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<br />CONDI~IONS 0[' PERMIT J'.FFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned undev,tands that this permit may be subject to "dee~ J:estrictions" which
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance with any applicable deed r~strictiorrs.
<br />B. UNLICENS~D CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractuz or contractors to undertake work, they may be required
<br />to be licensed in accordance with state and loc&l regulations. If the contractor is not
<br />licensed as required by law, both t.ht~ o\mer and contractor IndY 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 tile intended work, they are advised to contact the
<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 which they
<br />will be responsible. If you, as the owner signs as the contr~ctor, you a~e indicating that
<br />you, rather than the contractor, are responsible for the wory-. 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 Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES .~D UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, 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 Florida Department of Agriculture
<br />and Consumer Affairs. If the applj.cant is someone other that the "owner", I cerify tha~ 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 corrunencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT,
<br />I certify that all the information in this application is
<br />be done in compliance with all applicable laws regulating
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indicated.
<br />certify that no work or installation has corrunenced 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 juri.sdiction. I al.so
<br />certify that I understand that the regulations of other governmental agencles 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, WaterlWastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabilitative Services, Environmental Health Unit-We:ls,
<br />Wastewater 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 .drainage plan addressing a "compensating volume" will be submitted wh.i.ch
<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 w~rk and not as
<br />authority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of ~ permit prevent the Building Official from thereafter requiring a
<br />correction of errors.in pJ.ans, construction, or violations of any code. Every permit
<br />issued shall become invalid unless the work authorized by such permit is corrunenced 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 permit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Building Official. An approved inspection must be logged during each six
<br />month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENT::: ,:;.; 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 NOT NEED TO RECORD AND POST A "NOTICE OF. COMMENCEMENT",
<br />
<br />accurate and that all work will
<br />~onstruction, zoning, and land
<br />
<br />I
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />SIG.
<br />
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Deroce me this _ day of
<br />by
<br />
<br />n rkno..,} ",dged
<br />19_
<br />
<br />51'/1.1' OF FLORIDA
<br />COUNTY OF
<br />The foregoing i.ns~ment wa~M;lm9_Vfled~~~.~
<br />Before me4this _ dq'i of~, ~..L
<br />by vo~a"n'r\0
<br />(name of person ac nowledged)
<br />~ho is personally Known to me, or
<br />
<br />(name of person acknowiedged)
<br />Owho is personally ~l1own to me, or
<br />
<br />Owho has produced .
<br />(type of identification)
<br />and whoO did Odid not. take an oath.
<br />
<br />,Dwho has produced
<br />(type of ider.tificationJ
<br />and who Odid ~id not take aJ: oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed,
<br />
<br />printed or stdmped
<br />
<br />
<br />,;).o...-;-.~.
<br />'l~,
<br />~~1 ~~~h~n t eel 'Jr S
<br />
<br />j' No'.Cl
<br />~ -....."
<br />
<br />[\\€f\ 1\,,\\,\ (nGt.S:ClV\
<br />,amped
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