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<br />....VjWJ..l.J.Ul~O ull l:'l!JHL'1.L'L' AE'fIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'rhe undersigned understand:! thijt thia piirmit may be subjeot to "deed restrictions" whlch
<br />nl~Y be more restrictive than City regulations, The undersigned assumes responsibility for
<br />compli~nce with any applicable deed restrictions.
<br />B. UNLICENSED CON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSIBUITIES
<br />If the owner has hired a contractor 0.1: contractors ~o undertake work, they may be required
<br />to be licensed 1.n 'Becardanoe with state and local regulations. If the contractor is not
<br />licensed as required by law, both the owner and contraotor may be cited for a mlsdemeanor
<br />violation under state law. If the owner or intended contractor are uncertain as to vJhat
<br />licensing requirements may apply for the intended work, they are advised to oontaot the
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />Fllrthtn:mol:e, it the owner has hired a contractor or oontractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sectionstl of this application for \Jhich they
<br />will b~ responsible. If you, as the owner signs ~a the oontractor, YQ4 are indicatlng tllat
<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 indicatiQn that he is not properly lioensed 81ld is
<br />Ilot entitled to permitting privil~ge8 in the City of Zephyrhills.
<br />C. TRANSPOR'l'ATION IMPAC'f FEES AND U'fILITY CONNECTION FEES
<br />lJ. CONS'i'RlICTUION 1,IEN LAW (CHAP'l'ER 713, FLORIDA STATUTES, AS AMENDED)
<br />r certify that I, the applioant, have been provid~d with a oopy of "Florida's Constr\lction
<br />lien Law - Homeowner's Protection GuideH prepared by the Florida Department of Agriculture
<br />and ConS\lmer Affairs. If the applicant is someone other that: the "ownerH, I cerity that I
<br />have obtained a copy of the above deaoribed Clooument and promise in good faith to delivet
<br />it to the "owner" prior to commencement,
<br />E. CONTRAC'l'OR' S/OWNER' S AFFIDAVI'f
<br />I certify that all the information in this application is accurate and tllat all work will
<br />be done in compliance with all applicable laws regulating construction, zoning, cmd land
<br />development.
<br />Applioation is hereby made to obtain a permjt to do work and installation as indicated. 1
<br />certify that no work or installation has cornmenoed prior to issuance of II permit and that
<br />all work will be performed to meet standards of all laws regulating construotion, City
<br />codes, zoning regulations, and land development regulations in the j\lrisdiction. J also
<br />certify that I understand that th~ regulat:ions of otb~r governmental agenoies Inay apply to
<br />the intended work, and that it ia 'my responsibility to identify what actions I IlIllSt taKe Lo
<br />ue in compliance, Such agencies include but are not limited tOI .Department of
<br />Environmental Regulatipn-Cyprels Bayheads, Wetland Areaa and Environmentally SenEl~tive
<br />Lands, WRter/Wastewater Treatment
<br />*Soutllwest Florida Water Management District-Wells, 'Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />.Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*\Jepar:tl1lenl of Health lie Rehabilitative Services, Environmental Health IJnit-Wt;l1.l11,
<br />Wastewater Treatment, septic Tanks
<br />*U.S. Environmental ~roteetion Agency-Asbestos abatement
<br />J olso Gertify that, if fill material is to be used in Flood Zone 'IAH or "A,ete.H, it is
<br />understood that a dratnage plan addressing a "compensating volume" 'will be submitted Vlhicll
<br />is prepared by a professional engineer registered in th~ State of Florida prior to permit
<br />i.:isuance.
<br />A pennit 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 codea,
<br />nor sllall issuance of a permit prevent the Building Ofticial from thereafter requiring a
<br />correction of errors in plans, aon~~ruotioq, or vi9~~~ions of any oode. Every pe~~it
<br />is~ued shall beoome invaHd unhu tho work Iluthorizea by such permit: is oOllunenced vJ1thin
<br />six months of issuance, or if work authorized by the permit is suspended or abandoqect tor a
<br />period of six months after the time the work is commenced. One 90 day extension of tlme
<br />may be allowed for the permit with tee charge of $15.00. The extellsion shall be !equeated
<br />ill writing to the Building Offioial. An approved inspeotion must be logged during each aix
<br />month period, or the project will be considered abandoned. .
<br />WARNING TO OWNER. YOUR iAILURE 'ro RECORD A NOTICE OF COMMENCEMENT MAY RESUL'I' IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR ~ROPERTY. IF YOU INTEND TO OBTAIN rINANGIl>lq,~CJN~UL'r
<br />WI'l'H YOUR LENDER OR AN J\'l'TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENt!'. JOBS UNIJI!:R
<br />$2,500 IN VALliE DO NO'l' NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT",
<br />
<br />
<br />--z ~-e~
<br />
<br />WNER OR AGENT
<br />
<br />
<br />-ftL~
<br />CONTRACTOR
<br />
<br />S'rATE: OF FLORIDA Di+5 C
<br />COUNTY OF r 0
<br />'l'he foregoing instrument was acknowledged "2
<br />Bt:lfure me thisk day of M/j'f ~;>
<br />lJ y C:;::R... U tJ(: --
<br />,....,/, (Ilame of perl30n acknowl,dged)
<br />~who is personally known to me, or
<br />
<br />STA'!'E OF FLORIDA PAS.
<br />COUNTY OF . L {)
<br />The foregoin9 instrument W~lt.(kllowledged
<br />Betore me t~is ~jay of -, "" za}:J
<br />by ~ B ~
<br />~~(name of person acknowledged)
<br />~hQ i~ personally known to me, or
<br />
<br />o who has produced
<br />~(type of identification)
<br />and w~ [B'aid not take an oath.
<br />
<br />~4.~
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Dwho has produoed
<br />~e of idantifioat:lon)
<br />and who Ddid (Bj1d not take all oath
<br />
<br />~ A. MJ:€i!
<br />
<br />Signature of person taking acknowleugmt:lllt
<br />
<br />Name
<br />
<br />13rzuu- 4 - H )IJF L-
<br />t y P ed, p IfIlr a\.eSrudeA AlitIetllOp t:l d
<br />!~; My Commission 00116710
<br />~Clf"" Expires June 22. 2006
<br />
<br />_ ______8 gvCE.-a~ (})I][ L
<br />
<br />1I..l\\e typed, pdnte~~~~~I}.,eA~bel
<br />
<br />;.~ ; My Commission 0011671 (1
<br />~O#",'" Expires June 22, 2006
<br />
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