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<br />CONDITIONS~O~;PERMIT AFFIDAVIT
<br />A. NOTICE OF DEEO RESTRICTIONS
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<br />The ,undersigned understands that this perlit lay be sub3ect to "deed restricti~nsM which ~ay be mort rtstr,ictive than City
<br />regulations. The undersigned nSUl1ll respDnsib~lity:;for.,colp1iil,11ca,"i!.h any appl ieable deed restrictions.
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<br />B. UNL I CEN'SED CON'fRACTORS ANn l;OI:'j,TRAfTOR 8.ESPONS I B I LIT I ES' '.
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<br />If the ollnr:r has hired a nntractor or contractorl to undertake work,theY~lay be requir:d to be licensed {n' a~c~rdance with
<br />state and local regulations. If the contractor 11 not licensed as require;l.by').aw .b.oth till! ~l!ncr and cWltnctor uy be
<br />cited for a aisdueanor violation under state lall.: If the DKner (.r intended c'ontr~ctc,r 'are uneHtain ;'s'io 'what \'ieensing
<br />require.ents lay apply fDr the intended work, they are advised to contact the City Df Zephyrhills Building Depart.ent, (813)
<br />788-6611. ' ,'"
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<br />Furtherlore, if the owner has hired a contractor or contractDrs, he is advised to have the eDntraet~r(sl sign portions of the
<br />'Contractor Sections' of this application for which they will be respomd'bil!: If ycot'l','a'S Ule- c,wl\er s.jgn jos .the c[,ntractor,
<br />you are indicating that you, rather than the contractor, are respDnsible for the wDrk. If the cDnt;actbr wishes y~u to sign
<br />as cDntractor that aay be an indication that he is not properly licensed and is not entitled tD per~itting privileges in the
<br />City of lephyrhills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D.
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<br />CONSTRUCTION LIEN LAW
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<br />(CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
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<br />I certify that I, the applicant, have been provided lIith a copy of "Florida's CDnstructiDn Lien LaM - HDleollner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sDle(.ne other than the
<br />'owner", I certify that I have clbtained a, copy of the above described de,cuJllent and prc.mi:c, in ge,od fai th to deliver it to the
<br />'oKner' prior to cOI.enceDent. I
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
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<br />I certify that all the information in this application is accurate and that all wDrk Mill be done in coapliance with all
<br />applicable laws regulating constructiDn, zoning, and land development.
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<br />Application is hereby Dade to obtain a perlit to'do work and install~tion as indicated. 1 certify that no work or
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<br />installation has commenced prior to issuance of a perlit and that all work will be perfDr-med tD ~eet standards of all lalls
<br />regulating construction, City codes, zoning regulati~ns, and land development regulatiDns in the jurisdiction. I also
<br />certify that I understand that the regulations of other governmental agencies ~ay apply'tD the intended work, and that it is
<br />IY responsibility tel identify what actions I lust take to be in cOlllpliance. Such agencies include but ~l e liot liaited to:
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<br />I Department Df Environmental ReQulation - Cypress Bayheads, Wetland Areas and EnvirDnmentally Sensitive Lands,
<br />Water/Wastellater Treatment
<br />f SDuthwest Florida Water'ManaQelent District - WellS; Cypress Bayheads, Wetland Areas, Altering HatercDurses
<br />I Arty Ce,rps ,of EnQineHs - Seallalls, Docks, Navigable Ilaterways
<br />I ~epart.ent Df Health ~ Rehabilitative Services. Environmental Health Unit - ~['lls, Hastellater Treat~en~. Septic Tanks
<br />I US EnvirDnaental Protection AQency - Asbestos abatement
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<br />I also certify that, if fill material ~S\,to be used in Hc.od Ze,ne "Aft Dr MA,ett.', it is underste,e,d th~l a drainage plan
<br />addressing a 'coapensating volulle" wi'lf be '~ublitted which is prepared by a profe"Ssie.nal.enginc,er regi:l~ied in lhe State of
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<br />Florida prior 10 ,~rllli t issuance.
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<br />A perlit issued shall be construed to be a license to prDceed with the wDrk and nDt as au~hDrity tD viDI~te, cancel alter, or
<br />set aside any prDvisiDns of the technical codes, nor shall issuance of a permit prc,vent the Building official frDI thereafter
<br />",.i.i., . ".",\i.. ,f ,..... i. pl...; ,...1..,\\.., .. ,i.l.'i... .1 .., ,.... .,... p.,.I' I..." ,'.11 ..".. ,.,.lid
<br />unless the work authDrized by such permit is tomDenced within six months Df issuancc" Dr if "Drk authol J~ed by the per.it is
<br />suspended or abandonc,d fDr a period of six lonths after the tiJe the work is cD~menced. One 90 day e=IE~5iD'\ of tite, lay be
<br />alloMed for the permit with fee charge of $15.00. The extension shall be requested in writing tD the Building Official. An
<br />approved inspectic,n l!Iust be le,gged during each six month period, e.r the prc.ject Iii 11 be cc,nsidered dbcillde.ned.
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<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
<br />RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
<br />INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
<br />BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE
<br />DO NOT ~EED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
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<br />SIGNATUR~R-~~
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<br />DATE ___ _t!:2._?~-(~~_?!---------------'-------
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<br />NOTARY AS TO ~, '
<br />OWNER OR AGENT~~~~---
<br />IIoQry btic. State of Rorida
<br />MY COMMISSION EXPIRES_JM~(~~~~J~~4~3
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<br />londed Th(u Tray Fain: In,ulance Ine.
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<br />5 I GNATURE _1---.:::" ~ - ~--------
<br />CONTRACTOR
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<br />DATE____~t'-~~~~~-------------------
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<br />NOTARY AS TO r /7 '
<br />CONTRACTOR__~~-~~~-
<br />"\ Not Public, St.t. of florida
<br />MY COMM I 55 I ON EXP I RE5~1_~!!I!!I!!~O.!!jAIIi{JL.btne..6, 19.9~
<br />Bonded Th{u Jroy Fain: Insurance In~
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