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<br />CONDITIONS OF PERlvIIT AFFIDAVI'I'
<br />A. NOnCE OF' DEED RES'I'RICTIONS
<br />'l'he underfligned understands that tbi;:; penni t may be sub:j ect to "deed restrictions" wbi eb
<br />may be more r-estricti Vii:: than City regul ations, The undersigned a::>:mmes responsibili.ty for
<br />compliance vdth any applicabl e deed restrictions,
<br />B. UNLICENSED COf'lTRAC'l'ORS AND CONTAAC'rOR RESPONSIBILITIES
<br />If the owner lIas 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 not
<br />licensed a::> required by lavJ, both the mmer and cont cactor may be cited for a misdemeanor
<br />violation und",r state law, If the ovmer 01: intended contractor are uncertain as to v~hat
<br />licensing requirements may apply for the intended work, they are advised to contact tile
<br />City of Zephyrhill.s 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 SectionsH 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, ratlier than the contr-actor, are responsible for the Hork, I f 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 :6ephyrhills,
<br />C, 'l'RAHSPOR'l'A'I'ION H1PAC'1' fEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAP'fER 713, FLORIDA S'fA'fUTES, 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 ~'lorida Department of Agricul.ture
<br />and Consumer Affairs. If the applicant is someone other that the "o~mer", I cerify that I
<br />Ilave obtained a copy of tbe above described document and promise in good faith to deliver
<br />it to the "owner" prior to corrunencement,
<br />E, CONTRACTOR' S/OWNER' S Ar'FIDAVI'r
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance Hith all applicable laws regulating construction, zoning, and land
<br />developmeut.
<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 connenced prior to issuance of a permit and that
<br />all Hork will be performed to meet standards of all laws regulating constrllction, City
<br />codes, zoning regulations, and land development regulations in the jurisdictioll, 1 al::>o
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended work, and that lt 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 Environmelltally S",nsitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Wat~rways
<br />*Department of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U,5, Environmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone "AH or "A,etc.H, it is
<br />understood that a drainage plan addressing a "compensating volume" will be submitted which
<br />is prepared by a professional engineer registered in the state of Florida prior to permit
<br />issuance,
<br />A perndt 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 tile technical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of error"s in plans, constructi.on, or violations of any code. Every permit
<br />issued shall become invalid unless the work authorized by such permit is cOimnenced within
<br />six montlls 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 corrunenced, One 90 day extension of time
<br />may be allowed for the permit Hith fee charge of $15,00. The extension shall be requested
<br />in ~Jriting to the Building Official. An approved inspection must be logged during each si"
<br />month period, or the project will be considered abandoned,
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COI'1MENCEMEN'l' MAY RESUI.'I' IN YOUR
<br />PAYING TWICE FOR IMPROVElvlEN'l'S '1'0 YOUR I?ROPER'ry, IE' YOU IN'l'END '1'0 OB'rAIN b'INANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEb'ORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NO'l' NEED '1'0 RECORD AND poser A "NO'rICE OF COMMENCEMEN'r",
<br />
<br />SIGNATURE: OWNER OR AGEN'!'
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />acknovlledged
<br />19~
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _day of
<br />by
<br />
<br />S'I'ATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument Has
<br />Befor-e me this _ day of
<br />by
<br />
<br />acknowledged
<br />19
<br />
<br />(name of person acknowledged)
<br />o who is personally known to ml;;, or
<br />
<br />(name of person acknowledged)
<br />[1ho is personally known to me, or
<br />
<br />of identification)
<br />tak", an oath.
<br />
<br />Dwho has produced
<br />(type of identificatiou)
<br />and who Odid []did not take all oath
<br />
<br />o vlho ha::; produced
<br />(type
<br />and ~lhoO did Odid not
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed oJ.." ::;tamped
<br />
<br />Name typed, printed or stamped
<br />
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