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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be 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 ONner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by laN, both the owner and contractor lay be
<br />cited for a lisdeleanor violation under state IaN. If the ONner or intended contractor are uncertain as to what licensing
<br />require.ents .ay apply for the intended Nort, they are advised to contact the City of Zephyrhills Building Depart.ent, (813)
<br />788-6611.
<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 .ay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<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 LaN - 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 />"owner', I certify that I have obtained a copy of the above described docu.ent and prolise in good faith to deliver it to the
<br />.owner. prior to co..ence.ent.
<br />
<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 with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby lade to obtain a per.it to do work and installation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perfor.ed to .eet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
<br />certify that 1 understand that the regulations of other governlental agencies lay apply to the intended wort, and that it is
<br />.y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />I Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />I Southwest Florida Water "anaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />I ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />t Depart.ent of Health ~ Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />I US Environaental Protection AQency - Asbestos abatelent
<br />1 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 volu.e" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<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 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 cOllenced within six lonths of issuance, Dr if work authorized by the perlit is
<br />suspended or abandoned for a period of six lonths after the tile the work is cOI.enced. One 90 day extension of tile, lay be
<br />allowed for the perlit 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 lonth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COK"ENCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IKPROVE"ENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COKKENCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A .NOTICE OF COK"ENCEKENT".
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<br />i //i:;/~ ~? ~~/C~
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<br />SIGNATURE: OWNER OR AGENT
<br />
<br />/1?~fJ0
<br />/' SIGNA E: CONTRACTOR
<br />
<br />V STATE OF FlORID~ I J -
<br />1\ COUNTY OF f'J-Ilh.J~ ~-I~
<br />The foregoing instrument was acknowledged
<br />before me this~a~ .2(b , 19~ by
<br />
<br />.:5"f~ III Ap AI T Or!/) Q1
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did nQt
<br />take ~a~"}t~. V ...... / . .
<br />~~_e.b.. ~ ~-I<lt>
<br />(Signa~-e) .,
<br />f(~ ~~ {IlL L. yI.vi^j~
<br />(Name Typed, Printed or Stampe )
<br />NOT ARY PUBL I C Notary Public, Stat. of Florida
<br />My Conunisslon Expires Oct. 8, 199~
<br />lencIecI TIvv Troy Foin . In...,on.. In.
<br />
<br />STATE OF FLORIDA, ./'",1. j ./
<br />COUNTY OF ~A-/~~
<br />The foregoing t~strument was acl~lowledged
<br />befc.re me th i s 7 J1.!lt J ..2. t, ,19 ~ by
<br />- 7 01 ./
<br />J. C. iJA.()t<JN
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an at.
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC Notary Public, Stat. of Florida
<br />My Commission Expires Oct. 8, 1993
<br />lolIdeclllw Tf'- fain. IrwIran.. Ine.
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