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<br />UJl~!Jl'J:J.UJII::J UH' PERMIT AFFIDAVI'l'
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this permit may be subject to "deed restrictions" which
<br />may be more restrictive than City regulations. The undersigned assumes responsibility for
<br />compliance Hith any applicable deed restrictions.
<br />B. UNLICENSED CONTRA.CTORS AND CON'l'RACTOR 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 may 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 \vork, they are advised to contact the
<br />City of Zephyrhills Building Department, 013-7BB-6611.
<br />Furthermore, 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 responsible. If you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the contractor, 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 privileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA S'fATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />11en Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. If the applicant is someone other 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" prlor to commencement.
<br />E:. CON1'RACTOR' a/OWNER'S AFFIDAVIT
<br />1 certify that all the information in this application is accurate and that all work tdll
<br />be done in compliance with all applicable laws regulating construction, zoning, and lEwd
<br />development.
<br />Application 1s hereby made to obtain a permit to do work and installation as indicated. I
<br />certif.y that no work or installation has commenced prlor to issuance of a permit and that
<br />all work will be performed to meet;:.;,p,t<:l,ndards of all laws regulating construction, City
<br />codes, zoning regulations, and land. development regulations in the jurisdlction. I also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the lntended work, and that it is my responsibility to identify what actions I must take to..
<br />be in compliance. Such agencies lnclude but are no't limited to: "Department of
<br />Environmental RegUlation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewal:er 'freatment
<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 <It 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.", it is
<br />understood that a drainage plan addreSSing a "compensating volume" will be submitted which
<br />is prepared hy a professional engineer registered in the State of Florida prior to permit
<br />issuance.
<br />A permit isslled shall be construed to be a license to proceed with ~he 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 />issued shall become invalid unless the work authorized by such permit 1s commenced within
<br />silt months of issuance, or if t'1ork authorized by the permi.t is suspended or abandoned for a
<br />period of six months after the time the work is commenced. One 90 day extension of thue
<br />may be allowed for the permit with fee charge of $15.00. 'rhe 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 '1'0 OWNER: YOUR FAII,tJRE TO RECORD A NO'l'ICE OF COMMENCEMEN'l' MAY RESULT IN YOUR
<br />PAYING TWICE ll'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB'I'ATNFINANCING, CONSUL'l'
<br />WI'l'H YOUR LENDER OR AN A'r'l'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDP.:R
<br />$2,500 IN VAI'uE DO NO'I' NEED 'f0 RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
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<br />
<br />SIGNA'l'URE: OWNER OR AGENT
<br />
<br />~~.._-
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />S'I'A1'E OF FLORIDA
<br />COUN'I'Y OF
<br />'I'he forego.i.ng instrument was
<br />Before me this __ day of
<br />by
<br />
<br /><H..k.nowledged
<br />__, 19_
<br />
<br />STA'l'E OF nORIDA
<br />COUN'I'Y OF
<br />The foregoing instrument was
<br />Before me this _day of.
<br />by
<br />
<br />acknowledged
<br />19
<br />
<br />(name of person acknowledged)
<br />Owho is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and whoO did Od.i.d not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />(name of person acknowledged)
<br />Chho is personally known to me, or
<br />
<br />o who has produced
<br />(type of identification'
<br />and who Ddid [}:lid 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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