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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this peraitaay be subject to 'deed restrictions' which lay be lore restrictive than City
<br />regulations. The undersigned assuaes responsibility for coapliance with any applicable deed restrictions.
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<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 aay be
<br />cited for a aisdeaeanor 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, (813!
<br />788-6611.
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<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.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE2.
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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 Departaent 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 docuaent and promise in good faith to deliver it to the
<br />'owner" prior to cOlaencelent.
<br />
<br />r E. CONTRACTORIS/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in co.pliance with all
<br />J a~plicable laws regulating construction, zoning, and land developaent.
<br />
<br />Application is hereby tade to obtain a pertit to do work and installation as indicated. I certify that no work or
<br />installation has cottenced prior to issuance of a pertit and that all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developtent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governaental agencies aay apply to the intended work, and that it is
<br />ay responsibility to identify what actions I lust take to be in coapliance. Such agencies include but are not lilited to:
<br />I Depart.ent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />WaterlWastewater Treat.ent
<br />I Southwest Florida Water KanaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />I D artaent of Health ~ Rehabilitative Services Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />I 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 'cotpensating volute' will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A pertit 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 ~erlit prevent the Building Official frot 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 pertit is coatenced within six lonths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six tonths after the tile the work is co.tenced. 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 aonth 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 FOP. IKPROVEKENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />1
<br />COKKENCEKENT. JOB UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OFC9I'fl1ENCEtlENT".
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<br />
<br />R OR AGENT
<br />
<br />
<br />
<br />
<br />was acknowledged
<br />, 1 9..i...:L. by
<br />
<br />STATE OF FLORIDA ,//~
<br />COUNTY OF {fa. J d..- c;~ _
<br />The foregoing instrument was acknowledged
<br />before me th i s' ,.-17 , 19 ---7.-L by
<br />
<br />STATE OF FLORIDA !1~ J
<br />COUNTY OF b" a~a...c,t
<br />The foregoing instrument
<br />before e this,? 7
<br />
<br />
<br />h-3S
<br />
<br />whc, is pers 1all y knol1P tCI m 'or who has
<br />produced ~i/'" 4e,"'1'Vf'L
<br />as identification and who did/~!d noi
<br />take an oa~tf.J...~. \/' /I~ /J. ?7
<br />V ~'dL ( ;V -r~
<br />!Signatur '\..
<br />
<br />t..r{~
<br />who i:y pel-so~n 11y known J1f) me' .r who
<br />dUd '/I.' .... ,
<br />Pl-O uce .. f,;'v..t,t....i/) .. '.. .....,,~t.. .~
<br />as identification and who did/did not
<br />take an oat~;? (!.. (t L!.,j'-:~::-:::::;:::;
<br />j ) t ~Y . 'Cc
<br />..
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
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