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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit .Iay 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.
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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 i~"licensed as required by law, both the owner and contractor .ay be
<br />cited for a lisdeleanor violation under state IaN. '.rf~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 Depart.ent, (8131
<br />788-6611.
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<br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorlsl 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.
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<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 - Ho.eowner'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 prolise in good faith to deliver it t" the
<br />"owner" prior to cOllencelent.
<br />
<br />:~
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<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 co.pliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />I
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<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work Dr
<br />installation has cO.lenced prior to issuance of a perlit and that all work will be perforled to leet standards of all la#s
<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 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 liaited to:
<br />I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />I Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Water~ays
<br />I De art.ent of Health & Rehabilitative Services Environ.ental Health Unit - Wells, ~astewater Treatlent, Septic Tanks
<br />I Environ.ental 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 "colpensating volule" Mill be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it issuance.
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<br />A per.it issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alte'! or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol there2fter
<br />requiring a correction of errors in plans, construction, or violations of any code.. Every perlit issued shall becole i0valid
<br />unless the work authorized by such perlit is cOI.enced within six lonths of issuance, or if work authorized by the permit is
<br />suspended or abandoned for a period of six lonths after the tile the work is cOllenced. One 90 day extension of ti~e, gay 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 lust be logged during each six .onth period, or the project will be considered abandoned.
<br />IIARNING TO OIlNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT KAY RESULT IN YOUR PAYING JIIICE FOR IHPROVEI'1EIHS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COM" CEKENT".
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<br />td.J~
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<br />
<br />SIGNAT E: OWNER OR AGENT I I' IN'.s J...t1JuJ
<br />IE 1--1 ;;Z 4~(H W. VLJ
<br />
<br />was acknowledged
<br />, 19.,R by
<br />
<br />STATE OF. FLORIDA ~ ~
<br />COUNTY OF S,C U
<br />The foregoing instrument
<br />before me th i s 1I (a.~
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF Pasco
<br />The foregoing instrument
<br />before me this June 29
<br />
<br />~'jas acknovdedged
<br />, 199d- by
<br />
<br />Elizabeth W. WinslOW
<br />who is personally known to me or who has
<br />produced Personally known
<br />as identification and w~~did not
<br />
<br />tak~~n~~ )~~
<br />
<br />(SignatUl-e)
<br />
<br />D. Katherine Martin
<br />
<br />(Name Typed, Printed or Stamped)
<br />
<br />NOTARY PUBLIC NOTARY PUBLIC, STATE OF FLORIDA.
<br />MY COMMISSION EXPIRES: August 26, 1995.
<br />BONDED THRU NOTARY PUBLIC UNDERWRrlERS.
<br />t:FCC t31)..g-J
<br />
<br />who is~e~~~I*~\~~JL~, me Erl wh(. h:r:
<br />
<br />1'1 eoduLed
<br />as identification and who ~tdid not
<br />take an oath . "
<br />RV-'>R ,flo.. I.....:::i'~ lJ..ik
<br />(SignatLrce) .... r-
<br />~,f\}(.t.<'.c... tg~\,,-\-
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
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