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<br />CONDI'l'lONS OF PE:RNIT AF'FIDAVI'r
<br />A. NO'l'lCE OF' DEED RES'I'RICTIONS
<br />'l'he undersigned understands that thi::; pennit Inay be subject to "deed restrictions" wldeh
<br />Utay iJe more l:estrictive than Cityn:glllations. The undersigned assumes re::;ponsibility for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED COi-.jTRAC'l'ORS AND CONTAAc'rOR RESPONSIBILI'l'IES
<br />If the O~ler lias hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accordance with state and local regulations. If the contractor is not
<br />licensed ao:; required by lavJ, both tile oHner and contractor may be cited for a misdelllec::lnor
<br />violation under state law. If the owner or intended contractor are \Ulc=rtain as to what
<br />licensing requirements may apply for the intended work, they are advised to contact tIle
<br />City of Zephyrhilll:> Building Department, 813-788-6611.
<br />Furthermore, if the ovmer has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application tor whicll 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 vdshes
<br />you to sigll as contractor that may be an indication that he is not properly licensed and is
<br />not entitled to penni tting privileges in the City of Zephyrh111s.
<br />C. 'l'RANSPOR'rA'l'ION IMPACT v'EES AND UTILITY CONNEC'I'ION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAP'rER 713, FLORIDA S'fA'fUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />1 ien LaH - Homeowner's Protection Guide" prepared by the l!'lorida Department of Agdclll.ture
<br />and Consumer Affairs. If the applicant is someone other that the "o~mer", I cerifythat 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 AlfFIDAVI'r
<br />I certify tllat all the information in this application is accurate and that all work will
<br />be done in compliance Hith all applicable 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 />certify that no Hork or in::;tallation 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 in the jurisdi.ctioll. 1 also
<br />certify that I understand that the regulations of other governmental agencies Hlay apply to
<br />the intended work, and that it is my responsibility to identify what aclionl::i I must takl:: to
<br />be in compliance. Such agencies include but are not Umi led to: ~'Depal.tment of
<br />F:;nvironmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally St:;nsitivt::
<br />Lands, Water/WasttMater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Anny Corps of Engilleers-SeaHalls, Docks, Navigable WaterVlays
<br />*Department of Health & Rehabilitative Services, Environmental Healtll Unit-Wells,
<br />Wastewater Tr~atment, Septic Tanks
<br />*U.:::>. Environmental Protecti.on Agellcy-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" vJill be submitted which
<br />is pr:epared by a professional eng.ineer registered in the State of Florida pd or: to penni t
<br />is::iuanc,,,,.
<br />A peunit isslIed shall b"" construed to be a license to proceed Hith the Hork j;l.nd not as
<br />authority to violate, cancel, alter, or: set aside any provisions of tlie technical codel:i,
<br />nor 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 becoIlle invalid unless the Hark authorized by such permit is conunenaed within
<br />six month::1 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 corrunenced. One 90 day extension of time
<br />lIlay be alloY/ed for the penni t with fee charge of $15.00. 'rhe extension shall be requested
<br />in ~Jri ting to the Building Official. An approved inspection must be logged dlu:ing each six
<br />month period, or the project Hill be considered abandoned.
<br />~'1ARNING '1'0 OWNER: YOUH E'AlLURE TO RECORD A NonCE OF COI'1MENCEMEN'I' MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMEN'l'S TO YOUR PROPERTY. n' YOU INTEND '1'0 OB'rAIN IfINANCING, CONSULT
<br />WITH YOUR LENDER OR AN A'l"1'ORNEY BEI!'ORE RECORDING YOUR NO'rICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALUE DO NOT NEED '1'0 RECORD AND pos'r A "NOTICE OF COMMENCEMEN'r".
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />SIGNATURE: OWNER OR AGEN'I'
<br />
<br />S'l'ATE OF FLOHIDA
<br />COUN'rY OF
<br />The: foregoing instrument was
<br />Before me this __ day of
<br />by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF'
<br />The foregoing instrument was
<br />Before me this ______day of
<br />by
<br />
<br />acknoVlledged
<br />19~
<br />
<br />acknowledged
<br />19
<br />
<br />(name of person acknowledged)
<br />o who is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />C1ho is personally known to me, or
<br />
<br />Dwho has produced
<br />(type
<br />and VJhoD did Ddid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />Dwho has produced
<br />(type of idenUficaU Oil)
<br />and vJho Ddid []did not take an Oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowlddgment
<br />
<br />-
<br />Name typed, printed or stampt::d
<br />
<br />Name typed, printed or stamped
<br />
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