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<br />CONDITIONS OF PERMrl AFFIDAViT
<br />.A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this peraitjjay be subject to 'deed restrictions" wbC:h, may be ,Iliore .res,trictive than Ci t~
<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 t; undertake Nork, th~y say be required to be licensed in accordance Nith
<br />state and local regulations. If the contractor is not. ljcensed as required by law, both the owner and contractor lay be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what lic:nsing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (B131
<br />788-6611.
<br />
<br />Furtherlore, if the owner has hired a contractor or contractors, he is ;dvised to have the contractor(sl 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 aay 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 FEE~
<br />
<br />D. CONSTRUCTION LIEN L~~ (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have be~n provided with a copy of "Florida's Construction Lien Law - HOleoNner's Protection
<br />Guide" prepared by the Florida Department of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
<br />"oNner", I certify that I have obtained j copy of the above described document and promise in good faith to deliver it to the
<br />"owner" prior to cOltence.ent.
<br />
<br />E. CONTRACTOR'S/OWNER'~ AFFIDAVIT
<br />I certify that all the infor.ation in th:s application is accurate a~d that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, Loningl ard land developlent.
<br />
<br />Application is hereby made to obtain a p~rlit to do work and in~tallation as indicated, I certify that no work or
<br />installation has co.menced prior to issu1nce of a per.it and that all work will be performed to leet standards of all laNS
<br />regulating construction, City codes, zon:og regulations, and land develop.ent regulations in the jurisdiction. I also
<br />certify that I understand that the regul,tions of other governmental agencies lay apply to the intended work, and that it is
<br />IY responsibility to identify what actie .s I lust take to be in cotpliance. Such agencies include but are not lilited to:
<br />t Departlent of Environlental ReQulatioo - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />I Southwest FIDrida Water KanaQelent Discrict - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlV Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health ~ Rehabilitative .oervices, Environmental Health Unit - Wells, Wastewater Treataent, Septic Tanks
<br />t US Environlental Protection AQencv - Acbestos abate.ent
<br />I also certify that, if fill .aterial i~ to be used in Flood Zone "A' or "A,etc,", it is understood that a drainage plan
<br />addressing a "colpensating volule" will ~e sub.itted which is prepared by a professional engineer registered in the State of
<br />Florida prior to pertit issuance,
<br />
<br />A pertit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, Dr
<br />set aside any provisions of the technical codes, nor shall issuance of a pertit prevent the Building Official frol thereafter
<br />requiring a correction of errors in pIano, construction, or violatiDns of any code, Every pertit issued shall becole invalid
<br />unless the work authorized by such perli~ is co.menced within six tonths of issuance, or if work authorized by the permit is
<br />suspended or abandoned for a period of Sox tonths after the tile the work is co.~enced. One 90 day extension of tile,'lay be
<br />alloNed for the perait with fee charge of $15,00. The extension shall be requested in writing to the Building Official, An
<br />approved inspection lust be logged durin) each sil lonth period, or the project Hill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORel A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING THICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINAN.~INS, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDINS YOUR NOTICE OF
<br />CD,"NC'" T. JDBS UNDER ":'OD I' Y~DT N"D TD "CDRD AND ~~~F ~"~
<br />
<br />
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />
<br />STATE OF FLORIDA I
<br />COUNTY OF fItS (! U
<br />The foregoing instrument was acknowledged
<br />befc'l-e me this ;;'()~Ql[J;~F/J...L by
<br />
<br />1: ,/t ;! k"-L-<-?c./'YFI &, /'-::], a-e-L
<br />whc. is p~'::,s~~~y knO\'Hi tc, mc! Clj- whcl has
<br />prc.duced
<br />as identification and whc, dill/did not
<br />take an oath.
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrumel
<br />befcl\-e me th i 5 J. - L
<br />
<br />
<br />vias acknovlledged
<br />/c..".19 ~ by
<br />
<br />__'0-/ uLL~1'-' JJ. j( 5' ~
<br />~!h.?___i s pel-sona 11 y known to me Dr who has
<br />pl-oduced
<br />as identification and who did/d~
<br />take an oath.
<br />.---- --_..- ._..._---- _.---
<br />
<br />---
<br />
<br />(Signa.tle> :d,' ~ *
<br />,tj ./ I.tJ.--t. __ . U!.. P d.
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
<br />~~ilA SU~. ,,-.
<br />..,:....cuy Pubn... ~.~HlffmJ
<br />""- "'. ..aa:~ !!C'; .1:"
<br />......lIm.' .. , ~~a
<br />No, ~~ J'~a~
<br />
<br />(SignatLlI-e) l/ '
<br />/l '~L
<br />(Name Typed, Printed
<br />NOT ARY ~'tJBL I C
<br />
<br />k~~
<br />
<br />Cq- Stamped>
<br />
<br />DEBRA SUE STREETS
<br />Notary Public, Sfa!G ot Aorida
<br />My comm, expiros 0,;1. 29, j l:l9S
<br />Nc. CC1~G?9J
<br />
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