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<br />.~ CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this per.it lay be subject to "deed restrictions" which ;ay be lore restrictive than City
<br />regulations. The undersigned assu.es responsibility for cOlpliance with any applicable need restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR_~ESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, thJ; nay 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 owner and contractor lay be
<br />cited for a .isde.eanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirelents .ay apply for the intended wor~f they are advised to contact the City of Zephyrhills Building Departlent, IBI3)
<br />788-6611.
<br />
<br />Further.ore, if the owner has hired a contractor or' ~ontractors, he is advised to have the contractorls) sign portions of the
<br />"Contractor Sections. of this application for which they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor~ are responsible for the work. If the contractor wishes you to sign
<br />as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction lien law - HOleowner's Protection
<br />Guide" prepared by the Florida Depart.ent of Agriculture and Consul~r Affairs. If the applicant is so.eone other than the
<br />.owner" , I certify that I have obtained a copy of the above described docu.ent and prolise in good faith to deliver it to the
<br />.owner" prior to co..encelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infor.ation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developaent.
<br />
<br />Application is hereby .ade to obtain a perlit to do work and installation as indicated. I certify that no work, or
<br />installation has cOllenced prior to issuance of a perlit and that all w>>rk will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations nf other governlental agencies lay apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />I Departlent of Environ.entaI ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive lands,
<br />Water/Wastewater Treatlent
<br />. Southwest Florida Water Manlgelent District - W~lls, Cypress,Bayheads, Wetland Areas, Altering Watercourses
<br />I Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />f Depart.ent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f US Environ.ental Protection AQency - Asbestos abatelent
<br />I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc,", it is understood that a drainage plan
<br />addressing a "colpensating volule" will be sublitted which is prepared by a professional engineer registered in the state of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid
<br />unless the work authorized by such per.it is cOllenced within six lonths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six .onths after the tile the work is com.enced. One 90 day extension of tile, lay be
<br />allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six lonth period, Dr the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT KAY RESULT IN YOUR PAVING THICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING, YOUR NOTl'CE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".;
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />/ ' ,- \
<br />, " ,/'{ / .
<br />L~ . '/sIdN:T~~;:~~T~C~R
<br />
<br />,l
<br />
<br />.-.-#',
<br />,....1 <7
<br />"Lvlf."} yC>---
<br />
<br />was acknowledged
<br />, 19 _ by
<br />
<br />STATE OF Fl~A
<br />COUNTY OF It\ l' l L.4 )
<br />The foregoing~trument
<br />bE~fol-e me th i ~/O
<br />
<br />vias acknovlledged
<br />, 19~ by
<br />
<br />STATE OF flORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />~); U~i:J /i;C!1w'(r~OvV
<br />who is personally known to me or who has
<br />produced :::P1" 17'''''IOlA'''' 11'( ~V\{)(..J "'-'
<br />as i ntification and who did/oid not
<br />tak n oath.
<br />
<br />
<br />MY PUBllC. ~auta Gf rllJf\~, ill I';';'J';
<br />;~v C0rnrl)1~,$;I)n [X;:';f~ i1~Y ?, :,~;-j4
<br />;:-~,r.',,[.a ~~ l~l,; im", (..lc,._r:q,t.al.$' 'Id, ~J
<br />IName Typed, Prlnted Dr S~ompe~)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
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