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<br />I'
<br />
<br />. CONDITIONS OF P[RMIT AFFIDAVIT
<br />A. NOTICE OF DEED RES~RICTIONS
<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 with any app icable deed restrictions.
<br />B. UNLICENSED CONTRACT RS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired contractor or contractors to undertake work, they may be required
<br />to be licensed in aecorfance 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 1 w. If the owner or intended contractor are uncertain as to what
<br />licensing requirements ay apply for the intended work, they are advised to contact the
<br />City of Zephyrhills Bui ding Department, 813-780-0020.
<br />Furthermore, if the own~r 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. "t you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the co~tractor, are responsible for the work. If the contractor wishes
<br />you to sign as contract4r that may be an indication that he is not properly licensed and is
<br />not entitled to permitt~ng privileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPAqT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTROCTUION LIEN DAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien Law - Homeowner's ~rotection Guide" prepared by the Florida Department of Agriculture
<br />and Consumer Affairs. rf the applicant is someone other that the "owner", I eerify that I
<br />have obtained a copy of ~he above described document and promise in good fait~ to deliver
<br />it to the "owner" prior ~o commencement.
<br />E. CONTRACTOR'S/OWNER'sl AFFIDAVIT
<br />I certify that all the irformation in this application is accurate and that all work will
<br />be done in compliance wi~h all applicable laws regulating construction, zoninq, and land
<br />development.
<br />Application is hereby ma e to obtain a permit to do work and installation as indicated. I
<br />certify that no work or nstallation has commenced prior to issuance of a permit and that
<br />all work will be perform d to meet standards of all laws regulating construction, City
<br />codes, zoning regulation, and land development regulations in the jurisdiction. I also
<br />certify that I understan that the regulations of other governmental agencies may apply to
<br />the intended work, and t at it is my responsibility to identify what actions I must take to
<br />be in compliance. Such gencies include but are not limited to: "Department of
<br />Environmental Regulation ,Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater ~r~atment
<br />"Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses :
<br />"Army Corps of Engineers~eawallS' Docks, Navigable Waterways
<br />"Department of Health & ehabilitative Services, Environmental Health Unit-Wells,
<br />Wastewater Treatment, Se tic Tanks
<br />"U.S. Environmental Prote tion Agency-Asbestos abatement
<br />I also certify that, if f 11 material is to be used in Flood Zone ftA" or ftA,etc.", it is
<br />understood that a drainag plan addressing a "compensating volume" will be submitted which
<br />is prepared by a professi nal engineer registered in the State of Florida prior to permit
<br />issuance.
<br />A permit issued shall be onstrued to be a license to proceed with the work and not as
<br />authority to viOlate, can el, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a p rmit prevent the Building Official from thereafter requiring a
<br />correction of errors in pans, 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, ot if work authorized by the permit is suspended or abandoned for a
<br />period of six months aftet the time the work is commenced. One 90 day extensic,n of time
<br />may be allowed for the pe~mit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Buildin~ Official. An approved inspection must be logged during each six
<br />month period, or the prOj~ct will be considered abandoned.
<br />WARNING TO OWNER: YOUR F ILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVEM NTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
<br />WITH YOUR LENDER OR AN AT ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />", eo, m v>c"' "" NO' ., I' '0 ,"C'" AN' ""' A "'0,,"' J. s~c~
<br />
<br />
<br />
<br />SIGNATURE: OWNER OR AGENTI SIGNATUR(f ~ONTRACTOR
<br />
<br />I
<br />STATE OF FLORIDA I
<br />COUNTY OF
<br />The foregOing instrument w s acknowledged
<br />Before me this _ day of , 2CL-
<br />by
<br />(name of person ackno ledged)
<br />Owho is personally known to me, or
<br />
<br />
<br />Dwho has produced
<br />(type
<br />and whoD did D did not
<br />
<br />o identification)
<br />t ke an oath.
<br />
<br />an
<br />
<br />Signature of person taking 4knowledgement
<br />
<br />,.........SHELLy J~.~.
<br />.oa\\tlUfI'I.-N
<br />: ~"'~YPll."'~ ame
<br />:I_~~
<br />5 \;~~J Bonded thru (OO0}432....254:
<br />: ~',~Rfl~~'..$' F:crida Notary Assn.. toe :
<br />,............................. ..... ............
<br />
<br />Name typed, printed or starn ed
<br />
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