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<br />coNDITIoNS~O~cPERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS'
<br />
<br />The,und~rslgned understa~ds that this perlit lay bl 5ublect to "deed restrictions' ~hich ~ay be ~ore restr,ictive than City
<br />regulations. The underslgned assumes responsibility;for;,colpllance with any applicable deed restrictions.
<br />'l -,</,.' " .
<br />
<br />UNLItENSED CONTRAC~ORS AND CONTRACTOR RESPONSIBILITIES
<br />
<br />B.
<br />
<br />If the owner has hired a contractor or contractors to undertake work, 'they lay be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the OHn~r and contractor ftay be
<br />cited for a lisde.eanor violation und~r state law., If the owner or intended contractor are uncErtain as to what licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Z~phyrhills ~uilding Departlent, (813)
<br />788-6611. ·
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<br />Further.ore, if the owner has hired a contractor ~r contractors, he is advised to have the contractorlsl sign portions of the
<br />'Contractor Sections' of this application for which they Hill be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are respe.nsible for the work. If the ce;ntracte,r wishes ye,u to sign
<br />as contractor that lay be an indication that he is not properly licensed and is not entitled to per~itting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D.
<br />
<br />CONSTRUCTION LIEN LAW
<br />
<br />(CHAPTER 713~ FLORIDA STATUTES, AS AMENDED)
<br />
<br />I certify that I, the applicant, have been provi'ded with a copy of 'Florida's Construction Lien Law - HOleowner's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and Consumer Affairs. If the applicant is sOle6ne other than the
<br />'owner., I certify that I have obtained a, copy of the above described de,culllent and pre,mise in ge,od faith to deliver it to the
<br />'owner' prior to COllencelent.
<br />
<br />: \, . ~~,:~., \. \ ; :
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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 wor~ will be done in coapliance with all
<br />applicable laws regulating construction, zoning, and land development.
<br />
<br />Application is hereby lade to obtain a per.it to'do work and installction as indicated. I certify that no work or
<br />installation has cOI.enced prior to issuance of a perlit and that all work will be performed to ~eet standards of all laMS
<br />regulating construction, City codes, zoning regulations, and land development regulations in the iurisdiction. I also
<br />certify that I understand that the regulations of other governmental agencies ~ay apply'to the intended work, and that it is
<br />.y responsibility tel identify what actions I lIust take to be in ctlmpliance. Such agencies include bill i'1 e ne,t liaited to:
<br />
<br />I Departte~,t elf Envir~nllental ReQulation - Cypress Bayheads, Hetland Areas and Environmentally Sensi tivi? Ldnds,
<br />Water/Wastewater Treatment
<br />I Southwest Florida Water' ManaQelent District - Hells; Cypress Bayheads, Wetland Areas, Altering HatercClurses
<br />I ArlY Corps ~f EnQineers - Seawalls, Docks, Navigable Waterways
<br />I Departlent uf Health ~ P.~habilitative Services. Environmental Health Unit - W~lls, Hast~Hater Treat~en~, Septic Tanks
<br />I US Environaental Protection AQ~ncy - Asbestos abatement
<br />
<br />I also certify that, if fill latl?rial is to be used in Flc.od Zone "A" tlr 'A,etc.', it is understoe,d t1."t a drainage plan
<br />addressing a 'colpensating volume" will be sublitted which is prepared by a professional engineer regist~led in the State of
<br />Florida prior to permit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with the work and n~t as auth6rity to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official froft thereafter
<br />requiring a ct.rrection e.f errors in plans; constructie,n, e.r violations of any ce,de. Every pN~it isslll!d "hall bece,.e invalid
<br />unless the work authe.rized by such penH is ce.ftIIlenced within six lIlonths of issuance, or if H(>I~; alltl,{q ],ed by the perlit is
<br />suspended or abandoned for a period tlf six lonths after the tiJe the Hork is [o~men[ed. One 90 day e:tensiol\ of tile, lay be
<br />allowed for the per~it with fee charge of $15.00. The extension shall be requested in Hriting to the Building Official. An
<br />approved inspectie,n f.lust be lelgged during each six month pl'riod, c.r thl' project Iii Ilbe [C,nsidered dbol,de,n"d.
<br />
<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 N(7;A~~~PO OTlCE OF COMMENCEMENT".
<br />
<br />
<br />Sl=R~l~GENT- SlGNATUR~~"---
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<br />,.---,-"-,--\
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<br />::::~~-~j~.j~ ~ --------~-------
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<br />OWNER OR AGENT --~-~-~-
<br />
<br />MY COMMISSION
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<br />DATE___O_~~o2~~_J2J_1331_________________
<br />
<br />NOTARY AS TO ~ '-7l W
<br />CONTRACTOR___ _ - -~-~-~---
<br />~ Mary H. ~--p
<br />MY CO'll"': I SS 1 ONN5f'it~; ~,-S.t.at&-Q.f~Of.!da-a.t-La~
<br />My commission Expires Dec. 14, 1991
<br />Bonded thru Agent's Notary Brokerage
<br />
<br />:~Ttg~ PV?JLIC. STATE OF nORmA.
<br />BONDED ~~8Jg:;.::~~LEISC: June 3D, 19d..
<br />UNDERWRITERs.
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