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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this per.it .ay be subject to "deed restrictions" which lay be lore restrictive than City
<br />regulations. The undersigned assu.es responsibility for cOlpliance with any i1pplicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they aay 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 />require.ents .ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, (8131
<br />788-b611.
<br />
<br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(sl 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 .ay 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. 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 - Ho.eowner's Protection
<br />Guide" prepared by the Florida Depart.ent of Agriculture and Consu.er 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 pro.ise in good faith to deliver it to the
<br />"owner" prior to co..ence.ent.
<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 co.pliance with all
<br />applicable laws regulating construction, zoning, and land develop.ent.
<br />
<br />Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work or
<br />installation has co..enced prior to issuance of a per.it and that all work will be perforled to .eet 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 govern.ental agencies lay apply to the intended work, and that it is
<br />.y responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not li.ited to:
<br />f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />f Southwest Florida Water "anaQelent 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. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f uS Environlental Protection AQency - Asbestos abate.ent
<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 volu.e" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it issuance.
<br />
<br />A per.it 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 per.it 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 tonths of issuance, or if Mork authorized by the pertit is
<br />suspended or abandoned for a period of six .onths after the ti.e the work is cOltenced. One 90 day extension of tile, lay be
<br />allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection .ust be IDgged during each six .onth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEHENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEHENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COH"ENCE"ENT. 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 />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19 _ by
<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 />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~c7: ~
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDJr-)
<br />COUNTY OF ...L/" A <J./' A
<br />. The foregoing instrument was aC~~Wledged
<br />befcll-e me this /6 ~ , 19 .;L by
<br />
<br />.<:?~/7A~ /)/~~ ()J~~
<br />who IS personally known to me or who has
<br />produced Fj)L #-(1 / S-J'~ 7'//- S-c. -30~_
<br />as identificatic1n and who ~did not
<br />
<br />t~k?2 ;;t;~ -zf~~.;
<br />
<br />(s~~re)
<br />L' )
<br />Rr f-rA- B. €W/~
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />NOTARY PUBLIC, STATE OF FLORIDA
<br />My commission expires Jan. 28,1995
<br />Bonded thru Patterson - Becht Agency
<br />
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