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<br />CONDITIONS OF F~RMIT AFFIDAVIT
<br />A. ~OTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be ~ubject to "deed restrictions" which lay be tore 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 say- be r~qui~-~d-t~j;;-iicensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lav be
<br />cited for a lisdeleanor violation under state law. If the owner Dr intended contractor are uncertain as to what lic~nsing
<br />requirelents lay apply for the intended work, th~y are advised ;0 conlact the City of Zephyrhills Building Departaent, (813)
<br />788-bbl1.
<br />
<br />Furtherlore, if the owner has hired a contractor or contr~ctors, he is advised to have the contractor!s} sign portions of the
<br />'Contractor Sections" of this application for which theY Hill 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 worL 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 permitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~
<br />
<br />D. CONSTRUCTION LIEN LA~ (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 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 document and promise in good faith to deliver it tel the
<br />"ollner' prior to cOllencelent.
<br />
<br />E. CONTRACTOR'S/DWNER'S AFFIDAVII
<br />I certify that all the information in this application is accurate and that all work will be done in compliance 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 wor~ Dr
<br />installation has cOltenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning regtlations! and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governmental agencies lay apply to the intended wor~, and that it is
<br />IY responsibility to identify what actions I lust take to be in compliance. Such agencies include but are not liaited to:
<br />I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Landsr
<br />Water/Wastewater Treatment
<br />f Southwest Florida Water "anaqeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways '
<br />I Departlent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic TanKS
<br />f US Environ.ental Protection AQency - Asbestos abatement
<br />I also certify that, if fill aaterial is to be used in Flood Zone "A" or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'compensating volume' will be subtitted lIhich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A pertit 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 pert it issued shall beeole invalid
<br />unless the Mork authorized by such perlit is co..enced within six Bonths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six lonths after the tile the work is co&~enced, One 90 day extension of ti~e, 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 Bonth period, Dr the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMMENCEMENT",
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />Tt-IE fC.j-egc,ing inst\-ulTlen't v.io:; \.,c.\";j::.,.ledgt::d
<br />befol-e me this 19_ .3y
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />.llt' i'DI l:.'goiny instrument "Jas ackno"dedged
<br />befcl\-e me this , 19_ by
<br />
<br />who is personally known to me Dr who has
<br />pl-oduced
<br />as identification and who did/did not
<br />take an c.ath.
<br />
<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 />
<br />(Signatun~)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
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