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<br />CONDITIlNS o~ P~PMIT AFFIDAVIT
<br />A.' NOTICE OF DEED RESTR;ICIF:r..;:::)
<br />The undersigned understands that this plri'~liY be ~ubject ,~ "1eed restrictions" which .ay be .ore restrictive than City
<br />regulations. The undersigned assu.es re!;ponsibi!i~l fOT CII~f,"'i'[~ with any applicable deed restrictions.
<br />
<br />B. UNL I CENSED CONTRACTORS ANI' CONTR_fir, YOR RESPONS I B I LIT I ES
<br />If the owner has hired a contractor or contractors ~J underti:~~ ~ork, they aay be required to be licensed in accordance with
<br />state and local regulations. If thl! contrachr ;~ no;; J icensed :i'i required by l~w, both the owner and contractor .ay be
<br />cited for a .isde.eanor violation under 5ta~e lah. If the owner or intended contractor are uncertain as to whal licensing
<br />require.ents .ay apply for the intended work, ~hel Jr~ 2dv~seu ~:, contact the City of 2ephyrhills Building Departtent, (913)
<br />799-6611.
<br />
<br />Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor!s) sign portions of the
<br />"Contractor Sections" of this application for which they Mill 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'indiLation that he is not properly iicensed and is not entitled to per.itting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORT AT I ON I MPACT FEES A"iD_,!JT Y, L I TV CONNECT I ON FEE~.
<br />
<br />D. CONSTRUCTION LIEN LA~ (~HAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien LaN - Ho.eowner's Protection
<br />Guide" prepared by the Florida Depart.ent of Agriculture and Corsu.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'lence.ent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infor.ation in this application is accurate and that all work will be done in co.pliance Nith'all
<br />applicable laws regulating construction, zoning,and land .1evelop.ent.
<br />
<br />Application is hereby .ade to obtain a per.it t~ do Hork and installation as indicated. I certify that no work or
<br />installation has co..enced prior to issuance of a perait lnd that all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land Jevelop.ent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governmental agencies .ay apFly to the intended work, and that it is
<br />'Y responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not liaited to:
<br />I Depart.ent of Environ.ental ReQulation - Gypres~ Bayheads, (etland Areas and Environ;entally Sensitive Lands,
<br />Water /lIastellater 'i; ea tOlent
<br />I Southwest Florida Wate~ "anaQe.ent District - Wells, Cypress Hayheads, Wetland Areas, Altering Watercourses
<br />I Any Corps of EnQineers - Seawalls, Docks, Navigr:ble lIatu;;,v.ys '
<br />t Deparlaent of Health I. Rehabilitative Servit:e~ElivirrH\t~ntal ~lth Unit - Wells, Wastewater Treataent, Septic Tanks
<br />t US Environ.ental Protection AQen~ - ~sbe5tos ahatp.!ent
<br />
<br />T ...., _'_ .,. _ to : .r:.. .' _, .:: r ,.. o. ,,1; . . J _. ~..' . _ ,. ~. . . . -, ~. ... . . ... . , _-"... '.' - ,.-
<br />.a. O.l;)U LCI ...11) ...,.u..., .., 1.\lJ. L"'~C:I .lOL .aj lrU .!..;. t".J...... .." . ~..''''''u ;l~ II UI n,l.:;''-.,..~.i.~ UHUt.1 ~\.i..lLHJ ~i1tlj, d ~j aJ.Hd~C pJan
<br />addressing a "colpensating volule" will he sub.itted which is prepared by a professional engineer regi~tered in the State of
<br />Florida prior to per.it issuance.
<br />
<br />A per.it issued shall be construed to be a license to prDcerc w'th the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the tecnnical c~li?s, nor shall i5~u,~~e of a per.it prevent the Building Official frot thereafter
<br />requiring a correction of errors in plans, ,xm::Gruction! or VilJhtions of any code. Every peTtit issued shall becote invalid
<br />unless the work authorized by such per.it ;5 cOI.enced withi;, 5j~ .ooths of issuance, or if work authorized by the permit is
<br />suspended Dr abandoned for a period of six .onths after the t;. ;he work is cOI.enced. One 90 day extension of tile, lay be
<br />allowed for the perlit with fee charge of $15.00. The ext~ns~Jr ~hall be requested in writing to the Building Official. An
<br />approved inspection must be logged during e~(h 5i~ tonrh periodf or the project will be considered ahandoned.
<br />WARNING TO OIlNER: YOUR FAILURE TO RECORD h NST1C~ OF CGMHENCEME.lf MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCiHH, ~Oh~ULT WITH YOUR ,ENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COMI'IENCE"ENT. JOBS UNDER $2 ,500 H~ VALUE DO NGI iiEED 'iO PECO:iDiND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF#FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was a~knowledged
<br />before me this ___, 19_.
<br />
<br />~, "TE OF FLORIDA
<br />\ iUNTY OF
<br />1 ~ foregoing instrument
<br />fL<re me th i s
<br />
<br />was acknowledged
<br />19_ by
<br />
<br />whcI is personally known to lifl? OJ I^oho has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />~ ) 1S personally known to me Dr who has
<br />produced _______
<br />:-;,~ identification and who did/did not
<br />'cake an oath.
<br />
<br />(Signature)
<br />
<br />(C.]nature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLTC
<br />
<br />(t: '1me Typed, Pr i nted 0',- Stamped)
<br />r.', JT ARY PUBL I C
<br />
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