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<br />CONDI'rIONS OF PERl'lI'l' AFFIDAVIT
<br />A. ~OTICE Of DEED RESTRICTIONS
<br />'rhe ~Ildersigned understands thqt this permit may be subject to "deed restriotions" which
<br />,mi;!Y l)e...more restrictive than city regulations. 'I'he undersigned assumes responsibility for
<br />"ci'o'I'IJPli\,h'I'ce Hi th any applicable deed restrictions.
<br />B. U1H,ICENSED 'CON'I'RAC'l'ORS AND CON'I'RAeTOR RESPONSIBILI'I'IE:S
<br />1 f the oHner has hired a contractor or contractors to undertake work, they Illay be regui t'ed
<br />to be Ii cenaed in accordance Hith state and 10ca.1 regu1atl ona. If the contractor is not
<br />licensed as required lJy la~" both the owner and contr:actor: !!lay be cited for a misdemeanor:
<br />violation under state la~L If the owner' or intended contractor are uncer'Lain as Lo vlhat
<br />licensing requirements may apply for the intended work, they are advised to contact the
<br />city of Zephyrhills Building Depat-tment, 813-788-6611.
<br />Fur:thermoJ:e, it the ovmer has hired a contractor or oontractors, he 1s advised to have the
<br />contractor(s) sign portions of the "Contractor SectionsH of this appli,cation for whiell they
<br />Hill be Lesponsible. If you, as the owner signs as the contractor, YQll are indicating that
<br />you, tather than the contractor, ar'e responsible for the Hork. I f the contt'actor Ivishes
<br />you to sign as coutractor that may be an j ndication that he is not pl:operly licensed and is
<br />nol "mUtled to permitting privileges in the City of Zephyrhi.l1s.
<br />c. 'l'AANSPOR'l'ATION IMPAC'l' fEES AND U'l'ILI'l'Y CONNECTION li'EES
<br />D. CONS'l'RIlCTUION LIEN LAW (CliAP'l'ER '713, FL.ORIDA S'I'ATUTES, AS AMENDED)
<br />I Gerli fy that I, the applicant, have been provi.ded Hi th a copy of "Florida's Constr\lcti.on
<br />lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other that the "ownerH, I eerify that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" pr10r to commencement,
<br />E:. CON'I'RAC'l'OR' S/OWNER' S AFFIDAVI'I'
<br />I oertify that all the information in this application is accurate and LIlat all work will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />development,
<br />Application is hereby made to obtain a permi t to do wor'k and installation as i ndiaated. I
<br />certify that no \wrk or installation has cormnenced prior to issuance ot 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 j\ll:isdiction. I also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended Hark, and that it is my responsibility to identify what actions I mllst take to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Envirollmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Bensttive
<br />Lands, Water/Wastewater Treatment
<br />.Southwest Ji'lorida Water Management District-Wells, Cypress Bayheads, Wet.1and Areas,
<br />Altering Watercourses
<br />*ArIl\Y Corps of Engineers-SeaHalls, Docks, Navigable WaLen,ays
<br />*Department of Health & Rehabilitat1ve Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Septic Tanks
<br />loU.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.H, it is
<br />undeJ:stood that a dralnage plan addressing a "compensating volume" 'will be submitted Hhicb
<br />is prepared by a professional engineer registered in the State of Flodda pdol' to permit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work 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 />issu~d shall become invalid unless the HorK authorized by such permit is aOllunenced ~,lthin
<br />six months of issuance, or if work authorized by the permlt is suspellded or aballdoqed for a
<br />period of SLK 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 ~equested
<br />in writing to the Buildlng Off1cial. An approved inspection must be logged during each six
<br />month period, or the pt'oject Hill be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR FAIlJURE TO RECORD A No'rrCE Of COMMENCEMENT MAY RESUW' IN YOUR
<br />PAYING TWICE FOR Il1PROVEMENTS TO YOUR PROPER'rY. IF YOU IN'rEND TO OB'I'AIN Jj'INANqlNq, ~OlH1UI:I'
<br />WITH YOUR LENDER OR AN A'l"I'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. ~JOBS UNfJER
<br />$2,500 TN DO NOT NEED '1'0 RECORD AND POS'l' A "NO'l'ICE OF COMMENCEMEN'IIll.
<br />
<br />";' / I//~~
<br />"-G'-~~~~~ IER O~- ~
<br />
<br />
<br />STA'n OF FLORI DA //J n _ . _)
<br />COUN'ry OE' - t:-~
<br />'l'he for",egOing instrument wasB, aclmowledged
<br />Before )l\e U:iS.~_ day of ~_t:. _, J..fk</
<br />by. /f;:n rJ ~...I?~
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />
<br />SIGNATURE:
<br />
<br />CON'rAAC'l'OR
<br />
<br />STA'I'E OF lj'LORIDA f)~_
<br />COUN'rY OF r (
<br />The foregoing instrument was aoknowledged tI.
<br />Befor~e. th:S ~1',!;o~9" ~, 10 {LT
<br />by ~,,/~ ---
<br />...-./ (name of pers n aa'llowledgect)
<br />l~ho is personally known to me, or
<br />
<br />~~lW PI/IX
<br />",0 ..... ~'C' CLARALRICHARDSON
<br />N-~'I~;;--t}~I1'r i~mV:~gl:t~~200 ed
<br />~~~ . ,
<br />of,!; O"lO":; Bonded Thru Budget Notary Sertices
<br />
<br />Dwho has produced
<br />Tt:~~"'- ident:-ffToaU~~)
<br />and Hho Ddid o*~-t\ke an oath
<br />
<br />~;t, ~(t,~ ..-----.-'
<br />
<br />Signatur.e of person taking,J:!.ckno,loI.l.a""'lllt:lnt
<br />,~I'~ PI/s( C1J\RAL~
<br />",'" ....... 'C' MY COMMISSION # DO 204940
<br />*.- EXPIRES' A\lgllsl:t.1.1OO7..____
<br />Name typed, prin ~ 4fotdAIJt4iIIlIM!lletNotarySelVIC85
<br />"~(,)Ff\.Ci
<br />
<br />E1Who has produced]).L(U),~o -(P(Pg-Lf9-7S~-o
<br />~i ~(ty~. of. identification)
<br />. ~,.,. ..tilIi. . an oath.
<br />· '. ,?J....." '.. ",
<br />~ r/~~~
<br />Signature of person taking acknowledgement
<br />
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