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<br />~ CONDITIONS OF PERMIT AFFIDAVIT <br />A. NOTICE OF DEED RESTRICTIONS <br />The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lore restrictive than City <br />regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions. <br /> <br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES <br />If the owner has hired a contractor Dr 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 owner and contractor lay be <br />cited for a lisdeleanor violation under 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 Zephyrhills Building Departlent, 1913} <br />789-6611. <br /> <br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s} 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 />Suide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the <br />"owner", I certify that I have obtained a copy of the above described doculent and prolis! in good faith to deliver it to the <br />"owner" prior to cOllencelent. <br /> <br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT <br />I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all <br />applicable laws regulating construction, zoning, and land developlent. <br /> <br />Application is hereby lade 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 work 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 of 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 />f Departlent of Environlental ReQulation - Cypress Bayheads, Metland Areas and Environlentally Sensitive Lands, <br />Water/Wastewater Treatlent <br />f Southwest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses <br />f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways <br />f Departlent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks <br />f US Environlental Protection AQency - Asbestos abatelent <br />I also certify that, if fill laterial 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 perlit is cOllenced within six lonths of issuance, or if work authorized by the perlit is <br />suspended or abandoned for a period of six lonths after the tile the work is cOllenced. 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, or the project will be considered abandoned. <br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR <br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF <br />~~IS UNDfR 1l~:ALUE DO NOT NEE>> TO RECORD ~A .NO~'::" CDKNENCEftENT'. <br /> <br /> <br /> <br />----- ATUi!-:- iiER~------~--------- ---t1ii~~i~---------------------------- <br /> <br />~~~~YO~FF~~~~DA__~_~~_________________ <br /> <br />The foregoing instrument was acknowledged <br />before me this ~~.~, 19_~ by <br /> <br />_____~~_aL~_~Z:tC_~LL~-S____________ <br />who is personally known to me or who has <br />produced __"Z).,c--U:'.:f_c.s...._..b-'..&_~- <br />as identification and who did aid not <br /> <br />~:~:_::_~~-~~--------- <br /> <br />(Signature) <br />____~~~f1L~--~~-LLC~~-------------- <br />(Name Typed, Printed or Stamped) <br />NOTARY PUBLI C <br /> <br />,/:::.....xp ;'/~~ ~ - <br /> <br />6' -,;) -9~--" <br /> <br />STATE OF FLORIDA ~ <br />COUNTY OF ____________~~__________________ <br />The foregoing instrument was acknowledged <br />before me this~aXL_~_~_' 19_2.?~ by <br /> <br /> <br />~h~-i~-p;~;T~-k~~~~~~-~h~-h~~ <br /> <br />produced _______________________________ <br />as identification and who did/did not <br /> <br />~:~:_:=-~~--~~~------- <br />~~~~::~~=:~qy~~~_~__~/~~sC------- <br /> <br />(Name Typed, Printed or Stamped? <br />NOTARY PUBLIC <br /> <br />j::-Xf,l./' S <br /> <br />b -.2 -;95-- <br />