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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit .ay be subject to '~~sd restrict:ons" which may be more restrictive than City
<br />regulations. The undersigned iSSUles responsibility for com~ii~nLJ with any applicable deed restrictions,
<br />
<br />B _ UNL I CENSED CONTRACTORS AND.. CONTR{:~CTOR F:E?J~~pl\I~E.~.).h.I"1::JE~
<br />If the owner has hired a contractor or contractors ~o undertake work, tr.2Y ~ay Je required to be licensed in accordance with
<br />state and local regulations. If the'contrdctor is.~o~ licensed as required by law, bo~h the owner and contractor lay be
<br />cited for a lisdeleanor violation under ~tat~ :o~. If the owner or intended contractor 'are uncertain as to what licensing
<br />requirelents lay apply for the intended work, \h~y are adviseo to contact the City of 7ephyrhills Building Depart.ent, (813)
<br />788-bbl1.
<br />
<br />Furtherlore, if the owner has hired a contractor or contra[tor~, ~~ l5 advised to have the contractorls) sign portions of the
<br />"Contractor Sections" of this application for which they Hill be res~ojlsiblE. If you, a~ the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are respJnsible 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 CON~~CLIOI\J-EEE?
<br />
<br />D. CONSTRUCTION LIEN LAY- (CHAPTER 713, FLORIDA STATUTES~ AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien LaH - HOleoHner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. if the ,applicant is someone other than the
<br />'oMner', I certify that I have obtained a copy of the above d2scribed document and promise in good faith to deliver it to the
<br />"oMner" prior to cOlmenceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work Hill be done In compliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereb~ lade to obtain a perlit to do work and installation ~s indicated. I certify that no Mork or
<br />installation has cOltenced prior to issuance of a perlit and that all work will be ~erfor~ed to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction, I also
<br />certify that I understand that the regulations of other governlental agencies may apply to the intended work, and that it is
<br />IY responsibility to identify what actions I aust take to be in cOlpliance. Such agencies include but are not liaited to:
<br />t Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
<br />Water/Wastewater TreatMrnt
<br />t Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Hetland Areas, Altering Watercourses
<br />f ArlY Corps of EnQineers - Seawalls, Docks, Nav)gable Waterw~ys
<br />f Department of Health L Rehabilitative Services, EnvironmEnt 1 Health Unit - Wells"Wastewater Treatlent, Septic Tanks
<br />t US Environlental Protection AQency - Asbestos abatement
<br />I ~lcn 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 volume" Mill be sublitted which IS plepared by a professiondl eny.neel reg;stEfej in thE StJt~ ~f
<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 permit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, constructio~~ ~or violations of any code, Every per~it issued shall becOle invalid
<br />unless the work authorized by such perllit is commenced ~hin six Ilonths of issuarkE, or if work autheorized by the perllit is
<br />suspended Dr abandoned for a period of six tonths af~ the tile the work is COffi~enced.' 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 must be logged during each six Ilonth period, or the project will be (onsidE~Ed abandoned.
<br />WARNING TO OWNER: ~OUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING THICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR HOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO HOT NEED TO RECORD AND POST A "NOTICE OF COMMEI1CEMENT",
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />....- .---,-.
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />was acknc,wledged
<br />, 19_ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregc,ing
<br />before me this
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />instrument was acknowledged
<br />1q_ by
<br />
<br />-_._---~.~"'.."._-~ ~--_. .-
<br />
<br />who IS personal~y known to me Dr wno has
<br />pl-oduced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification aGd who did/did not
<br />take an oath.
<br />
<br />.
<br />
<br />(S i gna tLll-e)
<br />
<br />(Signature)
<br />
<br />.
<br />
<br />(Name Typed~ Printed Dr stamped)
<br />NOTARY PWpLLc:;:.
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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