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<br />C~NDITIONS OF PERMIT AFFIDAVIT
<br />A. ~~TICE OF D~~D RESTRICTlqNS
<br />The undersigned understands that this per~;,tIiY be subject to "deed r~~ti'\ctions" Mhich lay be lore restrictive than Cii'y
<br />regulations. The undersigned assules responsi~iliiy for cOlpliance Mith any ~pplicable deed restrictions.
<br />
<br />B. UNL I CENSED CONTRACTORS {~ND CONT13A~-:TOR RESPOhlS I 1:3 I LIT I ES
<br />If the owner has hired a contractor bT ~ODtractor5 tg u~ertake "Ol~~ they lay bE ~~quired to be licensed in accordance Mith
<br />state and local regulations. If the contractor is not l!censed 2~ required by law, ;~th the uMner and contractor lay be
<br />cited for a lisdeleanor violation under state law. If the o~ne: or l~t~nded contractor are uncertain as to what licensing
<br />requirelE!nts lay apply for the intended work, they are advised" COiitact the Cay of Zephyrhills Building Deparhent, (8131
<br />788-b611.
<br />
<br />FurtherlorE!, if the owner has hired a contractor or contractors, he is advised to have the contrartorlsJ sign portions of ihe
<br />"Contrachr Sections" of this application for which they lIill be responsible. If y~u, as the ""nei sign as the contractor,
<br />you are indicating that you, rathE!r than the contractor, .re responsible for the work. If the contractor Mishes you to sign
<br />as contractor that lay 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 FEE~
<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 - HOleowner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and Consu.er Affairs. If the applicant is sOleone other t.han the
<br />"owner", I certify that I have obtained a copy of the above described docu.ent and promise in good faith to deliver it to the
<br />"owner" prior to cO'lence.ent.
<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 />applicable laws regulatitq 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 Nill be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning rE!gulations, 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 Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environaentally SensitiVE! Lands,
<br />Water/Wastewater TrE!atlent
<br />f Southwest Florida Water HanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f ArlY Corps of EnQineers - Seawalls, DOCKS; Navigable Waterways
<br />f Departlent of Health l Rehabilitative Services. Environlental HE!alth Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f US Environlental Protection AQency - Asbestos abatE!tent
<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 />addressinq a "colpensating volule" Mill be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perait issuance.
<br />
<br />A perlit iSSUE!d shall be' construed to be a license to procE!ed with the worK and not as authority to violate, cancE!1 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 beeole invalid
<br />unless the work authorized by such perlit is cOltenced within six lonths 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 commenced. 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 lonth 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 FOP. IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCINS, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMHENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OP COMMENCEMENT".
<br />
<br />_if ,p/1/I~-r;t;:.. J,,/I (} 1. ~
<br />SIGNATURE: CONTRACTOR
<br />(3&00 - 517 - 7:;; - c(J/!
<br />
<br />STATE OF FLORIDA ~
<br />COUNTY OF ~~
<br />The foregoing in t1-ument V.IrJs. ~Cll~lEdged
<br />before me this , lY by
<br />
<br />-
<br />
<br />_, r,&,~
<br />
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<br />SIG MURE~ e ~UF.R fiR AGENT .
<br />j(~ 57J ~ ~;( ,- - ;l (; - ~ rr-
<br />/:
<br />SlATE OF FLOHID~~n ~
<br />COmH" GF ~ ~_-L-U
<br />The fnre;:lo i n9 in,J'i:;;p'. w.s ."knowledged
<br />befol-e me this! 1 , 19..!:lIl by
<br />
<br />!-J..OL{O f::, keEI!'./
<br />who is per~n~ltY kno~n to me c~ who has
<br />produced Ld!J()[.(25 Us'fJI.X!l=
<br />
<br />~:0~;;t~ Z;~d not
<br />
<br />(Si)ilnature U
<br />CHEl2lfL J DEI3'fArI
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />-Dl-P<-A--LJ apAJ .s-I / c; 7 3
<br />
<br />
<br />KEAJAJE7H R.tdW612-
<br />who is pel-!:'311Y kno\'1ll to me or_whO
<br />produced / 'C..r U~t2 LIe GtlJ(l C::-
<br />as i entification and who did/did not
<br />tal-; lal oath.
<br />
<br />
<br />has
<br />
<br />
<br />~
<br />
<br />(SignAture) 'A
<br />C t-!EI2VL J. UE8Y4r1
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />--.--L,V-~ {c,p0 6. /'773
<br />
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