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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 to "deed restrictions" which .ay be .ore restrictive than City
<br />regulations. The undersigned assu.es responsibility for co.pliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBI~ITIES
<br />If the owner has hired a contractor or contractors to undertake work, they .ay be required to be licensed in accordance with
<br />state and local regulations. If thP. tontractor is not licensed as required by law, both the owner and contractor .ay be
<br />cited for a .isde.eanor violation under state law. If the owner 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 of Zephyrhills Building Depart.ent, !BI3}
<br />78B-6611.
<br />
<br />Further.ore, 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 .ay 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 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 Construc.tion 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 protise 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 Hork will be done in co.pliance with 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 perfor.ed to .eet 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 li.ited to:
<br />f Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands,
<br />Water/Wastewater Treat.ent
<br />f Southwest Florida Water "anaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />f Depart.ent of Health & Rehabilitative Services. Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f US Environ.ental Protection AQency - 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 "co.pensating 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, Dr
<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 beco.e invalid
<br />unless the work authorized by such per.it is co..enced within six lonths of issuance, or if work authorized by the per.it is
<br />suspended or abandoned for a period of six .onths after the ti.e the work is cOI.enced. One 90 day extension of tile, .ay 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 />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"EHT "AY RESULT IN YOUR PAYING TWICE FOR I"PROVE"ENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />C",KENCEKEHT. JOSS ONOER '2,500 IN :AlUEDO NOT NEEO TO RECORO ANO PO'T~NOTJCE OF COONE,CE,ENT',
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<br />
<br />~~?p~. . ~~~~
<br />SIGNA : OWNER OR MiEN SIGNATURE: CONTRA OR.
<br />
<br />STATE OF FLORIDA ~
<br />COUNTY OF I ~D
<br />The foregoing instrument was acknowledged
<br />before me '":;9" It" , I:' :i?- .b. y
<br />
<br />W~YtL A ...12..-u-__:rYlL,t/T1./rV ......__
<br />who' per~nall y kno~n tQ,dTle Dr who has
<br />producedJ)/CA/u'e./~ ~~~
<br />as identification and who did/did not
<br />
<br />take (i~' X' JU/Z&,~YL"
<br />
<br />(Signature
<br />AM.V ~.
<br />(Name Typed, Printed
<br />NOTARY PUBLIC
<br />
<br />Sw dlV 11.I
<br />or Stamped)
<br />
<br />STATE OF FLORIDA ,/f)'iI.
<br />COUNTY OF _'G.--Q-~ .
<br />The forego i ng i?1 tl-ument I>laS ac knclw 1 edged
<br />befclre me this tf~ /0 , 19 '1~ by
<br />
<br />~..AIl.. cC
<br />who is per onal~~ knc I to me Dr w~o has
<br />produced 7J)~ ~uc..~
<br />as identification and who did/did not
<br />take ~__..oath 'Y. {i
<br />CL-'7 ~. 4~:ru.;y,-.
<br />(Signatui
<br />~A M Y l__ ~'5::' uJ d N IV
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
<br />........
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<br />
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<br />0lIIdII SIll "\J
<br />,., L'_
<br />Noll1y Pu*,'" flRorlda
<br />My camm. .... Gat... U.
<br />CoIIInL No. ~
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