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<br />CONDITIONS OF PERlvlIT AFFIDAVIT
<br />A. No'rrCE OF' DEED RES'l'RICTIOHS
<br />The undersigned understands that this p~rmit Inay be subj~ct to "d~ed restrictions" wllich
<br />may be more l.:estrictiv.:: than City .l:egulations. '1'he undersigned a::;::;umes re::;ponsibility tor
<br />compliance with any applicabl e deed L'estrict:.ions.
<br />B. UNLICI!~NSED COf~TRAC'l'ORS AND CONTRACTOR Rh:SPONSIBILI'l'IES
<br />If the ovmer lias hired a contractor or contractors to undertake work, they may be l.:equir..::ej
<br />to be licensed in accordance witli state and local regulations. If the contractor is not
<br />licensed a::; required by lavl, both the OHoer and contractor may be cited for a misdemecHlOr
<br />violation under state law, If the owner or intended contractor are uncertain as to vrllat
<br />licensing requirements may apply for the intended work, they are advised to contact tIle
<br />City of Zephydlills Building Departrn.;nt, 813-788-6611.
<br />Furthermore, if the owner has hired a contractor or contractor's, he is advised to hi:lve the
<br />contractor(s) sign portions of thE: "Contractor Sections" of this application for which tlley
<br />will be respon::;ibl~. It you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the cOlltractor, are responsible for the Hork. 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 pri.vileges in the City of ~ephyrhills.
<br />C. 'l'RANSPOR'l'A'l'lON IMPACT ):'EES AND UTILITY CONNEC'I'ION FEES
<br />D. CONS'I'RUCTUION LIEN LAW (CHAPTER 713, 'nORIDA S'l'A'l'UTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien LaH - Homeowner's Protection Guide" prepared by the Iflorida Depactment of Agriculture
<br />;:Illd Consumer Affairs. If the applicant is someone other that the "ovmer", 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 "o\>>Iner.1I prior to corrunencernent.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI'l'
<br />I certify tlli:lt all tile information in this applicati.on is accurate and that all vlOrk vlill
<br />be done in compli.ance v~ith all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do Hork and installation as indicated. I
<br />certify that no Hork or in::;talIation 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 reguli:ltions in tile jurisdiction. 1 also
<br />cE:rtify that I understand that the regulations of other governmental agencies may apply to
<br />the intended vwd., and that it is my responsibility to identify what actions I musttal;.e to
<br />be in compliance. Such agencies include but are not limited to: ....Department of
<br />E:nvironrnental Regulation-Cypress Bayheads, Wetland Areas and Environmentally St;;nsitive
<br />Landl;:i, WC:lter/Wastev~ater TreC:ltment
<br />*Southwe~t Florida Water Management District-Wells, Cypress Bayhead~, Wetland Areas,
<br />Altering Watercourses
<br />~Army Corps of Engilleers-SeaHalls, Docks, Navigable WaterVlays
<br />*Department of Health & Rehabilitative Servicel;:i, Environmental Healtll Unit-Wells,
<br />WasteHater Treatment, Septic Tanks
<br />*U.S. Environmental Protection Agency-Asbestos abatement
<br />1 also certify that, if fill material is to be used ill Flood Zone "A" or "A,ete.", it is
<br />understood that a drainage plan addressing a "compensating volume" Hill be submiLLE:d which
<br />i.::i prepared by a pJ:ofessional eng.ineer registered in the State of 11'] ori.da pr'io!: to penuit
<br />is.::iuance.
<br />A permit issued shall be Gon~trued to be a licens..:: to proceed with thE: Hork and not as
<br />authorit.y to violate, cancel, alter, or set aside any provisions of tlie technicC:ll code::;,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring Q
<br />correction of errors in plans, construct~on, or violations of any code. Every permit
<br />i::;sued shall become invalid unless the work authorized by such permit is couuneuced within
<br />six montlls of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />period ot six month::! i:lfter the time the work is commenced, One 90 day extension of time
<br />may be alloHed for the permit with fee charge of $15.00. The extension sllall be requested
<br />in vniti.ng to the Building Official. An approved inspection must be logged dur-ing each si}>
<br />month period, or the project will be considered abandoned.
<br />WARNING 'fO OWNER: YOUR FAILURE TO RECORD A NO'I'ICE OF COlvJMENCEMEN'I' HAY RESUT/l' IN YOUR
<br />RAYING TWICE FOR IMPROVENEN'l'S '1'0 YOUR PROPERTY. IE' YOU IN'l'END '1'0 OB'l'AIN l1'INANCING, CONSUL'i'
<br />WITH YOUR LENDER OR AN AT'l'ORNEY BEr'ORE RECORDING YOUR NO'rICE OF COMMENCEMENT, JOBS UNDER
<br />$2, 50~ I~N VAI~UE DO NO'l' Nri:-E>~D 'ro RECORD AND POST A "NO"] OE~'C;MMENCEMENT". ,
<br />
<br />
<br />_U ' ~ ~ (.. i--r- . I fv1-, if _.1Y .______
<br />SIGNATURE: HER OR AGEl' SIGNATURE: NTRACTOR 7-
<br />
<br />s'rATE OF FLORIDA "'P
<br />COUNTY Ot' .~. a 5 c ()
<br />The foregoing instrument was acknoHled~ed
<br />Before me this .L6.:thday of Fe b. , cil!.~O if
<br />by C::;~~cl'l - tY1~Jj;:]rrl
<br />......_ .-kname of person acknowledged)
<br />~ho is personally known to me, or
<br />
<br />STA'l'E OF FLORIDA
<br />COUNTY OF
<br />'I'he foregoing instrument was ~knowled.iled
<br />Before me. this l.l::tb....citr of Jh, o.{fJ)t2!i
<br />by GY'.:lJ;( ~tZ;::Jr
<br />~, ~(name of person a Rnowledged)
<br />\.U1fio is personally known to me, or
<br />
<br />fj);;J.5C 0
<br />
<br />o who has produced
<br />(type of identification)
<br />i:lnd whoD did ~id not take an oath.
<br />
<br />__~_ X. x5 UJZVyl~_
<br />Si~f person taking acknowledgement
<br />AMY L. SWANN
<br />... t..Iotary Public, S~at8 of Florida
<br />N am€My :t8/fttftr. eKlf.l~::d, 2UOr' tamp ed
<br />Comm. No. DO 236922
<br />
<br />o who has produced ...
<br />(type of ldentificatiou)
<br />and Hho Ddid ~id not take an oath
<br />
<br />_ (bLI X ;d LIVZ1/Vl~
<br />
<br />S~f per::;on taking acknowledgment
<br />
<br />AMY l. SWANN
<br />1'1 am~OlWl~~lIp~~~ fhJ{tQtamped
<br />My comm. expo Oct. 6, 2007
<br />Comm. No. DO 236922
<br />
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