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<br />CONDITIONS OF PF.RMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit .Iay be subject to "deed restrictions" which lay be lure .restrictive than City
<br />regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions:
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
<br />state and local regulations. If the contractor 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, (813)
<br />788-6611.
<br />
<br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor Is} 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
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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 Nith a copy of "Florida's Construction Lien LaN - HOleoNner'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 doculent and prolise in good faith to deliver it to the
<br />"owner" prior to cOllencelent.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will 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 Dr
<br />installation has cOllenced prior to issuance of a perlit and that all Nork 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 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 Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />f Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health l Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />I US Environlenta! Protection P.!lenr:y - IIs!l~st~!'3b;!t!'!~P!!t
<br />I also certify that, if fill laterial is to De used in Flood Zone "A" or "A,etc.', it is understood that a drainage plan
<br />addressing a "colpensating volule" Mill be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
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<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 perlit 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 Mork authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the perlit is
<br />suspended Dr abandoned for a period of six lonths after the tile the work is cOI.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 lust be logged during each six lonth pellod, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR IHPROYE"ENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />CllII__T. 10BS,lIlIDER '2,500 I. VAlUE DO NOT !lEEo TO IlEtDlU>~~"J~
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<br />V .~~ ( J2 .
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<br />SIGIAfURE\~,~R AGENT SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF 'PA.c.,c..O
<br />The foregc.ing instJ-ument If/as acknc.wledged
<br />~efore me this 17e~, 1 , 19~ by
<br />
<br />E I WOO d Ko ;x
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath. ~
<br />f). t::~ e...Ll/i~'
<br />(Signature)
<br />7) J::o..-I-!-,e",--iNe.. Martl'IV -#FCCI37~i1
<br />(Name Typed. Printed or Stamped)
<br />!:-!OTARY PUBLIC NOTARY PU~LI~ ~;.ti:E~~ :,~g~~I~~'199S.
<br />:~;E~~t~~s~gTARYi'UBLlC UNDERWRITERS.
<br />
<br />STATE OF FLOR~
<br />COUNTY OF ~
<br />The foregoing ins~ument was a. ck"nowledged
<br />befc.re me this J~~, 19..,~~ by
<br />
<br />:Ja>n e. s ~S 1J,.v
<br />who is ~ersonallY known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take~n oat . ? ~ '
<br />~ {/. <~_.~-
<br />(Signa-c!Jre)
<br />At) UIS/I- A.
<br />(Name Typed, Printed
<br />NOTARY PUBLIC
<br />
<br />/YO/X
<br />or Stamped)
<br />
<br />ito
<br />
<br />LOUISA A. ROIX
<br />State of Aorida
<br />My Camm. Exp. Dec. 1, 1995
<br />. COMM#CC164347
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