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<br />CONDITIONS UF PERMIT AFFIDAVIT
<br />A. t-IOT I CE OF DEED REJ?TR 1 CT IONS .
<br />The undersigned understands that this perlit lay be subject to "deed restrictions" which .ay be lore restrictive than City
<br />regulations. The undersigned assu.es responsibility for co~pliance Nith any applicable deed restrictions.
<br />
<br />B. WNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contract~~~-t~~I~dertake -;;':k-;th~y--~;y""b;-;:;q;i"';;;-'t~i-icensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor .ay be
<br />cited for a .isde.eanor violation under state IaN. 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 Depart.ent, (BI3)
<br />7BB-bb II.
<br />
<br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(sJ sign portions of the
<br />"Contractor Sections. of this application for which they Nill 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 per.itting privileges in the
<br />City of lephyrhills.
<br />
<br />r:. TRANSPORTATION H1PACT FEE~ ?-)ND UTIJ_ITY,J:ONNECTIOI'( FEE,;!,
<br />
<br />D. ~ONSTRUCT I ON L I EN .,LAI1 (CHAPTER 713, FUJR I Df) STATUTES, ,-=,S ()I'1ENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - Ho.eo"ner's Protection
<br />Guide" prepared by the Florida Depart.ent 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 prolise in good faith to deliver it to the
<br />.0Nner" prior to co..encelent.
<br />
<br />E. ~ONTRACTOR · S/OlrJNER 'S AFF I Df'lY-.!.I.
<br />I certify that all the inforlation in this application is accurate and that. all work "ill be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land develop.ent.
<br />
<br />Application is hereby ,ade to obtain a perlit to do work and installation as indicated. I certify that no work Dr
<br />installation has cOllenced prior to issuance of a per.it and that .all work "ill be perforled to leet standards of all la"s
<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 governlental agencies .ay apply to the intended work, and that it is
<br />.y responsibility to identify "hat actions I lust take to be in co'pliance. Such agencies include but are not lilited to:
<br />, Departlent of Environlental ReQuJation ... Cypress Bayheads, Wetland Areas and EnvironlentaIly Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />I Southwest Florida Water nanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />, ArlY Corps of EnQineers - SeaNalls, Docls, Navigable Waterways
<br />. Departlent of Health & Rehabilitative Services, Environlental Health Unit... Wells, Wastewater Treatlent, Septic Tanks
<br />, US Environlental Protection Aqency - Asbestos abatelent
<br />I 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 .co.pensating yolute" Nill be sub.itted 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 becote invalid
<br />unless the Mork authorized by such per.it is co..enced within six .onths of issuance, Dr if work authorized by the per.it is
<br />suspended or abandoned for a period of six lonths after the ti.e the work is co..enced. One 90 day extension of ti.e, .ay be
<br />alloNed for the perlit Kith fee charge of 115.00, The extension shall be requested in writing to the Building Official. An
<br />approved inspection .ust be logged during each six lonth period, Dr the project "ill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT nAY 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 />COMMENCEMENT. JOBS UNDER $2,500 IN YAlUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />SIGNATURE: OMNER OR AGENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />befor-e me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATE OF FLORIDA
<br />COUttTY OF
<br />The foregoing instrument
<br />b""fc'l-e me this
<br />
<br />",as acknowledged
<br />, 19_ by
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identificaticon and who did/did ne.t
<br />take an oath.
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />tmTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTAR'( PUBLIC
<br />
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