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<br />C01WI'l'IONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'I'he undersigned understands thqt this pl'lrmit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. Tile undersigned assumes responsibility for
<br />con~liance with any applicable deed restrictions.
<br />B. UNIJICENSEP'CON'l'RAC'l'ORS AND CON'l'HACTOR RESPONSIBII,I'l'IES
<br />If the O\-l!ler has hired a contractor or contractors to undertake work, they Illay be required
<br />to bto licensed 1n accordance wJ.lh .:It<lte and local regulations. If the contracto"r is not
<br />licensed CIS required Ly la~..., both the o~mer and contractor IOay be cited for a misdtollleanor
<br />violation under state l<lw. If the owner' or intended contractor are tHlcertain as to ~ihat
<br />licensing requirements may apply for the intended work, they Clre advised to conta.ot the
<br />City of Zephyrhills Building Department, 813-768-6611.
<br />Furtherlllol:e, 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 reaponsible. If you, as the owner signs as the contractor, YQl,! are indicating that
<br />you, rather than the contractor, are responsible for the Work. If the contractot' wishes
<br />you to siyn as contractor that may be an indication that he is not properly licellsed and is
<br />lIot elltitled to pennitting privileges in the City of Zephyrhi.lls.
<br />c. 'I'RANSPOR'l'A'rION IMPAC'l' FEES AND U'L'ILI'l'Y CONNECTION FEES
<br />lJ. cONs'rRlIc'l'UION LIEN LA~~ (CHAP'I'ER '713, FlJORIDA STATUTES, AS AMENDED)
<br />1 certify that I, the applicant, have been provided with a copy of "Florida's Constrllction
<br />lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and ConsUloer Affairs. If the applicant is someone other that the "owner", I cerify that I
<br />Ilave obtained a copy of the above described document and promise in good faith to deliver
<br />j t to the "owner" prior to conunencement.
<br />E. COWl'RAC'I'OR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the information in this application is accurate and tllat all work will
<br />be dOlle in compliance with all applicable laws regu1 CIting constnlCtion, zoning, and 1 and
<br />development.
<br />Application is hereby made to obtaln a perrolt to do work and installation as :indicated. I
<br />ce~tify that no Hark or installation has commenced prior to issuance of a pennit and that
<br />all work will be performed to meet standards of all laws regulating construotion, City
<br />codes, zoning regulations, and land development regulations in tile jurisdiction. I also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />tile intended work, and that it is my responsibility to identify what aotions I must take to
<br />be in compliance. Such agencies include but are not limited tOI *Department ()f
<br />Envirollmental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Sens~tive
<br />J,ands, Water/Wastewater Treatment
<br />*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />~AnllY COLpS of Engineers-Seawal.ls, Docks, Navigable WaterHays
<br />*iJepartment of Health Ii Rehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />~u.S. Environmental Protection Agency-Asbestoa 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 drai.nage plan addressing a "compensating volume"'wi.ll be sublllitted Hhich
<br />is pl"epar'ed by a plofessional engineer registered in the State of Jj'Jorida pdor to penoj t
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />autho,d l:y to violate, cancel, altet, or: set aside any provisions of the tecllllical codes,
<br />nor o5l1al1 issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construction, or viotations of any code. Every permit
<br />iStiu~d shall become invalid unless th~ ~'lork authorized by such permit is oOlLunenced within
<br />six months of issuance, or if work authorized by the permit is suspended or abandorled t~u a
<br />period of six months after the time the work is conunenced. One 90 day extension of tillle
<br />may be allowed fer the permit with fee charge of $15.00. The extension shall be ~eques~ed
<br />in writing to the Bui Idlng Official. An approved inspection must he logged dud ng each s:i K
<br />mouth periOd, or the project Hill be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR B'AILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL'1' IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'rEND TO OBtI'AIN E'INANqmq, ~qNl;iUI/I'
<br />WI'l'H YOUR LENDER OR AN AT'l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. JOBS UNDER
<br />:?2,500 IN VALUE DO NOT NEED '1'0 RECORD AND POS'l' A "NO'l'ICE OF COMMENCEMEN'llll.
<br />
<br />S I GNA'l'URE I OWNER OR AGENT
<br />
<br />SIGNA'I'URE: CON'I'RAC'l'OR
<br />
<br />S'l'A'l'E OF FLORIDA
<br />COUNTY OE'-
<br />'rhe foregoing instrument was
<br />Beforto me this _._ day of
<br />by.
<br />
<br />o who haa produced
<br />(type
<br />and who[] did Ddid not
<br />
<br />STA'I'E OF FLORIDA
<br />COUWI'Y OF
<br />'I'he foregoing instrument wa,s aoknowl edged
<br />Before me this .------'pay of---, 1!1~_
<br />by
<br />(name of person acknowledged)
<br />[1ho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification)
<br />and who Odid OUd npt t,ake all oath
<br />
<br />acknowledged
<br />, 19_
<br />
<br />(name of person acknowl<;dged)
<br />Owho is personally known to me, or
<br />
<br />of identification)
<br />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 />- ------~-~-_.-._~---_._~._.~-.
<br />Name typed, printed or stamped
<br />
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