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<br />CONDITIONS OF PERMIT AFFIDAVIl
<br />A , ~OT I CE OF DEED RESTR I CT I ot!f~.
<br />The undersigned understands that this pertit lay be subject to "deed restrictions" which lay be .ore restrictive than City
<br />regulations, The undersigned assules responsibility for co.pliance Mith any applicable deed restrictions,
<br />
<br />B. W~L I CENSED CONTRACTORS At.l~L_f;JJNTJ31i~LOR p'~SF:'_Q~EiI~I LIT I ~$._
<br />If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance Mith
<br />state and local regulations, If the contractor is not licensed as required by law, both the owner and contractor lay be
<br />cited for a lisde.eanor violation under state law, If the owner or intended contractor are uncertain as to "hat licensing
<br />require.ents .ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, 18131
<br />788-6611,
<br />
<br />Further.ore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s} sign portions of the
<br />"Contractor Sections" of this application for which they Mill be responsible, If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work, If the contractor wishes you to sign
<br />as contractor that tay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrhills,
<br />
<br />(' TRANSPORTAl I ON ~ MF'ACL FEE~ ?-)ND ur I '=--lTY __COl~!::!FCTJ Ot-t. FEE,$.,
<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 - Ho.eowner's Protection
<br />Guide" prepared by the Florida Departaent of Agriculture and Consuler Affairs, If the applicant is so.eone other than the
<br />"owner", I certify that I have obtained a copy of the above described docu.ent and pro.ise in good faith to deliver it to the
<br />"OHner" prior to co.tence.ent,
<br />
<br />E. CONTRACTOR I S/m,Jt;JER' S AFFIDA_"!..!.I.
<br />I certify that all the infor.ation in this application is accurate and that all work will be done in co.pliance with all
<br />applicable laws regulating construction, zoning, and land develop.ent,
<br />
<br />Application is hereby .ade to obtain a pertit to do work and installation as indicated, I certify that no work or
<br />installation has co.tenced prior to issuance of a per.it 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 I understand that the regulations of other govern.ental agencies aay apply to the intended work, and that it is
<br />my responsibility to identify what actions I .ust take to be in co'pliance, Such agencies include but are not liaited to:
<br />, Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands,
<br />Water/Wastewater TreatMent
<br />, Southwest Florida Water ManaQe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f Arty Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />, Depart.ent of Health l Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
<br />f US Environ.ental Protection AQency - Asbestos abate.ent
<br />I also certify that, if fill material is to be used in Flo~d Zone "A" Dr "A,etc.", it is understood that a drainage plan
<br />addressing a "co.pensating volu.e" will be subtitted which is prepared by a professional engineer registered 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 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 per.it issued shall beco.e invalid
<br />unless the work authorized by such perlit is coa.enced within six tonths of issuance, Dr if work authorized by the per.it is
<br />suspended or abandoned for a period of six lonths after the tile the work is co.tenced, One 90 day extension of ti.e, tay 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 inspection .ust be logged during each six aonth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCE"ENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVEMENTS TO YOUR
<br />PROPERTY, IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />C""'ENC~ U'DER 12,5 VAlUE DO NOT NEED TO RECORO ANO POST. "NOTICE OF CORRENCERENl". .
<br />
<br />
<br />
<br />SIGNATURE: OWNER OR AGENT SIGNATURE: CONTRACTOR
<br />c::...
<br />
<br />
<br />was acknowledged
<br />, 19 9~ by
<br />
<br />COhh-(.,LL
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrumentlwas acknowledged
<br />before me this , 19_____ by
<br />
<br />me or who has
<br />
<br />who is personally known to me or who has
<br />pl-oduced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />() V re~
<br />S amped) -
<br />
<br />(Signature)
<br />
<br />! ....,..... LINDA KAY HARRELSON
<br />I,*i!\,.r~:. MY COMMISSION' CC 114006
<br />;.: : : EXPIRES: June 25. 1995
<br />'%. ,,; 80ndlld ThI\I NotaIY PullIIC lJndBlWIl\II'I
<br />. , -
<br />,,;~:;;;;'~;.""~""""""'''-'
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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