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<br />CONDIT~ONS OF PERMIT AFFIDAVIT
<br />A. NOT I CE OF DEED RESTR I CT :;J':,N<?,
<br />The undersigned understands that this per.it .~~( ie subject t~ "deed restrictions' which .ay be .ore.restrictive than City
<br />regulations. The undersigned assu.es responsibil"ty for cotpliance with any applicable deed restrictions.
<br />
<br />B. ul-iLIC:::~~:::: ~1.:'~!~E.:~I"":..QB5-~ NG __~ON.TRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor Dr centf<""ors tOI.ndertalCe won, th:~y ~al' be rf!~ui;'2~ to be 1icens~d in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor .ay be
<br />cited for a .isde.eanor viol~ti~n under state ~a~. If the owner ~r intended contractor are uncertain as to what licensing
<br />requirelents .ay apply for the intended work, they are advised to c~ntact the City of Zephyrhills Building Depart.ent; (8131
<br />788-6611.
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<br />Further.ore, if the owner has hired a contractor or cDnt~actors, he is ad~ised to have the contractor(sl sign portions of the
<br />"Contractor Sections' of thl~ ~p'~lication for "h~ch they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the c~ntrartor, are responsible for the work. If the contractor wishes you to sign
<br />as contractor that .ay b~ an indication that he 15 1I0t properly licensed and is not entitled to per.itting privileges in the
<br />City of Zephyrhills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D, CONSTRUC'11UN LIE~~ ;....c.~_; U':::-Y':!='TER '7t3~ FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of 'Florida's Construction Lien Law - Ho.eowner's Protect~uif
<br />Guide" prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is so.eone 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 CO.lencelent.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDaYlI
<br />I certify that all the infor.ation in this application is accurate and that all work will be done in cotpliance with all
<br />applicable laws regulating construction, zonillg, and land develop.ent.
<br />
<br />Application is hereby .ade to obtain a pertit to ~o work and installation as indicated. I certify that no work or
<br />installation has co..enced prior to issuance Jf a pertit and that all work will be perforted to leet standards of all laws
<br />regulating construction, City codes; zonin~ reqv.l~~iolis, and land developtent regulations in the jurisdiction. I also
<br />, certify that I understand that the regulatiJns ;i ~ther governlental agencies tay apply to the intended work, and that it is
<br />3j r~r~~n5ih!!;t~ tn irlpotify what actions I .ust take to be in co.pliance. Such agencies include but are not lilited to:
<br />f Depart.ent of Environtental ReQulation - Cipres5 Bayheads, Wetland Areas and Environ.enialiy Sensitive LdilOS,
<br />Water/Wast2water Ir~at.ent
<br />f Southwest Florida Water "anaQetent District - Wells, Cypre~: Bayheads, Wetland Areas, Altering Watercourses
<br />f Arty Corps of EnQineers - Seawalls, Docks, Navigable WaterwdYs O'
<br />f Departlent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
<br />f US Environ.ental Pr~~tc~ion AQenrt - Asbestos abatelent
<br />I also certify that, if fill taterial is to be u~ed i" Flood Z~~~ 'A" Dr "A,etc.', it is understood that a drainage plan
<br />addressing a 'colpensating voluae" ~ill be subtitted which is prepared by a professional ergineer registered in the State of
<br />Florida prior to per.it issuance. ·
<br />
<br />A per'lt IssueB snaii h~ Lan~tru~d to ~~ ] !~r~~c- tn ;~,[~~j with the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall is!iualice Ilf a pertit prevent tile iluildi,Hj GffiLio:l ~rc'~ ~hereaft!'r
<br />requiring a correction of errors in plans, construction, Dr yiolations of any code. Every per.it issued shall becole invalid
<br />unless the work authorized by such per.it is cOUIP-nced within six .onths of issuance, Dr if work authorized by the pertit is
<br />suspended Dr abandoned for a period of six .onths after the ~i.e th~ work is co..enced. One 90 day extension of tite, lay be
<br />allowed for the pertit wit.h fee r.harge of ~15.C~, T~~ exten~;on shall be requested in writing to the Building Official. An
<br />approved inspection lust be logq~d during each six .onth reriod, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CilKKENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IKPROVEKENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COK"ENCEKENT. JOBS UNDER $2,500 IN VALUE DO NUl NEED TO RECORD AND POST A "NOTICE OF CO""ENCE"ENT'.
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<br />SIGNATURE: CONTRACTOR
<br />
<br />-
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />was acknowl~:~?~
<br />19 _ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me thi",
<br />
<br />STATE OF~FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />befc.re me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />-- ------...,.--
<br />who is persDnally known to me o~ who has
<br />produced
<br />as identification and whc, did/d~. '-;0':
<br />take an oath.
<br />
<br />who is personally known to me Dr who has
<br />produced
<br />2S identification and who did/did not
<br />take ail oath.
<br />
<br />,::iiy:,aturei
<br />
<br />(Signatul-e)
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
<br />(~~me Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
<br />.
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