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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 .ore restrictive than City
<br />regulations. The undersigned assules responsibility for co.pliance 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 .ay 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 Depart.ent, (813)
<br />788-6611.
<br />
<br />Furtherlore, if the owner has hired a contractor or contractors, 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.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEEg
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<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 Consuler Affairs. If the applicant is sOleone other than the
<br />"owner" , I certify that I have obtained a copy of the above described docueent and prolise in good faith to deliver it to the
<br />"owner" prior to cOllencelent.
<br />
<br />}
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infortation in this application is accurate and that all work will be done in cOlpliance with all
<br />a~plicable laws regulating construction, zoning, and land developlent.
<br />
<br />J
<br />
<br />Application is hereby tade to obtain a perlit to do work and installation as indicated. I certify that no work Dr
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perforled to leet standards of all 12.5
<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 />ty responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited \c':
<br />f Departlent of Environtental ReQuIation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />f Southwest Florida Water KanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering WatercDurses
<br />f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />f De artlent of Health ~ Rehabilitative Services Environtental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f Environlental Protection AQency - Asbestos abatelent
<br />I also certify that, if fill taterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "colpensating volute" Mill be sublitted which is prepared by a professional engineer registered in the State Df
<br />Florida prior to perlit issuance.
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<br />A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alt~f, Dr
<br />set aside any provisions of the technical codes, nor shall issuance of a verlit 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 tonths of issuance, or if work authorized by the permIt is
<br />suspended or abandoned for a period of six lonths after the tile the work is cOltenced. One 90 day extension of tile, ~av 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 duri,ng each six tonth period, or the roject will be onsidered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT KAY . S N UR PING TWICE FOR IMPROVEMENTS TO 'JOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER! AN JORNEY B FORE RECORDING YOUR NOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD "N T CE OF C MHENCEHENT".
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<br />SIGNATURE: OWNER OR AGENT
<br />
<br />
<br />Fe D R.. S' Lv D l.p84 c;,,~ 4 DC,
<br />
<br />(& ~s)
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF ? PI s.c 0
<br />The foregoing instrument was acknowledged
<br />before me this -'1-[1-1 UAP, 1cF1z by
<br />
<br />(7A0L-- D. SC+-'A PE::R.
<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 />who is personally known to me Dr who has
<br />pl-oduced r-L-- DR L-l C
<br />as identification and who did/did not
<br />take an oath. '. I_I ~,7
<br />C;Cj~, ~LA.A...UV'
<br />(Signature) . 1
<br />'D 0 1J A- '.{, ~U1TO f'-I
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLICNOTARY PUBLIC. STATE OF FLORIDA
<br />My commission expires Jan. 28, 1995
<br />Bonded thru Patterson - Becht Agency
<br />
<br />(SignatLll-e)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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