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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay 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 RESPQNSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they aay be required to be licensed in accordance with
<br />state and local regulations. If the~entr,ctor 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 work, 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 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 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 - 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 docusent and prolise 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 Mill be done in cOlpliance with all
<br />applicable 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 [Ollenced 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 governlen,al 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 />, Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />, Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />, ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />, Departlent of Health L Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />, US Environlental 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 "colpensating volule" will be sublitted which is prepared by a professiona~ 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 per.it 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 per.it is cO.lenced 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 cOllenced. 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 Mill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR IHPROVE"ENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COHHENCE"ENT. JOBS UNDER $2,500 IN VAL DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEHENT".
<br />
<br />.~~.~~~~
<br />
<br />
<br />
<br />
<br />Ptf4j<W-? l~ ~r;-vod
<br />
<br />nt was acknowledoed
<br />/, 19-1L. by .
<br />
<br />J
<br />/
<br />STATE OF FW!!~.!~,~_..{./'
<br />COUNTY OF 1/;7:/ " ')
<br />Tt,p fDreg~,in1 inst.ru""J
<br />before me this~ ~
<br />
<br />
<br />STATE OF FLORIDA ' .~
<br />COUNTY OF ~(t),
<br />The foregoing instrum
<br />before me this I '
<br />
<br />
<br />was acknowledged
<br />c'
<br />~ 1 9...22..- by
<br />
<br />who is personally known to me Dr who has
<br />produced Zt- t'Y.,L.-S:SU'-632 -35-' --/0;5
<br />as identification and W 0 did/did
<br />take an 0
<br />
<br />
<br />who is persDnally known to me Dr who has
<br />pl-oduced /1/ ~t' L ')<;6 .;; 32. ;17- //; ~,
<br />as identification and ho did/did not
<br />ke a It.
<br />
<br /><:
<br />(Signa.ure) ,
<br />t/J>;J; )/( J ~}))f)) /1/ ~
<br />(Name Typed~ Printed Dr
<br />NOTARY PUBLIC
<br />
<br />'L:>AV fi,,-tIV('cvrJ'Zl!/
<br />Stamped)
<br />
<br />"r?;' DAN FARNSWORTH
<br />(l);--'f~~ t.f'( COMMISSION /I CC 186067 EXPIRES
<br />'~":~!!~?/!: AplII21, 1996
<br />~~:qr:~'" toNDED THllU TROY fAIN INSURANCf, INC.
<br />
<br />;$..~~r~... DAN FAANSWOftTH
<br />€"; "JJ;."l:*1 t.f'( COMMISSION (J CC 1160&1' EXPlIlES
<br />ri"~;$: AplII21, 1996
<br />"'~iff.,i~,."" IONDED THAU TROY fAIN 1NSlMAHCE. INC.
<br />
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