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<br />CONDI7IONS Of PERMIT )'.FFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be
<br />may be more restrictive than City regulations. The
<br />compliance with any applicable deed r~strictions.
<br />B. UNLICENS~D CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has 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 as required by law, both the owner and contractor Inay 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 the intended work, they are advised to contact the
<br />City of Zephyrhills Building D~partment, 813-786-6611.
<br />Furthermore, if the owner has hired a contractor or c0ntractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sectionsff of this application for which they
<br />will be responsible. If you, as the owner signs as the contrac~br, 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 lic~nsed 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 bee~ provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection Guideff prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "owner", I cerify tha1: I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "ownerff prior to commencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT,
<br />I certify that all the information in this application is accurate and that all work will
<br />be dOlle in compliance with 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 work or installation 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 jurjsdiction. 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 mu~t 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, Water/Wastewater 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-Wells,
<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.ff, it ~s
<br />understood that a ,drainage plan addressing a "compensating volume" will be submi tted 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 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 a permit 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 permit is commenced 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 ~llowed 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
<br />PAYING TWICE FOR IMPROVEMENT::- /..; YOUR PROPERTY. IF YOU INTEND TO
<br />WITH YOUR LENDER OR N{ ATTORNEY BEFORE RECORDING YOUR NO ICE~ C
<br />S2.500 IN VALUE DO NOT NEEO TO RECORD AND PO"" A "N T OF (I M
<br />
<br />
<br />
<br />SIGNATURE: OWNER OR AGENT CON
<br />
<br />subject to "dee~ restrictionsff whi~h
<br />undersigned assumes responsibility for
<br />
<br />acknoh'ledgcd
<br />19_
<br />
<br />STATE OF FLORI
<br />COUNTY OF
<br />The foregoing j.nstrument was acknowledied
<br />Before me this ~day of DpcpmheI-, ~~~
<br />by James~. Williams
<br />(name of person acknowledged)
<br />~ho is personally ~nown to me, or
<br />
<br />
<br />SULT IN YOUR
<br />FINANCING, CONSULT
<br />EMENT. ,JOBS UNDER
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Defore me ch~s _ day of
<br />by
<br />
<br />(name of person acknow~edged)
<br />o who is personally ~nown to me, or
<br />
<br />o who has produced .____
<br />(type of identification)
<br />and whoO did Odid not . take an oath.
<br />
<br />Signature of person taking acknowledgement
<br />
<br />
<br />Yvo'n Sparling ,Notary
<br />
<br />~ ~n.~
<br />Name typ~d, printecf'i t.lwoec IV
<br />. \ _ MY com 00251358
<br />~ Expil'8l December 12. 2007
<br />
<br />Name ~vped, printed or stdmped
<br />
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