<br />,.
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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 Cify
<br />regulations. The undersigned assules responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR F:ESF:J.~NSIB!.l:..ITIE~
<br />If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with
<br />state and local regulations. If the contractor )s. not licensed as required by law, both the owner and contractor lay be
<br />cited for a lisde.eanor violation under state IaN. If the owner or intended contractor are uncertain as to what licensing
<br />require.ents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, (813)
<br />7BB-bb 11.
<br />
<br />Furtherlore, 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 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 lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrhills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~
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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 LaN - Ho.eoNner's Protection
<br />Guide" prepared by the Florida Departlent 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 doculent and promise in good faith to deliver it to the
<br />'owner' prior to cOI.ence_ent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIr
<br />I certify that all the infor_ation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land develop.ent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOI.enced prior to issuance of a per_it and that all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning regtlations, and land develop.ent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governmental 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 include but are not li.ited to:
<br />f Depart.ent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
<br />Water/Wastewater Treatment
<br />f Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways '
<br />f Department of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatment, Septic Tanks
<br />J US Environlental Protection Aqencv - Asbestos abatement
<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 'cotpensating volule' will be subtitted w~:ch is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A permit 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, nnr shall issuance of a pertit 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 per.it is cOI.eneed within six lonths of issuance, or if work authorized by the permit is
<br />suspended or abandoned for a period of six lonths after the tile the work is commenced. One 90 day extension of time, lay be
<br />allowed ~or the perlit with fee charge of $15.00. The extens~on 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 COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />C,"",'C""T.. JO:, UND" ",'O~ 'AlUE DO 'OT "'D TO "CO'D A'D PO.'T"A "OTIC' OF CO":'C""T',
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<br />~~ ~~
<br />
<br />SIGNA URE: OWNER OR AGENT IGNATURE: CONTRACTOR
<br />
<br />}.J~'-SoJ..J 7<y l'1AJJ
<br />who is personally knDwn to me"€l- d1t: ~,a-
<br />~reelL\E:e:J
<br />~!! ~delltif~,-""Ll.'" and whc, -8+EWdid not
<br />
<br />STATE OF FLORIDA 11
<br />COUNTY OF rA 5 eO
<br />The foregoing instrument was acknowledged
<br />befcq-e me this A.IDilG'1~ 3~ 19_U by
<br />
<br />W/Z.I SO Ai 7( Y HAJJ
<br />who is pel-sonally kno\.oJn to me .,r IJhl> h2~
<br />pn: elUEfid{;;l
<br />.:\:; i{;;lgpf; r'" ~tiU'l1 and who ~/did not
<br />
<br />tak~m~ 9b-'>7VYJ
<br />
<br />(Signature) Ai
<br />)( A Tf..f I ~e.1J J: 15 Ro--tAJ
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />STATE OF FLORI~
<br />COUNTY OF 1/ A se 0
<br />The foregoing instrument was acknowledged
<br />before me th i 5 J.)ova-f6a 3, 19.2.2_ by
<br />
<br />tak~12rl~ 9 ~
<br />(Signa ure)
<br />J.( Am LiiE e; ^-.J ..r 13R-t7WN
<br />(Name Typed ~ Pl- i nted or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />KATHLEEN ..1. ,",c','
<br />StOlt.., :f .
<br />My Comm. Exp,
<br />Camm. , CC
<br />
<br />(~\
<br />Jtl
<br />
<br />KATHLEEN J. 8ROWN
<br />State of F;c,""'.
<br />My Comm. Exp. April 2, 1~95
<br />CoIII'Il. . tc 095617
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