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<br />CONfJIrrIONS OF PERNIT AFFIDAVI'r
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'I'he undeJ:signed undeJ:stands that thiti permit may be subject to "deed restrictions" which
<br />filay be moL';:: I:estricti VI: than Ci ty regu.l a tions . The undersigned atisurnes retiponsJbili ty foL'
<br />compliance with any, applicabJ e deed restl:ictions.
<br />B. UNLICENSED COI'iTRAC'l'ORS ANT) CON'l'MCTOR RESPONSIBILI'l'IES
<br />1 f the ovmer has hired a contractor or contrClctors to undertake work, they mClY be I:equired
<br />to be licensed in accordance witll state and local regulations. If the contractor iti not
<br />licensed a:; required by .laVi, both the OvUlel' and contractor may be cited for a lIlisdemeculOr
<br />violation under state lavl. If the owner OL' intended contractoJ: are IHlc=rtClill as to what
<br />licensing J:equiJ:ements may apply for the intended work, they are advised to contact tile
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />Furthermore, if the ovmer has hired a contractor or contractors, he is adviSed to have the
<br />contractoJ:(s) sign portions of the "Contractor Sections" of this C1pplication tor which they
<br />will be responsible. If you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor wislles
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />not entitled to permitting pri,vileges in the City of <:'.ephyrhi.lls.
<br />C. 'l'RANSPOR'rATION H1PACT I."EES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAP'rER 713, FLORIDA STA'fUTES, 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 Guide" prepared by the l!'lorida Department of Agri cul ture
<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 faitll to deliver
<br />it to the "OHner"" prior to cOllunencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI'r
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do Hark and installation as indicated. I
<br />certi ty that no Hark or intitallation has cOlTunenced prior to issuance of a permi t and that
<br />all Hork will be performed to meet standards of all laws regUlating construction, City
<br />codes, zoning regulations, and land development regulations in the jurisdiction. 1 also
<br />certify that I understand that the regulations of other gqvermnental agencies Hlay apply to
<br />the intended vwrk, and that it 1s my responsibility to identify v~hat action::; I must take to
<br />be in compliance. Such agencies include but are not limited to: ~'DepaI:tment of
<br />I!:nvironmental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally St:::nsitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest FloL'ida Water Management Di~trict-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"'Army Corps of Engineers-SeaHalls, Docks, NaVigable Waterways
<br />kDepartment of Health &. Rehabilitative Services, Environmental Health Unit-WelLs,
<br />Watitewater Treatment, Septic Tanks
<br />*U.s. 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 dr"ainage plan addressing a "compensating volume" Hill 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 license to proceed with the work and not as
<br />authority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />110r shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construct!on, or violations of any code. Every permit
<br />issued shall become invalid unless the work authorized by such per'mit is cOllunenced within
<br />six months of i::lsuance, or if work authorized by the permit is suspended or abandoned for a
<br />per'iod of six months after the time the work is conunenced. One 90 day extension of time
<br />may be allowed tor the permit Hith fee charge of $15.00. The extension shall be requested
<br />in vniti,ng to the Building Official. An approved inspection must be Jogged during each six
<br />month peJ:iod, or the pr'oject Hill be considered abandoned.
<br />WARNING TO OWNER: YOlJH E'AILORE TO HECORD A NOTICE OF COlvJMENCEMEN'l' MAY RESUUl' IN YOUR
<br />PAYING TWICE FOR IMPROVEIvIEN'l'S '1'0 YOUR PROPERTY. U' YOU INTEND '1'0 OB'rAIN b'INANCING, CONSULT
<br />WITH YOUR LENDER OR AN AT'l'ORNEY BEb'ORE RECORDING YOUR NO'nCE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NO'l' NEED '1'0 RECORD AND POST A "NOTICE OF COMMENCE!I1ENT".
<br />
<br />SIGNATURE: OWNER OR AGEN'I'
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this __ day of
<br />by
<br />
<br />ackno\rlledged
<br />19_
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF'
<br />The foregoing instrument was
<br />Before me this __day of
<br />by
<br />
<br />(name of person acknowledged)
<br />o who is peL'sonally known to me, or
<br />
<br />acknowledged
<br />19
<br />
<br />(name of person acknoHledged)
<br />o/ho is personally known to me, or
<br />
<br />Dwho has produced
<br />(type
<br />and vlhol] did Odid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Dwho has produced
<br />(type of identification)
<br />and vlho Odid ['}:lid not take all oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, pri nted or stamped
<br />
<br />Name typed, printed or stamped
<br />
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