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<br />CONDITIONS OF PERMIT AFFIDAVIT <br />A. NOTICE OF DEED RESTRICTIONS <br />The undersigned understands that this perlitlay be subject to .deed restrictions' which lay be lore restrictive than City <br />regulations. The undersigned assules responsibility for cOlpliante with any applicable deed restrictions, <br /> <br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES <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 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, IB13r <br />7BB-6611. <br /> <br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl 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 FEE~ <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 Departlent of Agriculture and Consu.er 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 pro.ise 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 />I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands, <br />Water/Wastewater Treatlent <br />I Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses <br />I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways <br />I Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks <br />I uS Environlental Protection AQency - Asbestos abatelent <br />I also certify that, if fill laterial is to be used in Flood Zone 'A' Dr '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 tD 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, nDr 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 IKPROVEKENTS TO YOUR <br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF <br />COK"ENCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO R~CORD AND POST A 'NOTICE OF COMMENCEMENT'. <br />\) -4 ~ " <br />\~'{l t ' [{) <br />'~^lD(lIOg('J. ~ /,) r-A/lA,/ <br />SIGNATURE: CONTRACTOR <br /> <br />SIGNATURE: OWNER OR AGENT <br /> <br />was acknowledged <br />, 19_ by <br /> <br />STATE OF FLOR1J.A II Il L <br />COUNTY OF --1J n ~ ,..Q :.> <br />. The foregoing instrument was acknowledged <br />befc,re me this ~"b. 7 4 ' 19 q L by <br /> <br />? l' ~" <br /> <br />o is ersonally known <br />produced <br />as identification and who did/did not <br />ta~e an oath. \f, ~ t.r1rA) <br />~~o.J'ldhfA... ~~_ <br />(Signature) I 11 r <br />5AtJ D r-<.A h. 1"'1 U M r-O~ <br />(Name Typed, Printed Dr Stamped) <br />NOTARY PUBLIC <br /> <br />STATE OF FLORIDA <br />COUNTY OF <br />The foregoing instrument <br />befc.re me th i s <br /> <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 />(Signature) <br /> <br />lName Typed, Printed or Stamped) <br />NOTARY PUBLIC <br /> <br />NOTARY PUBLIC StATE' OF FLORIDA <br />MY COMMISSION EXP JULY 24,1993 <br />BONDED THRU GENERAL I"S. UNO. <br />