|
<br />,r------ ~.
<br />
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlitsay be subject to .deed restrictions. which lay be .ore restrictive than City
<br />regulations. The undersigned assules responsibility for co.pliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the ONner has hired a contracto~ or Fontractors to undertake work, they lay be required to be licensed in accordance with
<br />state and local regulations. If the contractor is no~ 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 />reQuirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Department, (BI3)
<br />7BB-MI1.
<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 Nhich 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.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEE~
<br />
<br />D. CONSTRUCTION LIEN LA~ (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of .Florida's Construction Lien Law - HOleowner's Protection
<br />Guide. prepared by the Florida Departlent 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 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 cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<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 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 regtlations, 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 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 lilited to:
<br />f Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
<br />Water/Wastewater Treatment
<br />f Southwest Florida Water HanaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways .
<br />f Departlent of Health L Rehabilitative Services, Environ_ental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f 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 .colpensating volule. 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 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 perlit is cOllenced within six lonths of issuance, or if work authorized by the per.it is
<br />suspended or abandoned for a period of six lonths after the tile the work is cOllenced. One 90 day extension of tile, lay be
<br />allowed ~or the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved-inspection lust be logged during each six .onth 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 />CD;'ENCE'ENT. JDDS ONDER' 500 IN VAlOE DO NOT NEED TO RECORD AN~D~~"
<br />
<br />
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF f) A S CD
<br />The foregoing instrument was acknowledged
<br />before me th i s ~AIJ<AR.'I '1, 19 -P:L by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF -P 1+ S c..-O
<br />The foregoing instrument was acknowledged
<br />before me this ~~g~, 19~ by
<br />
<br />}/ E/-SoJl ~y )~A AJ
<br />who is personally known to me Dr who has
<br />pl-oduced
<br />as identification and who did/did not
<br />
<br />t_l~- ~3ild~ .. (I. ,6/k~
<br />
<br />t'Siqnature) Z;
<br />I~ 4-TJ-fL,e-r ~} .J:.)7.; Rt3-r;J;J
<br />(Name Typed, 'r i -nted Cll- Stamped)
<br />NOTARY PUBLIC
<br />
<br />N ~LSD,.j 7?y M It';
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />ta~~ y ~Uf~--'
<br />
<br />~ignatLll-e) {/
<br />"'AmL EEJ<J ~ 13 R i/W.2J..
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PUBLIC
<br />
<br />tI'.~"t, .
<br />'1.... ..~. ~('
<br />~ .. ..'''''' '.
<br />j.,;g
<br />.~.;....,........,."
<br />
<br />KATHLEEN J. BROWN
<br />Slate of florida
<br />My Cot'l1ll1. Exp. April 2. 1_
<br />Carom. , CC Q95817
<br />
<br />~"lI.
<br />~;"
<br />~
<br />
<br />KA THlEEN J. BROWN
<br />State of FIoIIda
<br />My Corrm. ExIt. AId 2, 1995
<br />CoRm.' tc 095617
<br />
|