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<br />COl.JDITJONS OF' PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The under-signed understands that thi:> permit lfIay be subject to "deed restriction.s" which
<br />m~y be more restrictiv~ than City regulations. The undersigned assumes responsibility for
<br />compliance with .any applicable deed restrictions.
<br />B. UNLICENSED C'oN'fRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to \lndertake work, they may be required
<br />to be licensed in accordance with st~te and local regulations. If the contractor is not
<br />licensed as required by law, both the Oymer and contractor may be cited for a misdemeanor
<br />violation under state law. If the owner or intended contractor are uncertain as to what
<br />licensing requirements may apply for the intended work, they are advised to contact the
<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 for which they
<br />will be responsible. If you, as the OWner sign.s as the 60ntractor, you are indidating 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 per-mitting privileges in the City of Zephyrhills.
<br />C. 'fRANSPOR'l'A'rION JlI.1PAC'l' FEES AND U'rILl'I'Y CONNECTION FEES
<br />D. CONSTRUC'rUION LIEN LAvJ (CHAPTER 713, FLORIDA STATUTES, 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 Guideq prepared by the Florida 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 promise in good faith to deliver
<br />it to the "owner" prior- to conunencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI'f
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in c~~liance with all applicable laws regulating construction, zoning, and land
<br />dt::veloprnent.
<br />Application is hereby n~de to obtain a permit to do work and installation as indicated. I
<br />certify that no Hork 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 I understand that the regulations of other governmental agencies may apply to
<br />the .l.iltended work, and that it is my responsibility to identify what actions I must take to
<br />bein-"compliance. Such agencies include but are not limited to: "'Department of
<br />EntlrjQ~ental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />L~b~~ Water/Wastewater Treatment
<br />"'~thwest Inorida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />~i~ring Watercourses
<br />~Army Corps of Engineers-SeaHalls, Docks, Navigable Waterways
<br />"'Department of Health & Rehabilitative Services, Environmental Health Unit-WeLll:i,
<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 Yfhich
<br />is prepared by a professional engineer registered in the State of Florida prJor 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 r-equiring 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 cOllunenced w.i thin
<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 logged during each six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUIr'I' IN YOUR
<br />PAYING 'rWICE FOR Il'1PROVEMEN'l'S TO YOUR PROPERTY. IF YOU INTEND TO OB'I'AIN InNANCING, CONSUL'!,
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED 'ro RECORD AND POST A "NO'rICEOF COJltIMENCEMEN'I'''.
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />~,.I/ J4i~
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE Oli' InORI DA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this __ day of
<br />by_
<br />
<br />acknowledged
<br />__,2Q_
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />'!'he foregoing instrument Has acknowle%ed
<br />Before me this _day of ,_
<br />by
<br />(name of person ackno~fledged)
<br />C1ho is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />o who is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and whoD did Ddid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Owho has produced
<br />(type of identification)
<br />and Hho Ddid DUd not take an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, pr-inted or stamped
<br />
<br />Name typed, printed or stamped
<br />
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