to violate, cancel, alter, or set aside any provisions of the tt:c1mical 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 it; COllUlll:HlCed 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 conunenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspection must be Jogged during each 6ix
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN'l' MAY RESUW' IN YOUR
<br />PAYING 'rWICE FOR IMPROVEMENTS TO YOUR PROPERTY. It' YOU INTEND TO OB'!'AIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN AT'l'ORNEY BEFORE RECORDING YOUR NOTICE COMMEN 'M N'I'. JOBS UNDER
<br />$2,500 IN VALUE DO NO'f NEED TO RECORD AND POST A "NOTICE OF CO NC '
<br />
<br />~~)fW
<br />
<br />SIGNATURE: OWNER OR {AGEN'l'
<br />
<br />
<br />STATE OF' FLORIDA n c,..,..,
<br />COUNTY OF - ~~
<br />The foregoing instrument was acknowledged
<br />Before me this \~~ day of M~Y , e-2l>>3
<br />by ~l-6U:1" 8. ro71-l
<br />(name of person acknowledged)
<br />o wbo is personal.ly known to me, or
<br />
<br />STATE OF FLORIDA 13-
<br />COUNTY OF' 19-:5t! 0
<br />Tbe foregoing instrument was acknowledged
<br />Before me t,bis ~day of m/9 y , +'ir?a:>3
<br />by --Lll.iJ.<. ~ k p ~
<br />. ~ (name of person acknowledged)
<br />~o is personally known to me, or
<br />
<br />fYWhO has produced FL bL-
<br />(type of identification)
<br />
<br />a~~d;~ltot take an oath.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />~~(. GDe:.u..Ar
<br />
<br />Name typed, pri nted or
<br />
<br />Dwho bas produced
<br />(type of identification)
<br />id no' take an oath
<br />
<br />st~all
<br />~ aye CodeU,
<br />! . My Commisaill" 0005*5
<br />~ Of ~ Expires Auguat 26, 2OQ5
<br />
<br />
<br />person taking acknowledgment
<br />
<br />1,k~
<br />
<br />Name typed, printl::d or stamped
<br />#\~, Jaime L Felts
<br />*M *My Commls8ion CC880237
<br />....,.,..f\~. Expires October 17, 2003
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