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<br />l";UNLll'!'1.0NS OF PERMIT AFI!'IDAVI'I'
<br />A. NO~ICE OF DEED RESTRICTIONS
<br />'J'he undersigned understands t~at this permtt: may be sub:lect .,to "deed restrictions" which
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable dee,d restrictions.
<br />B. UNLICENSED CONTRACTORS AND CON'fRACTOR RESPONSIBIJJI'l'IES
<br />If the owner has hired a contrad:or or contractors to undertake work. they hlay be required
<br />to be licensed in accordance with state and local regulations. If the contractor is not
<br />licensed as required by law. bOUl the owner 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 ef Zephyrhills BUilding Department, 813-788-6611.
<br />Furthermore,. if the owner has hired a contractor or contractors, he is adv1sed 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 oWher signs as the contractor, you are indicating 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 1ndication that he is not properly licensed and is
<br />not entitled to permitting priVileges in the City of Zephyrhills.
<br />C. TRANSPORTA'rION IMPACT FEES AND UTI},ITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, F,LORIDA STATtJTEa, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - lIomeowner's Protection Guide" 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 commencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance with all a~plicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indicated. I
<br />certity 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 construction, City
<br />codes, zoning regulations. and land development regulations 1n the jurisdiction. I also
<br />certify that "I understand that the regulations of other governmental agencies may apply to
<br />the intended work, 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 Sensitive
<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 Waterways
<br />*Department of lIealth & Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />""U.s. Environmental Protection AgenCY-ASbestos abatement
<br />I also certify that. if fl11 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 which
<br />is prepared by a professional engineer registered in the State of Florida prior to permit
<br />iSsuance.
<br />A permit issued shall be construed to be a U.cense to proceed with the work IUld not as
<br />authority to violate, cancel. alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a permtt 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 Buch permit is oommenced within
<br />six months of issuance, or if work authorized by the penltlt is suspended or abandoned for a
<br />period of six months after the time the work is commenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. 't'he extension shall be requesb!d
<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 '1'0 OWNER: YOUR FAlI,URE 'fO RECORD A NOTICE OF COMMENCEMEN'r MAY RESUI," IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE D 0'1' NEED TO RECORD AND POST A "NOTICE OF COMMENC 1"'.
<br />
<br />
<br />SIGNATURE:
<br />
<br />
<br />'I"'
<br />
<br />STATE OF FLORIDA~ rJ
<br />COUNTY OF ~
<br />The foregoing instrument was ftctnowledged
<br />Before me this ~ day of l LA. Y . -ae.e.l
<br />by d IAt7\ \J jc.J. cy:>u--'
<br />
<br />~ '
<br />ame of person acknowledged),
<br />. .who is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />~not
<br />
<br />STA't'E OF FI.ORIDA
<br />COUNTY OF
<br />The foregoing instrument was ,ck~oW]edged
<br />Before me this ../.:1!!JJay of '- lA. I , afllZ.:L
<br />by (\/.vAy &~,-
<br />__ ~me of person acknowledged)
<br />LMi'() is personally known to me, or
<br />
<br />?Cl4<-U
<br />
<br />of identification)
<br />take an oath.
<br />
<br />
<br />Name
<br />
<br />,oJ"~ Suzanne Douglas-Allen
<br />
<br />typed:~*Hr:e~tllWfio~wtJ
<br />":!"fIT, .<,' Expires October 25, 2003 .
<br />-"f
<br />
<br />
<br />acknowledgment
<br />
<br />Name tyP!i_~~;:~~;llWPed
<br />
<br />--'""",.~' Expires October 25,2003 .
<br />
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