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<br />CONDITIONS OF p~nMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this per.it 'IaY be subject- h "-dl'ed restrictions" which Ilav. b~ IDr~ restrictive than City
<br />regulations. The undersigned assules responsibility for cOlpliance Kith any applicable dl!~d restrictiDns.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contracto~ or contractors to undertake work, they may be required to be licensed in accordance with
<br />state and local regulations. If tli!r'~bilt'ractor isnot"!icensf'd as required by law, both the owner and contractor lay be
<br />cited for a lisdeleanor violation under state IaN" If the 0Wne, or intended contractor are uncertain as to what licensing
<br />requirelents lay apply for the intended work, they are advis~G to contact the City of Zephyrhills Building Departlent, (813)
<br />788-6611.
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<br />Furtherlore, if the owner has hired ~ contractor or contractors, he is advised tD have the contractor(s~ ~ignportions of the
<br />'Contractor Sections" of this appliLation 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 r2sponsible 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 perlitting privileges in the
<br />City of ZephyrhilIs.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. CONSTRUCTION LIEN LAW (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 to the
<br />"owner" prior to cOllencelent.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this applir.ation is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating const'ruction, j:nningf :cittd land developlent" "
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<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work Dr
<br />installation has coalenced prior to issuance of a per.it and that all work will be perfor.ed to teet 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 govern.ental agencies may apply to the intende~ work, and~that it is
<br />IY responsibility to identify what actions I lust take to be in coapliance. Such agencies include but are not ]iaited to:
<br />f Departaent of Environaental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive LandsJ~_ __
<br />Water/Wastewater Treatment
<br />f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f Aray Corps of EnQineers - Seawalls, Docks, Navigable Waterways _..
<br />f Departeent of Health 1. Rehabilitative Services, Environlllental Health Unit - Wells, Wastewater Treahent, Septic Tanks
<br />f US Environlental Protection AQency - Asbestos abate.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 volule" will be sub.itted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issua~ce.
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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 perlit prevent the Building Official frol 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 perlit is cOI~enced within six lonths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six lonths after the tiee the work is com~enced. One 90 day extension of tile, lay be
<br />allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved ~nspection lust be logged during each s!x lonth period, or the project will' be considered abandoned.
<br />\/AHNING TO OWNER: YtlUR FAILURE TO RECORD ,~ l'iCTILi:. Or- COH~ENCEilENT I1AY RESULT IN YOUR Pr\Y1NG THICE FOR IMPROVEI1ENTS TO YOUR
<br />PROPERTY. IF YOU IN,END TO OBTAIN FlNANCING~ CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COI1"E~E~ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
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<br />SIGNATURE: CWNER OR A SIGNATURE: CONTRACT
<br />
<br />STATE OF FLORIDA
<br />COUNTY O( PAS CO
<br />The foregoing instrument was acknowledgp.d
<br />before me this March 31, , 19-21- by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />befcl}-e me th i 5
<br />
<br />"Ias ackno"J1 edged
<br />19_ by
<br />
<br />Leo A. Klodzinski
<br />-..-., -~----.
<br />who is personally known to me or who has
<br />produced Personally known
<br />as identification and who . /did not
<br />take
<br />
<br />
<br />who is personally known to me or who has
<br />prDduced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />Dl- Stamped)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(i) MARYH. RAY
<br />. ...., OOINl8SlClN' CO 1tI412 ElIPIIlU
<br />.. Oecemll9r 14. 'f_
<br />lU., ICINClIOTH....1l\OYfAIH IN8UlWICE.INC.
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