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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands thilt thi': per..it.ay be subject to 'deed restrictie,ns' which lay be lore restrictive
<br />regulations. The undersigned assules r~sponsibility for compliance with any applicable deed restrictions.
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<br />than City
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to und~rtake work, they may be required to be licensed in accordance with
<br />state and local regulations. If the contractor is Hot licensed as required by law, both the owner and contractor lay be
<br />cited for a .isde.eanor violation under state law. If the ONner or intended contractor are uncertain as to what licensing
<br />reQuire.ents .ay apply for the intended H~~k, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<br />788-6611.
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<br />Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portioHs 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 .ay be an indication that he is n~' 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 FEE2.
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<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 Depart.ent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
<br />'oNner', I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the
<br />'oNner' prior to cOI.ence.ent.
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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 Nith all
<br />applicable laws regulating construction, zoning, and land development.
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<br />Application is hereby .ade to obtain a per.it to do work and installation as indicated. I certify that no wor~ or
<br />installation has cOllenced prior to issuance of a per.it and that all work will be performed to meet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of uther governmental 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 liaited to:
<br />f Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />f Depart.ent of Health ~ Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tan~s
<br />f US Environ.ental Protection AQency - Asbestos ab~te.ent
<br />I also certify that, if fill .aterial is to be used in Flood Zone 'A' or 'A,etc,", it is understood that a drainage plan
<br />addressing a 'colpensating yolule" will be sub.itted Nhich is prepared by a professional engineer registered in the State of
<br />Florida prior to perait 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 per.it prevent the Building Official fro. thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall becole invalid
<br />unless the work authorized by such perlit is cOI~~nced within six Bonths of issuance, or if work authorized by the permit is
<br />suspended or abandoned for a period of six lonths after the ti.e the work is cOI.enced. One 90 day extension of tile, lay be
<br />alloNed f~r the permit 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 .onth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YuUR 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 RECOPD AND PUST A "NOTICE OF COMMENCEMENTs.
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<br />SIGNATURE: OWNER OR AGENT
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<br />SIGNATURE: CONTRACTOR
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<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19 _ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />befcq-e me th i s
<br />
<br />was acknowledged
<br />, 19 bv
<br />, .
<br />
<br />who is personally known to me or w~o has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />who is personally known to me Dr who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(SignatLll-e)
<br />
<br />(Si gnatLn-e)
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
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