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<br />\...UIWj,'J,'lUNti Ub' I;'ERMIT AFlfIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands thlJt thifi p~rmit may be subject to "deed restrictions" whlch
<br />nl~y be more restrictive than City regulations, The under~igned assumes responsibility for
<br />compli~nce with any applicable deed restrictions.
<br />B, UNLICENSED CON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBILITIES
<br />If tIle owner has hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in ilccordance with atate and local regulations. If the contractor is nul.
<br />) icensed as required by law, both the owner and contraotor may be ci tad for a m1.sdemeclllor
<br />violation under state law. If the owner or intended contractor are uncertain iH:l to ~Ihat
<br />Jicensing requirements may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills Bllilding Department, 813-788-6611.
<br />Furtherlno~:e, if the owner has hired a contractor or contractors, he is advised to have the
<br />contractor (B) sign portions of the "Contractor Sections" of this appU,cation for whi ell they
<br />wi),l be responsible. If you" as ~he owner signs ~s ~he contractor, YQ4 are indioating tll~t
<br />YOll, rather than the contractor, are responsible for the work. If the contractor l"iislles
<br />you to sign as contractor that may be an indicatiQn that he is not properly licensed alld is
<br />Ilot entitled to permitting privil~ge8 in the City of Zephyrhills,
<br />l;. TRANSPOR'l'ATION IMPAC'1' FEES AND U'rILITY CONNECTION FEES
<br />II. CONS'l'RllCTUION l.lEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />r certify that I, the applicant, have been provid~d with a oOPY of "Florida's Constrllction
<br />lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and ConSllmer Affairs. If the applicant 1a aomeone other that: the "owner", I cerify that I
<br />Ilave obtained a copy of the above described dooument and promise in good faith to deliver
<br />it to the "owner" prior to corronencement.
<br />E, CONTRAC'l'OR' a/OWNER' a AFFIDAVI'r
<br />I certify that all the information in this application 1s accurate and tJlat all work will
<br />be done in compliance with all applicable laws regulat1.ng constrllction, zoning, and land
<br />development.
<br />Applioation is hereby made to obtsin a permit to do work and installation aa indioated, 1
<br />certify that no work 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 o6nstruatlon, City
<br />codes, zoning regulations, and land development regulations in the jllriadiction. I alao
<br />certify that I understand that thQ regulations of otb~r governmental agencies Inay apply to
<br />the intended work, and that it is 'my responsibility to identify what actions I Il\IUlt take Lo
<br />lJe in compliance. Such agencies inolude but are not limited tOI *Department of
<br />Environmental Regulatipn-Cypress Bayh8ads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />* Southwest Inorida Water Management Distriot-Wells, : Cypress Bayheads, Wet] and Areas,
<br />Altering Watercourses
<br />*AcllIY Corps of Engineers-Seawalla, Docks, Navigable Waterways
<br />*iJepElrtmenl of Health & Rehabilitative Services, Environmental Ilealth \Jnit-Walla,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S, Environmental ~rotection Agency-Asbestos abatement
<br />I ~ll:lo certify that, if fill material is to be uaed in Flood Zone qA" or "A,etc,", it is
<br />understood that a dra1.nage plan addressing a "compensating volume" 'will be lilubmitted Vlhich
<br />is prepared by a professional engineer registered in th~ State of Florida prior to permit
<br />jssuance,
<br />A perlnit issued shall be construed to b. a license to proceed with bhe work and not as
<br />authority to violate, cancel, ~lter, or set aside any provisions of the technical coues,
<br />nor sllall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plana, Qon~~ruotioqr or vi9~~~iona of any oode. Every pe~mit
<br />h~u~d shall beoome invalid unle.. tho work Ituthodzed by suoh permit is oommenoed H1thin
<br />s1.)( months of issuance, or if work authorized by the perm1.t is suspended or abanuoqed tor a
<br />period of six months after the time the work is oorronenced. One 90 day extension of time
<br />may be allowed for the permit with f.. charge of $15.00. The extellsion ~hall be requested
<br />in wri ting to the Buildlng Offioial. An approved inapection must be logged during each sj l\
<br />llIonth period, or the project will be considered abandoned. ,
<br />WARNING TO OWNERI YOUR fAILURE '1'0 RECORD A NOTICE OB' COMMENCEMENT MAY RESUL'l' 111 YOUR
<br />PA'X'ING TWICE FOR IMPROVEMEN'!'S TO YOUR ~ROPERTY. IE' YOU INTEND TO OBTAIN 1!'INANqINq, ~qN~UL'1'
<br />WI'!'H YOUR LENDER OR AN A'l'TORNEY SE!'OR! RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNfJER
<br />$2,500 IN VALUE DO NO'l' NEED TO ~ECORD AND POST A "NOTICE OF COMMENCEMEN'r".
<br />
<br />H 'J.
<br />-------P ,'\h?I 1~ ~0-f
<br />S 1 GHA'l'l1RE :~NER OR AGENT
<br />
<br />~( Z?
<br />,/ ,1 ,- ~ ~-k. ctCf?
<br />SI~RE I ~ONTRACTOR
<br />
<br />S'J'A'l'E OF FLORIDA DAsco
<br />COUNTY OF L
<br />'l'he foregoing instrument was acknowledged
<br />before me this -3-- day of /IIl.4l' I ~ 3
<br />l> y GflUR t7tt~e,~
<br />~..........--( name of person acknowl,dged)
<br />~who is personally known to me, or
<br />
<br />STA'l'E OE' FLORID~'f 1'\ SC
<br />COUNTY OF ,r-t 0
<br />The foregoin<] instrument w~s ;)~no~il edged
<br />Betore me J:tlts -L.sja~ of IYI , j!I8~J
<br />by ~ 13 Ft:&.-
<br />_ (name of person acknowledged)
<br />~ is personally known to me, or
<br />
<br />and whoD did
<br />-J~
<br />
<br />o who has produced
<br />(type of identification)
<br />~ not take an oath.
<br />
<br />fl. ~
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Dwho has produced
<br />(!:'yp6 of idfmtifioatiol1)
<br />and who Ddid (gd1""'d not t,ake an oath
<br />
<br />~ /1-, {M~
<br />
<br />Signature of person taking aoknowledgment
<br />
<br />_ J3f?u:,E___---'-:i..'o-Lu!38 L
<br />llclllle typed, Pd~~ &r6ce"-'AMlped
<br />!~ .: My Commission 00116710
<br />'\;: 0' ~'.I Expires June 22. 2006
<br />
<br />r5/'Z-ve-[ /I, A5Bf"L
<br />
<br />Name typed, #.t_irLte, dOL' starnptid
<br />J>J' t:lruce A Asbel
<br />
<br />~~ ,; My Commission 00116710
<br />
<br />or ~'.I Expires June 22. 2006
<br />
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