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<br />CONDI'l'IONS OF PERl'lI'I' AFE'IDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands thqt this pennit may be subject to "deed restrictions" which
<br />may be mOJ:e l.esLd etl ve than City regulations, 'l'he undersi glled assumes responsibi liLy for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSEDc'ON'l'RAC'l'ORS AND CON'l'RACTOR RESPONSl BILT'l'IES
<br />If the owner has hired a contractor or contractors to undertake Hork, they may be required
<br />to bl:: licensed in accordance with state and local regulations. If the contractor is not
<br />liuensed as required by law, both the o~mer and contractor may be c1 ted for a misdemeanor
<br />violation under state Ic:l\i. If the OHner- or intended contractor are uncertain as to vlhat
<br />li censiilg requirements may apply for the intended work, they are advised to contact the
<br />City of Zephyrhills Building Department, 813-788-6611.
<br />Furthenno)::e, 1. t 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 whiell they
<br />will be responsible. If you, as the OHner signs as the contractor, YQY are indicating that
<br />you, r-ather than the contractor, aloe responsible for the work. I f the contractor Hishes
<br />YOIl to sign as contractor that may be an 1 ndicatiun that he is not properly Ii censed and is
<br />not entitled to permitting privil~ges in the City of Zephyrhills.
<br />C. 'I'RANSl?Ok'l'A'rION IMPACT FEES AND UTILI'l'Y CONNECTION FEES
<br />D. CONS'rRUC'rUION LIEN LAW (CHAprl'ER 713, FLORIDA STA'rUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Constr\lction
<br />lien Law - Homeowner's Protection Guide" prepared by the Florida Department of Agriclllture
<br />and Consumer Affairs. If the applicant is someone other that the "owner", 1 clar-ify that 1
<br />Ilave obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to commencement.
<br />E. CONTRAC'I'OR' S/OWNER' S AFFIDAVl'l'
<br />I certify that all the information'in this application is accurate and that all work villl
<br />be done in compliance with all applicable laws regulating constl-uction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indicated. 1
<br />certify that no Hork or installation has corrunenced pl.-ior to issuance of a pennit and that
<br />all work will be performed to meet standards of all laws regulating construction, City
<br />Godes, zoning regulations, and land development regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governmental agencies may apply to
<br />the intended work, and that it is my responsibility to identify what actions I IlIUst take to
<br />be in compliance. Such agencies include but are not limited to: *Department of
<br />Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sens1_tive
<br />Lands, Water/Wastewater rrreatment
<br />*Soutllwest florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />"AClllY Corps of Engineers-Seawalls, Docks, Navigable WaterHays
<br />*Uepartment of Health & Rehabilitative Services, Environmental Healtll Unit-Wells,
<br />Wastewater Treatment, septic Tanks
<br />1.\1 ~~ E.nvi~_'r>'nrr.ental P::ctectlo~l Ag:::.~..c.y -",,;.:;Ibe:;jLu~ c::d.Jc:lLt::lut:UL
<br />1 also certify that, if fill material is to be used in Flood Zone "A" or "A,ete.", it is
<br />understood that a dralnage plan addressing a "compensating volume" 'wiLL be submitted vihic:h
<br />is prepared by a professional engineer registered in the state of Florida prior to permit
<br />issuance.
<br />A permit issued shall be construed to be a license to proceed with the work and not as
<br />authori ty to violate, cancel, al ter-, or set aside any provisions of the technical codes,
<br />nor shall issuance of a permit prevent the Building Off:'icial from thereafter requi.ring 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 is cOllunenced within
<br />six months of issuance, or if work authorized by the permit is suspended or abandolled for a
<br />period of si.{ months after the tillle the work is conunenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be tequested
<br />in Ivriting to the Building Official. An approved inspection must be logged during each- si}{
<br />month period, or the pr-oject Hill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE '1'0 RECORD A NO'l'ICE OF COMMENCEMEN'l' MAY RESUL'l' IN YOUR
<br />PAYING 'I'WICE r'OR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO oB'rAIN l"INAl-H~ING,~qIH;lUl}r
<br />Wl'1'H YOUR LENDER DR AN A'l"rORNElY BEE'ORE RECORDING YOUR NOTICE OF COMl"1ENCEMEN'I'. ,JOBS UNDER
<br />$2,500 IN VALUE: DO NOT NEED TO RECORD AND POS'l' A "NO'l'ICE OF COMMENCE'MEN'I"t.
<br />
<br />~-:;,~~
<br />
<br />SIGNA'l'URE: OWNER OR AGENT
<br />
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<br />
<br />s'rATE OF FLORIDA
<br />COUN'I'Y OF
<br />The foregoing instrument was acknowledged
<br />Before, me this .l7bLJ-iay of JU14"-<-ry , ~ 2ov7
<br />bY__~~~/Y po O^~
<br />(name of person acknowledged)
<br />Dwho is personally known to me, or
<br />
<br />(jJMf20
<br />
<br />STATE OF FLORIDA ~Jc,
<br />COUWry OF ----
<br />The forego.ing instrument W~6 ".acknowledged
<br />Before me .tl;is 17tt- day ot":~":^--, ~ U1c. 7
<br />by /<:o} he, I)- /-J. cl/LtNf( _ ___
<br />(name of person aoknowledged)
<br />Olho is personally known to me, Ol.-
<br />
<br />
<br />prod\ ed (2(; 0,.-; iI'~ L rc 4-V
<br />(type of identification)
<br />Kldid not take an oath.
<br />
<br />l@'who has
<br />
<br />Ft.. f]rl/ft-< (,'(-.
<br />(type of identification)
<br />l1a3id not t.ake an oath
<br />
<br />Nallle typed, printed or stamped
<br />
<br />of person taking acknowled ement 8i
<br />
<br />~nl {~ /7t. He.tt--j JNtCE M. HElMS
<br />V Y COMMISSION 'DO 451295
<br />EXPIRES:~~y
<br />Bonded Thru NolalyNlllc ~
<br />
<br />
<br />f person taking acknowledgment
<br />~H"((o: 11-. t-tal
<br />-;---_._._~~-_.--_._. --,._,-~_.,- ..-..... ,.--,..-- .~.-
<br />d, printed br st~npbd
<br />
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