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<br />I Ii
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<br />CONDITIONS OF PE~~IT AFFIDAVIT
<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 with any apPlicable deed restrictions.
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they may be required
<br />to be licensed in accorJance 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 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 work. 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 permitt~ng privileges in the City of Zephyrhills.
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN L~W (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 P~otection 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 ~he above described document and promise in good faith to deliver
<br />it to the "owner" prior ~o commencement.
<br />E. CONTRACTOR'S/OWNER'S, AFFIDAVIT
<br />I certify that all the ipformation in this application is accurate and that all work will
<br />be done in compliance wi~h all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby mane to obtain a permit to do work and installation as indicated. I
<br />certify that no work or installation 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 RegulationtCypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/Wastewater rreatment
<br />*Southwest Florida WaterrManagement District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of EngineerstSeawalls, Docks, Navigable Waterways
<br />*Department of Health & II.ehabilitative Services, Environmental Health Unit-Wel.ls,
<br />Wastewater Treatment, Se~tic Tanks
<br />*U.S. Environmental Prot~ction Agency-Asbestos abatement
<br />I also certify that, if till 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 by a profess~onal engineer registered in the State of Florida pric1r 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, ca~cel, alter, or set aside any provisions of the technical codes,
<br />nor shall issuance of a ~ermit prevent the Building Official from thereafter requiring a
<br />correction of errors in Blans, construction, or violations of any code. Every permit
<br />issued shall become inva~id unless the work authorized by such permit is commenced within
<br />six months of issuance, dr if work authorized by the permit is suspended or abandoned for a
<br />period of six months aft~r the time the work is commenced. One 90 day extension of time
<br />may be allowed for the p~rmit with fee charge of $15.00. The extension shall be requested
<br />in writing to the Buildi~g Official. An approved inspection must be logged during each six
<br />month period, or the projlect will be considered abandoned.
<br />WARNING TO OWNER: YOUR iILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
<br />PAYING TWICE FOR IMPROVE 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 />$2,500 IN VALUE DO NOT NE D TO RECORD AND POST A "NOTICE OF COMMENCEMENT". ~
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<br />SIGNATURE: OWNER OR AGENT SIGNATURE~N~;OR~~
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />Before me this_ day 0
<br />by
<br />
<br />as acknowledged
<br />, 21L-
<br />
<br />(name of person ackn wI edged)
<br />Dwho is personally know to me, or
<br />I
<br />
<br />o who has produced
<br />(type
<br />and whoD did Ddid not
<br />
<br />f identification)
<br />ake an oath.
<br />
<br />Signature of person takin acknowledgement
<br />
<br />Name typed, printed or st mped
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF ); _
<br />'h. fo<.goiog ~1;l!"meO'~Wl.~~
<br />
<br />~~fore ~C\s ~ ',)." 0 _
<br />
<br />~ (name of person acknowledged)
<br />~o is personally known to me, or
<br />
<br />Dwho
<br />
<br />
<br />ckno?;\;,nt_ C)C
<br />
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