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CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this per.it.ay be subject to "deed restrictions" which aay be .ore restrictive than City regulations. The undersigned assuaes responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner has hired a contractor or contractors to undertake work, they .ay be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lay be cited for a .isde.eanor violation under state IaN. If the ONner Dr intended contractor are uncertain as to Khat licensing require.ents lay apply for the intended work, they are advised to contact the City of 2ephyrhills Building Depart.ent, (BI3) 788-6611. Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that .ay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the City of 2ephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES~ AS AMENDED) I certify that I, the applicant, have been provided with a copy of "Florida's Construction lien Law - HOleowner's Protection Guide" prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described docu.ent and prolise in good faith to deliver it to the "owner" prior to cOI'encelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infor.ation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no work Dr installation has cOI.enced prior to issuance of a perlit and that all work will be perfor.ed to .eet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other governlental agencies .ay apply to the intended work, and that it is .y responsibility to identify what actions I .ust take to be in cOlpliance. Such agencies include but are not li.ited to: f Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands, Water/Wastewater Treatlent f Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways t Departlent of Health & Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks f US Environlental Protection AQency - Asbestos abatelent I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.., it is understood that a drainage plan addressing a "colpensating volule" will be sublitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol thereafter requiring a correction of errors in plans, construction, or violations of any code. Every per.it issued shall becole invalid unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the pertit is suspended or abandoned for a period of six lonths after the tile the work is coslenced. One 90 day extension of tile, lay be allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An approved inspection .ust be logged during each six lonth period, or the project will be considered abandoned. WARNINS TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAY INS TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR lENDER OR AN ATTORNEY BEFORE RECoRDINS YOUR NOTICE OF COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT". SIGNATURE: OWNER DR AGENT SIGNATURE: CONTRACTOR was acknowledged , 19____ by STATE OF FLORIDA COUNTY OF The foregoing instrument before me this STATE OF FLORIDA COUNTY OF The foregoing instrument before me this was acknowledged ~ 19_____ by who is personally known to me Dr who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC