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<br />CONDITIONS OF PERMIT AFFIDAVI'r
<br />A, NO/rICE OF' DEED RES'I'RICTIONS
<br />'l'he undecsigned understands that this pcuni t may be subj ect to "deed restciction.s" whi ch
<br />Utay be more cestrictive than City r:egulations. 'l'he undersigned as:mmes re::;ponsibility for
<br />compliance with any, applicabl e deed .L,;,strictions,
<br />B, UNLICENSED COj~TRAC'l'ORS AND CON'l'kAC'l'OR RESPONSIBILITIES
<br />If the OHfler bas hired a contractor or contractors to undertake work, they may be r'equired
<br />to be licensed in accordance witb state and local regulations, If the contractor i::; not
<br />licensed a::> required by layJ, both the ovmer' and contractor !nay be cited for a misdem",anor
<br />violation under state law, If the owner or intended contractor are uncertain as to v~lat
<br />licensing requirements may apply for the intended work, they are advised to contact tile
<br />City of Zephyrhills Building Department, 813-788-6611,
<br />Furthermore, if the oymer has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application foe whicll they
<br />will be responsible, If you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the contractor, are responsible for the work, If the contractor wislles
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />not entitled to permitting pci vileges in the Ci ty of l'.ephydlills.
<br />C. 'l'RANSPOR'I'A'I'ION IMPACT E'EES AND UTILI'I'Y CONNECTION FEES
<br />D, CONSTRUCTUION LIEN LAW (CHAP'I'ER 713, FLORIDA STA'rUTES, AS AMENDED)
<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 Iflorida Department 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 promi,se in good faith to deliver
<br />it to the "owner" prior to corrunencement,
<br />E, CONTRACTOR' S/OWNER' S AFFIDAVI'I'
<br />I certify that all the information in this application is accurate and 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 \vork and installation as indicated, I
<br />certify that no work or in::;tallation has conmenced prior to issuance ot 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, 1 also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended vwrk, 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 Sc:nsitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"Anuy Corps of Engiueers-SeaHalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Enviconmental Healtll Unit-Wells,
<br />Wastewater Trbat!nent, Septic Tanks
<br />,"'u. oS. 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" Hill be submitted which
<br />is prepared by a professional engineer registered in the State of Florida prior to permit
<br />iSlOuance.
<br />A permit issued shall be construed to be a license to proceed with the ywrk i'lnd not as
<br />authority to violate, cancel, alter, or set aside any provisions of tile 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 coumenced within
<br />six months of i.:lsuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of SiK months after the time the work is conunenced, One 90 day eKtension of time:
<br />may be allowed for the pe:rmit with fee charge of $15.00. 'I'he extension shall be requested
<br />in v/riting 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 E'AILURE TO RECORD A NOTICE OF COl'1MENCEMENT MAY REBUI.'!' IN YOUR
<br />PAYING TWICE FOR IMPROVElvlEN'l'S '1'0 YOUR PROPERTY. IE' YOU INTEND '1'0 OB'!'AIN b'INANCING, CONSUL'!,
<br />WITH YOUR LENDER OR AN ATTOro~EY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALlIE DO NOT NEED '1'0 RECORD AND POS'I' A "NOTICE OF COMMENCEMENT",
<br />
<br />SIGNATURE: OWNER OR AGEN'I'
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />acknoylledged
<br />_,19_
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before mE: thi::; ---Slay of
<br />by
<br />
<br />STATE OF FLORIDA
<br />COUNTY 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 yJho is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />[1ho is personally known to me, or
<br />
<br />of identification)
<br />take an oath,
<br />
<br />o Hho has produced
<br />(type of identification)
<br />and Hho Ddid [}jid not take an oath
<br />
<br />D who has produced
<br />(type
<br />and YJhoD did Ddid not
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, pri nted or stamped
<br />
<br />Name typed, printed or stamped
<br />
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