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<br />CONDITIONS OF PERlvIIT AFFIDAVI'I'
<br />A. NO'l'lCE OF' DEED RES'I'RICTIONS
<br />'l'he undersigned understands that tin::> penni t may be subject to "deed restrictions" which
<br />Utay lJe more restrictive than City r'e<)lllations. The undersigned assumes responsilJility for
<br />compliance with any applicable deed restr.:ictions.
<br />B. UNLICENSED COhTRAC'l'ORS AND CONTRACTOR RESPONSIBILI'l'IES
<br />If the o~mer has hired a contractor or contractor::; to undertake work, thl::Y may be required
<br />to be licen::;ed in accordance with state and local regulations. If the contractor is not
<br />licensed as required by la~I, both the o~mer and contractor may be cited for a llIisdemt::clllor
<br />violation under state law. If the owner or intended contractor are uncertain as to wllat
<br />licensing requi.rements 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 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 whicll they
<br />will be responsible. If you, as the owner signs as the contractor, you are indicating that
<br />you, ratl1er than the contractor, are responsible for the Hark. If the contractor wishes
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />not entitled to permitting privileges in the City of :t.ephyrhi,lls.
<br />C. 'I'RANSPOR'I'ATION llvIPAC'!' f'EES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAP'l'ER '713, nORIDA S'I'A'l'UTES, AS AMENDED)
<br />I c~rtify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien LaH - HomeoHner's Protection Guide" prepared by the lnorida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "o~mer", 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 conunencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />I certify tllat all the information in this application is accurate and that all work will
<br />be done in compli,ance with all applicable laws regulating construction, zoning, and land
<br />developrnellt.
<br />Application is hereby made to obtain a permit to do Hork and installation as indicated. r
<br />certify that no work or installation has cmmnenced 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, zoniny regulations, and land development regulations in the jurisdictioll. 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: A'Department of
<br />~nvironmental RegUlation-Cypress Bayheads, Wetland Areas and Environmelltally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"'Array Corps of Engilleers-Sea\falls, DOcks, Navigable Waterways
<br />*Department of Health & Rehabilitative Service::;, Environmental Health Unit-Wells,
<br />Wastewater Tr~atment, Septic Tanks
<br />*U.S. Environmental Protection Agency-Asbestos abatement
<br />I al~o 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" Hill be submitted which
<br />is prepared by a profe~siollal engineer registered in the State of Florida prior to permit
<br />is::;uance.
<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 ti!e technical codes,
<br />nor shall issuance of a permi.t 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 per'mit is cOllunencl:ld wlthin
<br />six montlls of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of six months ,dter the time the ~JOrk is corrunenced. One 90 day extension of time
<br />may be allowed for the permit with fee cllarge of $15.00. The extension shall be requested
<br />in ~niti.ng to the Building Official. An approved inspection must be logged during eacb si)>
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR E'AILURE TO RECORD A NOTICE OF COMMENCEMEN'I' MAY RESUI/l' IH YOUR
<br />PAYING TWICE FOR IMPROVEJvlEN'l'S '1'0 YOUR PROPERTY. IE' YOU INTEND '1'0 OB'rAIN V'INANTING, CONSULT
<br />WITH YOUR LENDER OR ~~ ATTOro~EY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED '1'0 RECORD AND POS'l' A "NO'rICE OF' COMMENCEl'1EN'r".
<br />
<br />SIGNATURE: OWNER OR AGEN'I'
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />S'I'ATE OF FLORIDA
<br />COUNTY OF
<br />The foregoi.ng instrument was
<br />Before me this __ day of
<br />by
<br />
<br />ackno~lledged
<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 />acknowledged
<br />19
<br />
<br />(name of person acknowledged)
<br />Owho is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />OJho is personally known to me, or
<br />
<br />Owho has produced
<br />(type
<br />and \-lhoO did Ddid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Dwho has produced
<br />(type of identification)
<br />and Hho Ddid DUd not take an oati!
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, pd nted or ~tamped
<br />
<br />Name typed, printed or' stamped
<br />
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