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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />~. ~OTrCE'OF DEED RE~rRICTIONS'
<br />r.h~ undersigned' IInd'erstands th,at this perlit lIaY>b~ subject to "deed'restrictions- which uy be lor. rE!stric:tive than City
<br />regulations, . The undersigned assules responsibility for ctlJpI1ance "ith any applicable deed restril::tiolls.
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<br />B · UNL I CENSED CONTRACiORUJiJLCqNTRACTOR RESPONS I B !.hiT 1 E~
<br />If th, oNner has hired'; contrac:tClr or contractors to undertake Nork, they uy be required to be licensed in accordance with
<br />5t~t~ and hc;aJ ,regulations, If the contrado.r is not licensed as required by lalt, both the ollner llnd cDntractor I~Y be
<br />c:,~~~d,for a, tisdeteanor violation under state law. If the owner or intended contractor are unc.rtain as to "hat licensing
<br />requlfeunhaay apply -fDr the inten,ded Nork, they are ad\'ispd to conhct the City of 2ephyrhills Building Depadle9t.f81al'
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<br />further.ore, if the OKner has hired a contractor or contractors, he is advised to have the contractorlsl sign p~rtioll' of the
<br />'Co.nJrador Sections' Df this application for which'thef14i11 be responsible. If you, as the owner sign 11$ theClltlt'ractor,
<br />you are indicating that yon, rather than the contractor, are responsible for the Mork, If the contractor llishes you to sign
<br />as,contra~tor ,that uy be an indicaUan that he is ""t properly lic~nsed and is not entitled to perlitting privileges in the
<br />CH~ of Zephyrhil1s.
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<br />c. TRANSPORTATION IMPACT FEES AND UTILITY CONN~CTION FEES
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<br />o. CONSTRUCTION LIEN LA~ (CHAPTER 713, FLORIDA STATUTES. AS AMENDED)
<br />Itertify"that'I, the applicant, have been provided Nith a copy of "Florida's Construction lien laN 6 Ha.eoNner's Protection
<br />Sufd~. prepared by the Florida Depart.ent of Agriculture and Consumer Affairs. ,11 the applicant iS5oleone Dther than the ..
<br />'~,lfTl~r-J I certify that 1 h~ve obtained a copy of, the above described doculent and prolise in good faith to deHver ',it to the
<br />. "~'oljner' prior' to !:ollencennt. '
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<br />" E. CONTRACTOR I SJO~/N.s..~.? AFF U~.ffiL~~I.
<br />h:erJify that all the hlforaation in this application is accurate ilnd that aU Mork Ifill bt done in toapliant. with all
<br />applicable hilS regulating construction, lDnin9rllnd Illnd develop.ent.
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<br />ApplIcation is hereby lade, to llbtain il perlit to do Ilorkand installation u indicated. I certify that no !lork Dr, ,', !'!',.'
<br />in~tallatiDn has r:ollenced prior to issuance of a per.it'!and tha~ all work will be perforud to aeel standards of an JaMS ~i '
<br />regulating r:finstrudio'nl City codes, zoning regulations, and hnd developaent regulations in the jurisdiction, I il1s11
<br />cedify that I underst,i1nd that the reguhtions of othergoY,ernuntalageneies aay apply to thl! intended NDrk, and that it is
<br />.yn,spllnsibility to fdentify what actitlns I lust takitto be in totpliance. Such ilgencies include but are not B.ited t[ll
<br />, 'Qr.Dart.~nt of EnvirDnlental RenulatiDn N CypressBay~~ads, Wetland Areas and Environ.entally Sensitive Lands,
<br />. " " ,': : '. Wa.ter/Wastewat'er Tr~at.ent ',.
<br />t" ~~uthwe5t Florida Water "ana~e.~nt District - Wells, Cypress ~ayheads, Wetland Areas, Altering ~atercourses
<br />t~riY'Cor'iifof Enginll(S- Seilllillls, Dods; Navigable ~Waterifays ;,
<br />,p,ep'a'rtierit Df Heaith & Rehilb~1itativ, Services, Environaental Health Unit - Wells, WasteNater Treahent, Septic Tanks
<br />,'US ~nvirnn.i!nhl 'Protection AQ'enc'y. As'bestQs abiite.enf
<br />Iatso certify that, if fill .aterhl is tD be used in F.lood Zone 'AI or IA,etc,., it is understood that 11 drainage plan
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<br />ad~re:S5in9 a .colpensating volute- Kill be sub.itled Nhith is prepared lly II prohssional engineer registered in the Stale of"
<br />Florida prior to per. it i$suan~e.
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<br />A per.it issued sha.ll be constru~d to be a license to proceed Ni~h the Mork and nDt as authority tD Yiolatp, cantel alt~r, or
<br />set aside anyprovi5ion~ of thJ 'technic'al codes,'~or5Han issti'ancl! Of a perlit prevent the Building OffiCial fr(l' thereafter.'
<br />requiring a correction' of errors in plans, constructio~1 or violations of any code, Every pertit issued shall becol,e invalid
<br />unless the 1I0rk authorhed by such pHaU is ciifllllenced clwithin six lonths of issuance, Dr if work authorhed by the perli t is
<br />su'spended or abandoned for a period of six lonths after the tile the Mork is cOI.eneed. One 90 day extension of tile, lay be
<br />al'1:ow~d for the penit tlith fee charge Df $15.00, The:~:xhlision'shall be rl!qnested in Nriting to the Building Official. An
<br />ap~royed i'n5p~ctiDn lust be logged during each six to nth period, "or ~h~ project will be considered abandoned,
<br />,llA~NING TO OWMER: ,YOUR FAILURE TO RECORD A NOnCE ,OF COMI\ENCEtlENT'MAV RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR ': .,
<br />PROP~RTY. ' IF YOU 1 D TO OBTAIN Fl'HAUCJtm, CONSUlT Wnfl YOUR lENDER' OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COM"~NtEIlEHT., JOBS UN: ER $2,500' VALUE DO NOTN(EO to'RECOlro AND POST "NOT E OF COIlIlENC KENT-,
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<br />; SIGNATURE: CONTRACTOR
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<br />STATE OF FLORIDA ,/ SCTOAUHTETyDFOFFl, OR IDA ,',~ t l ,[ d _i:.' (j{, . .
<br />COllNTY DF. '/\,,' I!.t } l (1 ~,(,'/.L . _.
<br />TheforegQing instl"ument was acknowledged ' ,The foregc.ing il"15tiument was aC:knt.wledged
<br />befor" me this 11';;0):;// "191.:3 by' . i befCd/TIethi.~.L.!Jt~2/ 19;/'3 by
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<br />~.~,L! '~l/35Cv\/' __ v / '~/ r9- ~~:-C ';-v
<br />who 'is I?l?r~c;.naJl_Y ~~D.OWl"l to me c'r whet has who' i!llp-ersc.nally knCoWf) to /TIe or wnc. has
<br />pn1dLlced _ '; produced _
<br />a.s'identificatiol' who did lncit: as identit'ic:atiol' and who did/ditf/nc.,t
<br />t~ke':--~~ilth. ' , ' " takeel~th. 6" ~)'- />/
<br />_ /\ l' / " / ~,a..-~ " / ~A--t C~ '. '-j- /~'?:;~
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<br />( 9 na t t. e) 'b~". " ' !1.:.. ie, S~c;te(!f nJ;;ili1~s' gna tu'rj / .
<br />, - 2~i' (G:::::::,i~;:' L:dm~ ;"11' 27, jI' LI--- i),::) " [I A;; ;> /9- .i." . '. " ~ ., "
<br />(Na~e T:yped~ pd l"lted 0\- Starmp~d;"'>':";" inl"c~", inc. ( , ame Typed, Pr i nted or Stal/rl'P'eij.~. '<>, ..... .;r....'..';n,'4 _
<br />'~.QT~RV fUBLIC t'fQJAF'<'U'UBl-J.Q
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