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<br />CONnI'rIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'fhe undersigned understands thqt this permit may be subj ect to "deed restrictions" wbich
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for'
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED t~ON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBIJ,ITIES
<br />If tile owner 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 110t
<br />licensed as required by law, both the ovmer and contractor may be cited for a miademeauor
<br />violation under state la\l. I f the owner or intended contractor are uncerlain as to vlhat
<br />licensing requirements may apply for the intended work, they are advised to contaot the
<br />city of Zephyrhills Building Depa,r;tment, 613-766-6611.
<br />Furtherloo):e, jf 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 applj,cation for Hhich they
<br />vlill be r.esponsible. If you, as the owner signs 'IS the contractor, YQ\,! are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor \oIishes
<br />you to sign as contractor that may be an indication that he is not properly licensed alld is
<br />llot Ellltitled to permitting privileges in the City of Zephyrh1.11s.
<br />C. 'I'RANI:ll'OR'l'ATIOH IMPACT FEES AND UTILI'I'Y CONNECTION FEES
<br />lJ. CONS'l'RIlC'I'UION LIEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien La\ol - Homeowner's Protection Guide" prepared by the Florida Departmellt of Agriculture
<br />and Consumer Affairs, If the applicant is someone other that the "owner", I eerity tllat I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />.1 t to the "owner" prior to corrunencement.
<br />E:. cOWrRAC'I'OR' S/OWNER' S AFFIDAVI'I'
<br />I certify that all the information in this appl,ication is accurate and that all work will
<br />be done in compliance \oIith all appli.cable laws regulating construction, zoning, and land
<br />development.
<br />Application 1.s hereby made to obtaln a permit to do work and installation as indiaated. 1
<br />certify that no work or installation has commenced prior to issuance of a permit and that
<br />all work \Iill be performed to meet standards of all laws regulating construotion, City
<br />codes, zoning regulations, and land development regulations in the j\lrisdiction. I also
<br />certify that I 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 mllst take to
<br />be in compliance. Such agencies include but are not limited to: *Depat'tment of
<br />EnvirolllTjental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Sens1.tive
<br />Lands, Water/Wastewater rrreatment
<br />*Soutllwest florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"'Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Uepartu~nt of Health & Rehabilitative Services, Environmental Healtll 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,ete.", it is
<br />understood that a dl:'ainage plan addressing a "compensating volume" 'will be sUDmi tted v/hich
<br />is prepared by a professional engineer registered in tile 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 tlJe technical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requ.1.ring a
<br />oorrection of errors in plans, oonijtruation, or vio~ations of any oode. Every pfu:mit
<br />iSfjUed shall become invalid unless the work authorized by such permit is oouullenced Hithin
<br />Si.K months of issuance, or if work authorized by the permi.t is suspended or abandoqed 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 extellsion shall be reques~ed
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project vlill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE '1'0 RECORD A NO'rICE OF COMMENCEMENT MAY RESUW' IN YOUR
<br />l'AYING 'l'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN ~'INANqINq, ~qNl.?UI/I'
<br />WI'l'H YOUR LENDER OR AN A'r'rORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. .JOBS UNDER
<br />$2,500 IN VALUE DO NO'l' NEED 'I'D RECORD AND POS'l' A "NOTICE OF COMMENCEMENT".
<br />
<br />---~-~f-L?~
<br />
<br />S 1 GNA'l'URE: \,AWN ER OR AGENT
<br />
<br />
<br />S'l'A'I'E OF FLORIDA P
<br />COUNTY OF ____ /15 Co
<br />'l'he foregoing instrument was ackno~-.rledged
<br />BE:lfor~ me this ,2-'5~ day of ...fJeg~, ]c#7.003
<br />by~u..6 ~Fr:73F
<br />(name of person acknowl,dged)
<br />~o is personally known to me, or
<br />
<br />STA'l'E OF FLORIDA
<br />COUNTY OF
<br />'J'he forego.1ng instrument wS!~okrlO\oIledged
<br />Before me this 25'" )iay of 'E/I I .~3
<br />by ,GiEb CSFrr>E ,
<br />(name of person acknowledged)
<br />~ is personally known to me, or
<br />
<br />PASCO
<br />
<br />and who[] did
<br />~
<br />
<br />Dwho has produoed
<br />(type of identification)
<br />~ not take an oath.
<br />
<br />4. ~
<br />
<br />Dwho has produced
<br />JJ;ype of identifiGatlon)
<br />and Hho Ddid fBfld not t,ake all oath
<br />
<br />~~A-~
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Signature of person taking acknowledgement
<br />
<br />______J$J?::~( E Jl~tJ <5 BI3 L
<br />
<br />Name typed, printed or stamped
<br />:l'J' Bruce A Asbel
<br />
<br />\.'Y': .; My Commission 00118710
<br />
<br />0, r.'./' Expires June 22. 2008
<br />
<br />g(2 V C. ~ /1-, If filE L _____.__.____,
<br />Name typed, printed or stamped
<br />:l'J"'- Bruce A Asbet
<br />;,~ .; MyCommisslonD0116710
<br />~ 01 r.d' Expires June 22, 2008
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