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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 t~ "deed restricti~ns" which lay be lore restrictive than City
<br />regulations. The undersigned assu.es responsibility for cOlpliance with any applicable deed restricti~ns.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake w~rk, they lay be required to be iicensed 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 ONner 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 ~f Zephyrhills Building Depart.ent, (B131
<br />7BB-6611.
<br />
<br />Further.ore, if the owner has hired a contractor or contractors, he is advised t~ 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 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 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 Nith 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 leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govern.ental agencies .ay 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 lilited to:
<br />f Depart.ent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />WaterlWastewater Treat.ent
<br />f Southwest Florida Water "anaqe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f Ar.v Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />f Depart.ent of Health L Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f US Environ.ental Protection AQencv - Asbestos abate.ent
<br />I also certify that, if fill .aterial is to be used in Flood Zone "A" Dr "A,etc.", it is understood that a drainage plan
<br />addressing a "colpensating volu.e" will be sub.itted 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 aper.it prevent the Building Official fro I thereafter
<br />requiring a correction of errors in plans, construction, Dr violations of any code. Every perlit issued shall becole invalid
<br />unless the work authorized by such per.it is co..enced within six .onths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six .onths after the ti.e the work is co.tenced. 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 logged during each six .onth 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 IMPROVEMENTS TO YOUR
<br />PROPERry.. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />CO"KENCE"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 />~a~
<br />SIGNATURE: CONTRACTOR
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF t'ASC.o
<br />. The foregoing instrument
<br />befc11-e me th is 4 - 1.. q
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />befclre me this
<br />
<br />was acknowledged
<br />, 19 q 1... 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 />R \ C \-\ p.., R D P\. . e.. \-\ J\ t' l'V\ flI t-J
<br />who is personally known to me or who has
<br />produced DR\\lER'S L\ c..E. J'.JS E
<br />a~entifica~n and who did/did not
<br />
<br />t~~t;'~.! \) ~
<br />. '-.....----""
<br />(Slgnature)
<br />DE. 6B I t= Po.. RO\.0E. ',--L
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOT ARY PUBLI C :tt: u 102, / ~
<br />. \.iT ARY PUBLIC, STATE OF FLO
<br />My commission expires Oct, 2. 1
<br />~onded thru fatters(l"J - B.9cht Alt.,
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />,OTARY PUBLIC, ST^T~ Of rt Of"
<br />kv commlssiun expir.-'$ Ur;! ,'. ' 'c;
<br />l't_ "h1k1C tnlc~ r,_'~,14,-~;...: , r'''''''i''
<br />
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