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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlitlay ~e subject to "deed restrictions" which lay be lore 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 Dr contractDrs t~ undertake work, they 12Y be required to be licensed in accordance with
<br />state and local regulations. If the contraLtol is not licensed as required by lall, both the owner and contractor lay be
<br />cited for a aisdeaeanor violation under state IaN. If the owner or intended contractor are uncertain as to what licensing
<br />requirelents lay apply for the intended worK, they are advis~~ tG contact the City of Zephyrhills Building Departlent, (813)
<br />788-b611.
<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 per.itting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE2.
<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 - He.eowner'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 document and promise in good faith to deliver it to the
<br />'owner" prior to cOlaencelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIL
<br />I certify that all the inforaation in this application is accurat~ and that all work will be done in co.pliance with all
<br />applicable laws regulating construction, zoning, and land developeent.
<br />
<br />Application is hereby aade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of a perait and that all work 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 co.pliance. Such agencies include but are not lilited to:
<br />I Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
<br />Water/Wastewater Treatment
<br />I Southwest Florida Water KanaQelent 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 />I US Environaental Protection AQency - Asbestos abate.ent
<br />I also certify that, if fill laterial is to be used in Flood Zone "AE or "A,etc.", it is understood that a drainage plan
<br />addressing a "coapensating volule" will be subtitted which 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 pertit prevent the Building Official frot thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becole invalid
<br />unless the work authorized by such pertit is cOllenced within six lonths of issuance, or if work authorized by the pertit is
<br />suspended or abandoned for a period of six tonths after the tile the worK is cOltenced. One 90 day extension of tile, lay be
<br />allowed f~r the perlit Hith 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 Si~ ~onth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTILt CF COKMENCEMENT 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 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 />STATE OF FLORIDA
<br />COUNTY O{ PASCO
<br />The foregoing inflt:ument was acknowledged
<br />before me this ~~~, 19~3- by
<br />
<br />ktJ hf!,l2fK, Pi i(e ~d {5ea..L~J.I- K /? fe .- (i/~v,-)
<br />who is personal y kno'tm to ,me Clj- who ha&,b who is pel-sonally k~I~'tm to.me or ,lJhC' ~~?
<br />produced (-l- tf> 0 - 77/-J-iJ- 30/ pn.duced Pt.- 01 )f:-rr.,-?()() -0</.1'-3 v---)j" ~
<br />as identification and who did/did not as identification and who did/did nol;
<br />
<br />tak~~~ takeLtrtL! :Jf)d~
<br />
<br />(SW)e:.tur;:~') , y w'J '/ ;i-; (.?.?:gnatLrce) 1m -.- j, (I ,,-r-
<br />ngu.-~4{ /"- (7;;t/~ Ft.-ilL (J;;'07J -0 7/-23 -~ ':,;J-j" ,1/1.. ~ J 1//1 {/ fl a.#~
<br />(Name Typec.. Pr i nted or Stamped) ~me Typed. Pr 1 ntJd Cq- Stamped)
<br />NOT ARY PUBL i c ~r _ - Y I! /) NOT ARY PUBL I C
<br />---- / 1l....-6<.-<-Jl~c<-, / L~lf ~
<br />MarJorie . Carifenter, Notary Marjorie S. Carpenter, Notary
<br />NOTARY PUBLIC, STATE OF FLORIDA .",
<br />MY CO;ii ,';1 I.>:';,ON EXP:RES: JULY 31 i993 NO::.';Y PUBLiC, STATE OF FLORIDA'.
<br />SON.oEo TnHU NOTARY PU6L.,IC UNDERv.:RITfi:R;. MY COi'vi ,',ilSS:ON EXrlf\i:S: JULY 31, 1993".
<br />aONI.:H:D THHU NOTAHY PUBl.IC. UNDERWRITERS.
<br />
<br />STATE OF F\,.ORIDA ~ tJii. ~ ~
<br />COUNTY OF (J/hS(! 0 . C' ,t'v2 ct '~
<br />The foregoing instrument was acknowledged
<br />before me th i s f1 J:U /b..2--. 19..i...3...- by
<br />
<br />Yic:~
<br />
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