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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlitlay be subject to "deed restrictions" which lay be lore restrictive than City
<br />regulations. The undersigned assules responsibility for co.pliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner 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 law, both the owner and contractor lay be
<br />cited for a lisdeleanor violation under state IaN. If the owner Dr intended contractor are uncertain as to Nhat licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, 18131
<br />788-6611.
<br />
<br />Furtherlore, if the ONner 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 will be responsible. If you, as the ONner 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 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 Law - HOleowner's Protection
<br />Guide" prepared by the Florida Departaent 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 doculent and prolise in good faith to deliver it to the
<br />"owner" prior to cOllencelent.
<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 Nith all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no lork Dr
<br />installation has cOllenced prior to issuance of a perlit and that all work lill be perfor.ed to leet standards of all laMS
<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 governlental 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 inclu~e but are not lilited to:
<br />I Departlent of Environlental Requlation - Cypress Bayheads, Wetland Areas and Environaentally 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 />I Departlent of Health L Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />I US Environlental Protection Aqency - Asbestos abatelent
<br />I also certify that, if fill laterial 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 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 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 cOllenced 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 tile the work is cOllenced. One 90 day extension of tile, lay be
<br />allowed for the perlit with fee charge of tI5.00. 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~NCEKENT KAY RESULT IN YOUR PAYING TWICE FOR IKPROVEKENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COK~NCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COKKENCEKENT".
<br />
<br />d~ cfJA~
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<br />SIGNATURE: OIlMER DR AGENT
<br />
<br />c:j~ c /lJo4<A
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FlORIi? I' ;; II
<br />COUNTY OF tl---?/C~ [(~~
<br />The fDregOing~.~:t47nt was/as~nowledged
<br />before me thi . , 19 ~~ by
<br />
<br />II/; /! rc![S 't' Ih u/ .j~
<br />who is personally kn~ to me or who has
<br />produced
<br />as identification and
<br />take an oath;0~ '
<br />,~-1'--" ./
<br />(Signature)
<br />6~.//L t' r ~w/J1Ii/d
<br />(Name Typed, Printed or Stamped)
<br />
<br />NOT ARY PUBL I C Notary Public. Stat. of Florilla
<br />My Commission Explra Sept, 18, 1994
<br />Bonded Thru Trey Fain. Inlurance lnc.
<br />
<br />woo did/did not
<br />)
<br />~~. fJ7;c:.rA/--id /(jC
<br />
<br />~i ~
<br />STATE OF FLORIDA /;'/ / L !- .--,...._
<br />COUNTY OF d~.' ..--d--4/,.t.v'
<br />The foregoing instrument'was/acknowledged
<br />before me thi~.J#/41, 19~ by .
<br />
<br />{'hAH~ /-f J C tJ~ /loUJS
<br />who is personally known to me or who has
<br />produced -----
<br />as identification and who did/did not
<br />take an Dat~ j' 0 ___//.? /
<br />i-i./~-<,--<./ ",-~j /)()-<'-1./'U'7<.-(/
<br />(Signature) ') ,
<br />h/;c.t:L 1(;)':"'~//,4'i./j
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLI C
<br />Ho'nry Public. Stat. of Florida
<br />My Commission Expires Sept. II, 199.
<br />Bonded Thru Troy Fain . In.uran~ IIlCo
<br />
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