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<br />CONDI~ION5 OF PERMIT AFFIDAVIT
<br />A. NOTI~_E OF _Q.~ED_RE_!?JRICT.lpt-m
<br />The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lore restrictive than City
<br />regulations. The undersigned assules responsibility for (o~plian(e with any applicable deed restrictions.
<br />
<br />B. !JNL I CENSED CONTRACTORS AJi~L.CO!:llRA~TOR _RJ;:.p.E.91~S I B_1 L:Cf I Ei2.
<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 is not licensed as required by law, both the owner and contractor lay be
<br />cited for a .isde.eanor violation under state IaN. If the ONner Dr 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 Departlent, 18131
<br />788-6611.
<br />
<br />Furthereore, 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 pereitting privileges in the
<br />City of ZephyrhilIs.
<br />
<br />[' TRANSPORT A T I ON H1PHCT FEE~ {.)t-m UT I!:- I TY .J::;ONNECT I 01'>1_ FEE.2.
<br />
<br />D . ~ONSTRUCT I ON L I EN .!:-AH (CHAPTER 713. FUJH I Df) STATUTES ~ (,S ()MENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - Hoeeowner's Protection
<br />Guide" prepared by the Florida Departeent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
<br />"owner", I certify that I have obtained a copy of the above described doco,ent and proeise in good faith to deliver it to the
<br />"owner" prior to coelencelent.
<br />
<br />E. ~ONTRACTOR' S/QHNER' S AFFIDAY_IT.
<br />I certify that all the inforeation in this application is accurate and that all work "ill be done in co.pliance with all
<br />applicable laws regulating construction, loning, and land developeent.
<br />
<br />Application is hereby eade to obtain a pereit to do work and installation as indicated. I certify that no work or
<br />installation has cO'lenced 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 governlental agencies .ay apply to the intended work, and that it is
<br />IY responsibility to identify what actions I .ust take to be in co.pliance. Such agencies include but are not li.ited to:
<br />, Depart.ent of Environlental Requlation - Cypress Bayheads, Wetland Areas and Environlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />, Southwest Florida Water "anaqelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />J. ArlY Corps of Enqineers - Seawalls, Docks, Navigable Waterways
<br />, Departlent of Health L Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />, US Environ.ental Protection AQencv - 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 "colpensating yolute" Mill be sublitted 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 perlit prevent the Building Official fro. thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beco.e invalid
<br />unless the work authorized by such per.it is cOI.eneed within six lonths of issuance, or if work authorized by the pertit is
<br />suspended or abandoned for a period of six .onths after the tile the work is co..enced. One 90 day extension of ti~e, aay be
<br />alloNed for the per.it Hith 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 lonth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKKENCE"ENT 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 $2,50Q IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />was acknowledged
<br />, 1? _ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />befclj-e me th i 5
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />"leiS acknowledged
<br />~ 19_ by
<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 />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 />(SignatLu-e)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />tlOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOT AR'LPUBL I C
<br />
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