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<br />CUNtll'.I.'10NS OF PP.RMIT AFFIDAVIT
<br />A. NOT.ICE OF nEED REBTRIC'l'IONS
<br />~I'he undersigned understands t~at this pelrmit: mi~y be subject J:o "deed rest:rictions" which
<br />may be more restrictive than City.. regula tions. The undersigned assumes responsibility for
<br />compliance with any applicable deed restdctiollB.
<br />B. tJNLICENSEn CONTRAC'l'ORS ANn CONTRACTOR RESPON:9IBIJ,I'l'IES
<br />I f the owner has hired a contractor or cnntraet: ors to undertake work. they hlay be required
<br />to be licensed in accordance with state ~nd .Loea! regulations. If the contractor is not
<br />licensed as required by law. both the OWller 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 ~f Zephyrhills 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 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 j.ndication that he is not properly licensed and is
<br />not entitled to permitting priVileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTII.ITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, F,LORIDA STATUTE::!, 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 Gulde" 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'B AFFIUAVl'f
<br />I certify that all the information in this application is accurate and that all work wLU
<br />be done in compliance with all a~plicable l-aws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a perrn.it to do work and installation as indioated. I
<br />certity that: no work or installation has commenced prior to issuance of a perrn.it 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 agenc1es 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. Nav1.gable Waterways
<br />*Department of Health, Rehabilitative SerVices, Envlrolunental Health Unlt-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.9. 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 which
<br />is prepared by a professional engineer registered in the State of Florida prior to pennit
<br />issuance.
<br />A permit issued shall be construed to be a U.cense to proceed with the work f'nd 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 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 such permit is commenced within
<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 commenced. One 90 day extension of time
<br />may be allowed for the perm1t with fee charge of $15.00. The extension 8hall be requested
<br />1n writing to the Building Officlal. Au approved inspection must be logged during each six
<br />month periOd, or the project will be cons1dered abandoned.
<br />WARNING '1'0 OWNER I YOUR FAII.URE 'fO RECORD A NOTICE OF COMMENCEMENT MAY RESUI,T 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 Do OT NEED To RECORD AND POST A "NOTICE OF COMMENCEME
<br />
<br />
<br />SIGNATURE:
<br />
<br />
<br />",",
<br />
<br />STATE OF FLORIDA ~ ()
<br />COUNTY OF . Q..a.L.
<br />The foregoing instrument was acknowledged
<br />Befo.te me this--L2-d~ of ;~ If ' atffJ3
<br />by ,ju,~y S,{J.~I~
<br />__ !..name of person ackno~ledged).
<br />.~ is personally known to me. or
<br />
<br />Owho
<br />
<br />STATE OF FI,ORIDA
<br />COUNTY OF
<br />The foregoing instrument was ~~low]edged
<br />Before me this ~ay of ;::. J Y , Cltlrl:::L
<br />by I S ~ r-
<br />_ jname of person acknOWledged)
<br />~is personally known to me, or
<br />
<br />Ycuu,{)
<br />
<br />
<br />of identification)
<br />take an oath.
<br />
<br />o who
<br />
<br />Name typed.
<br />
<br />person taking acknowledgement
<br />Douglas-Allen
<br />a suzanne . ,iO" r.C874208
<br />pd WJ:Cus'l!'_. A!lf.2003
<br />~ , Expires 0
<br />"".,..",# .
<br />
<br />Sign
<br />
<br />
<br />Name
<br />
<br />or stamped
<br />
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