|
<br />f>r~ ,..-.;r
<br />
<br />CONDITIQNS C~ PERMIT AFFIDAVIT
<br />A. NOT I CE OF DEED RESTR I CT J.Di\lfi '
<br />The nndersigned understands that this perlit may be subject to 'deed restrictions" which lay be lore restrictive than City
<br />regulations. The undersigned assules r~spol~ibility for cOlpliacce Mith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the /Jllner has hired a contractor, or ~!>ntrac:tcrs b undertake work, they lay be requi;;dt;b;licensed in accc<rdance with
<br />state and local regulations. If the contractor is' not licensed as required by lall, both the owner and contractor lat be
<br />cited for a lisdeeeanor violation under state law. If th~ OllnEr or 'intended contractor are uncertain as to what licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, (BI3)
<br />7BB-bbl1.
<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 aay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of 2ephyrhills.
<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 providerl with a copy of "Florida's Construction Lien Law - HOleollner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and :onsuler Affairs. If the applicant is sOleone other than the
<br />"ollner", I certify that I have obtained a copy of the above descrihed document and promise 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 compliance with all
<br />applicable laws regulating construction, zoning,' and land developlent.
<br />
<br />Application is h~reby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of.a perlit and that all work will be perforled to leet standards of all laws
<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 governmental agencies lay apply to the intended lIork, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />f Department of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
<br />Water/Wa5tewater Tr~atlent
<br />f Southwest Florida Water KanaQelent District - WElls, Cypre~~ Bayheads, Wetland Areas, Altering Watercourses
<br />f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways .
<br />f Departlent of Health ~ Rehabilitative Services, Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f US Environlental Protection AQency - Asbestos abatement
<br />I also certify that, if fill laterial is to be used in Flood 2~r:e "An or "A,etc.., it is understood that a drainage plan
<br />addressing a "coapensating volule" will be sub.itted which is prepared by a rrofessional 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 code~, 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 pertit issued shall becole invalid
<br />unless the work authorized by such perlit is co..enced within six tonths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six lonths aftEr the tilP the work is cOllenced. One 90 day extension of tile, lay be
<br />allowed for the pertit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection,must be logged during each six tonth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHKENCEKENT MAY RESULT IN YOUR PAYING TWICE FOP. 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 VALUE no NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />was ackn0wledged
<br />, 19__.. by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />befcq-e me th i s
<br />
<br />STATE OF,FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was ~cknowledged
<br />~ if by
<br />
<br />-
<br />who is personally known to me Dr who has
<br />r,roduced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />who is personally known to me Dr who has
<br />prc,duced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(SignatUl-e)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOT ARY PUBL I C_
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
|