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<br />CUNJJl'l'lONS OF PERlIIJI'r AE'FIIJAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands thijt Lhi~ permit may be subject to "deed restrictionsU which
<br />may be mure rBstri cti ve than City regulations, The undersigned assumes responsibiU, ty for
<br />con~lii:lnce with any applicable deed restrictions,
<br />B. UNLICENSED CON'I'RAC'l'ORS AND CON'l'HACTOR RESPONSIBILI'l'IE:S
<br />If the O\vlHH' has hired a contractor or contl.:actors to undertake Hork, they IIlay be required
<br />to be licensed in accordance Hith state and local regulations. If the contractor: is not
<br />licensed as required by law, both the ovmer and contractor may be cited for a mLsdellleanor
<br />viol ati on under state laH. I f the owner or intended contractor are uncer'Lain as to vlhat
<br />1i censing requi remenb:l may apply for the intended Hor:k, they are advised to contact the
<br />city of Zephyrhills Building Depa,t::tment, 613-766-6611.
<br />Furthenl1on=, if the OHner has hired a contractor or oontraotors, he is advised to have the
<br />contraotor(s) sign portions of the "Con~ractor SectionsU of this application for Hhich they
<br />Hill be responsible. If you, as the oHner' signs as the oontractor, YQ4 are indicating that
<br />you, l'ather than the contractor, are responsible for the Hor-k. I f the contrClotor' Hishes
<br />you to sign as UOlltractor that may be an indication that he is not properly licensed and is
<br />not entitled to permitting privileges in the City of Zephyrhills.
<br />C, 'l'RANSPOR'l'ATION IMPACT IrEES AND UTILITY CONNECTION FEES
<br />D. CONS'l'RllC'l'llION LIEN LAW (CHAPTER 713, FLORIDA S'l'NrUTES, AS AMENDED)
<br />1 certify tllat I, the applioant, have been provided with a copy of "Florida's Construction
<br />lien LaH - Homeowner's Protection Guiden prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applioant is someone other Lhat the "oHIler", I oarify that I
<br />llClve obtained a copy of the above described document and promise in good faith to deliver
<br />it to tht:: I'owner" prior to conunencement.
<br />E. CON'rRAC'l'OR' S/OWNER' S AFFIDAVI'l'
<br />I oertify that all the information in this application is accurate and that all Hork will
<br />be done in oompliance with all appli,cable laHs regulating oonstruotion, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no v/Ork or installation has conunenced prior to issuance of a permit and that
<br />all work vlill be performed to meet standards of all laHs regulating construotion, City
<br />codes, zoning regulations, and land development regulations in the jurisdiotion. r also
<br />oertify that I understand that the regulations of other governmental agencies may apply to
<br />the intended Hork, and that it is my responsibility to identify what actions I IIll1SL 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 Sens1tive
<br />Lands, Water/Waste\vater 'rreatment
<br />"'SoutllHest Florida Water Management Distriot-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"'An"y Corps of Engineers-SeaHalls, Docks, Navigable WaterHays
<br />"'LJepartmenL of Health & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environmental Protection Agenoy-Asbestos abatement
<br />I also certify that, if fill material is to be used in Flood Zone ~A" or "A,eta.", it is
<br />understood that a, drainage plan addressing a "compensating volume" 'will be subrni tted which
<br />is prepared by a professional engineer registered in the State of Florida prior to pennit
<br />issuanoe.
<br />A permit issued shall be construed to be a license to proceed with the Hork and not as
<br />authority to violate, cancel, alter, or set aside any provisions of tbe technical codes,
<br />nor shall issuanoe of a permit prevent the Building Official from tllereafter requiring a
<br />oorrection of errors in plans, construction, or violations of any oode. Every permit
<br />iSfiued shall beoome invalid unless the HorK authorized by such permi t is cOllunenced within
<br />sJx montbs of issuance, or if Hork authorized by the permit is suspended or abandor~tid for a
<br />period of six months after the time the work is conoenced. One 90 day extension of time
<br />may be alloHed for tbe 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'sJx
<br />montb period, or the project Hill be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR FAILURE '1'0 RECORD A NOTICE OF COMMENCEMENT MAY RESUL'l' IN YOUR
<br />I:'AYING TWICE FOR IMPROVEMENTS TO YOUR PROPER'ry. IF YOU INTEND TO OBTAIN f'INAW~ING, ~QNijUL'I'
<br />WITH YOUR LENDER OR AN A'l"rORNEY BEFORE [\ECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2, SUO IN VALUE DO NOT NEED '1'0 RECORD AND POS'l' A "NOTICE OF COMMENCEMEN'l'''.
<br />
<br />
<br />~-~~
<br />SIGHA'l'l1RE: ~ OR AGEl~k.1" - '" SIGNA'rURE: CONTRAC'I'()R
<br />
<br />S'l'A'rE OF FLORI~ "STA'I'E OF FLORIDA
<br />COUNTY OF ~6l-6e.D COUNTY OF
<br />'llhe, foregoing il?'f-~lment Has,aik 0 Hledged The forego.ing instrument w~s aoknowledged
<br />Befo~~e this -:::zjday oof ~ . ' ~..2..lV3 Before me this ----.f,iay of I 19.-:._
<br />by ---;:-.q- III 1(t./J'1 -IL.€JJJ/ fi]. by
<br />(name of person acknowledged) (name of person aaknoHledged)
<br />DHho is personally known to me, or Qho is personally known to me, or
<br />
<br />~; has
<br />
<br />
<br />Dwho has produced
<br />(type of identifioation)
<br />and Hho Ddid DUd not take an oath
<br />
<br />Signature of person taking aoknowledgement
<br />
<br />Signature of person taking acknoHledgment
<br />
<br />\\\\"y";,"'"
<br />.,<s,-""..s:~
<br />-_.~._-~
<br />Name ~ :
<br />':o~~ or./~~"~
<br />J"f1"~
<br />
<br />Bobble Swetland
<br />~m93168 LC'pi,
<br />pdrPe~~!2. 1lJt.l.flmped
<br />BONDED THRU TROY FA'" I'!SURANC'
<br />
<br />Name typed, printed or stamped
<br />
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