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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 th~~ 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 contrGctor or cqptractors to undertake wor~1 they lay be required to be licensed in accordance Nith
<br />state and local regulations. If the contractor is not licensed a~ required by la~, bott the ONnEr and contractor lay be
<br />cited for a lisde.eanor violation under state IaN. If the owner Dr intended contractor' are uncertain as to Khat licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, IB13)
<br />78B-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 bl!! 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.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES.
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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 - HOleowner's Protection
<br />Guide" prepared by the Florida Departaent 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 docu.entand prolise in good faith to deliver it to the
<br />"owner" prior to cOlaencelent.
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<br />E. CONTRACTOR_~l.Q1.JNER · S AFF I DAV I T
<br />I certify that all the infonatlon in this application is accurate and that all Kork will be done in co.pliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
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<br />Application is hereby aade to obtain a perait 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 will be perfQrled 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 ot~er 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 Departaent of Environaental Requlation - Cypress Bayheads, ~etland Areas and Environlentally Sensitive Lands,
<br />Water/WasteMater Treatlent
<br />f Southwest Florida Water Kanaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f ArlY Corps of Enqineers - Seawalls, Docks, Navigablt Waterways
<br />f Departlent of Health L Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f US Environaental Protection Aqency - Asbestcs abotelent
<br />I also certify that, if fill ..a;:.:rial is t~ '.' !,P~ in Floorl Z,.ne "A" or "A,ete.., it is understood that a drainage plan
<br />addressing a "colpensating volule" Mill be sutJ.1i;ted Mhich is prepilr.::li by a protEsS~)liai 2Hgii't:2r il:9i5terel! in the State of
<br />Florida prior to perait issuance.
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<br />A perait 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 perlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, Dr violations of any code. Every' perli t issued shall becole invalid
<br />unless the work authorized by such permit is cOllenced within six lonths of issuance, or if Kork authorized by the permit is
<br />suspended or abandoned for a period of six aonths after the ti_~ the Mork is cos.enced. One 90 day extension of tile, lay be
<br />allowed for the perlit with fee charge of $15.00. The exten5~o~ 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 COKKENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IHPROVEKENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER DR AN ATTORNEY"BEFORE RECORDING YOUR NOTICE OF
<br />COKKENCEKENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD IIND POST " MOlItf- ENCEHENT".
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<br />
<br />CTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />befoT'2 me this 19_. .. bv
<br />
<br />~~~~~yO~/LORIDA 61<. e Vft~
<br />
<br />The foregoing instrument was acknowledged
<br />befri~-e me this , 19_ by
<br />
<br />.JY' A Q. ~S b- [..-0 Bf. tl (V
<br />who is persc'nally known to m?cr whc, ~.-,,5
<br />produced f'1) L
<br />as idpnt~fication and who did/did not
<br />ta~Ji!'-~-' oath. /"]1 / ,- ";1 /;1
<br />, \. VL., Li-/C.P'l
<br />._--~. ---
<br />(Si rj.B.\ure) " -' r j
<br />~r\rl (n. h~cc'rIL L
<br />(Name Typed, Pr i nted c,r tamped)
<br />NOT{~r~Y cUBI",I C cell -:;Y~(19
<br />
<br />t-hf I~-h, yh-e V YY\ el)..f e.:11
<br />~ho is persunall~ known to me or who has
<br />produced ~ \) L- __
<br />as identification and who d\d/did not
<br />ta~ .~~ ~hl.'; .~ .ttLeJL
<br />
<br />:f~';-;tV\ V/1 ~ F?li Qi.-tr /ci-
<br />(Name Typed, Printed or.sit~p~d)
<br />NOTARY PUBLIC, c.C ( L<;yll (/
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