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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 cOlpliance 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 Mork, they are advised to contact the City of Zephyrhills Building Departlent, (8131
<br />788-6611.
<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 FEE~,
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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 doculent and promise 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 />I a~plicable 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, Wetland Areas and Environmentally Sensitive lands,
<br />Water/Wastewater Treat.ent
<br />I Southwest Florida Water Manaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f Ar.y Corps of Enqineers - Seawalls, Docks, Navigable Waterways
<br />f De artlent of Health ~ Rehabilitative Services Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f Environ.ental 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 "coipensating volule" will be subMitted 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 .onths 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 cOI.enced. One 90 day extension of tile, lay be
<br />allowed for the penit 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 COMMENCEMENT MAY 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 RECORDINS Y~U~TICE OF
<br />,~.~'DE' ". 0 I' Y E >>0 NOT .EEO TO 'EOD'D AN~"O~ ,,".EE'E'T'. ~
<br />
<br />
<br />
<br />SIGNATURE: OWNER OR A ENT SIGNATURE: CONTRA TO
<br />
<br />
<br />STATE OF F~ {\JC
<br />COUNTY OF '-1LuD ~ (lAtXUHVU
<br />The foregoing instrument was acknowledged
<br />before me this ())~;rLh2L-1 , 19 Cf2 by
<br />
<br />lJOU i S ~ " t-~o. 31 un tA
<br />
<br />who is personalll known to me or who has
<br />produced ~Lt+
<br />as identification and who did/did not
<br />
<br />take ~~~ 1l~
<br />
<br />(SignatL~e; ~ena( IJ I' fl n~nT
<br />
<br />(Name Typed, Printed or Stamped.b-" _"
<br />NOTARY PUBLIC (YlL-1 (()/YlI'l1/ :55i tJ>. ~'f-f.'r~ 5,
<br />( 0& - 2()-cr;-
<br />
<br />STATE OF ~ tJ G
<br />COUNTY OF ,L/lLiJJ ~~
<br />. The foregoing instrument was acknowledged
<br />before me this~~Uh- ~Jf, 199~ by
<br />
<br />01~ I). ;;JC(~~
<br />
<br />who is personally known to me or who has
<br />produced IJ /-J?1
<br />as identification and who did/did not
<br />take an oat~ ~\, ,,1/1 /~
<br />~ ')1 ,~~ /-?<-
<br />(SignatLlre)u . H - f
<br />H, 1\-('110. C _,flnCl./?
<br />(Name Typed, Printed Dr Stampe:d) t.~f;reS",
<br />NOTARY PUBLIC CDyY\(Y'I\'5"S, O~
<br />mL1 -U'.. n~
<br />OCo~.L -,
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