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<br />CONDITIONS OF PERMIT AFF~DAVI~
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this pennit may be E:WYje,c:t: 1:0 "deed restrictions" which
<br />may be more restrictive than City regulations. The Llnd.~u;iqned assumes responsibility ~or
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBI [,I'rIE:~:
<br />If the owner has hired a contractor or contractors t:. 'lnde,rtake work, they Dlay be required
<br />to be licensed in accordance with state and local regulilt.Jonn. If the contractor is not
<br />licensed as required by law, both the owner and contr-ad:cor. muy be cited for a misdemeanor
<br />violation under state law. If the owner or intended contTact:or are uncertain as to what
<br />licensing requirements may apply for the 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 c:ont:ractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" Qf t:his application for which the~
<br />will be responsible. If you, as the owner signs as thc~ cQntractor, you are indicating that
<br />you, rather than the contractor, are responsible for thE! 'iYork. If the contractor wishes
<br />you to sign as contractor that may be an indication that: he is not properly licensed and if
<br />not entitled to permitting privileges in the City of Zc~phyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION H'~E:S
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATlP.rgS" M; AMENDED)
<br />I certify that I, the applicant, have been provided wi1:h a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guide" prepared by tllE! :rloJ:ida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone ot,hc~J: .that: the "owner", 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 commencement..
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT,
<br />I certify that all the information in this application is aCGurate and that all work will
<br />be done in compliance with all applicable laws regula.ting cOIlstruction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do wod~ ;ilnd installation as indicated. I
<br />certify that no work or installation has commenced p,riOJ: lto 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 regula1:iolllS in the jurisdiction. I also
<br />certify that. I understand that the regulations of othe:r g,:>vernmental agencies may apply to
<br />the intended work, and that it is my responsibility t.o identify what actions I must take tc
<br />be in compliance. Such agencies include but are not l:~dted to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland AreiUJ ;ilnd Environmentally Sensitive
<br />Lands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypl:ess Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Wait;E~rways
<br />*Department of Health & Rehabilitative Services, Envirc)IWental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environmental Protection Agency-Asbestos abatemellt:
<br />I also certify that, if fill material is to be used in Irlood Zone "A" or "A,etc.", it is
<br />understood that a drainage plan addressing a "compensating volume" will 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 pJ:oceed with the work and not as
<br />authority to violate, cancel, alter, or set aside any pJ:ovisions of the technical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construction, or violati()ns of any code. Every permit
<br />issued shall become invalid unless the work authorized by such permit is commenced within
<br />six months of issuanc:e, or if work authorized by the peJrndt is suspended or abandoned for a
<br />period of six months after the time the work is commencE!d. 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 inspec:tion must be logged during each six
<br />month period, or the project will be considered abandonl~.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO 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 />SIGNATURE: OWNER OR AGENT
<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 />.
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />Before me this day of
<br />by
<br />
<br />acknowledged
<br />
<br />(name of person acknowledged)
<br />o who is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />[lho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and whoDdid Ddid not take an oath.
<br />
<br />Dwho has produced
<br />(type of identification)
<br />and who Ddid [}tid not take an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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