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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS _
<br />!be undersigned understands that this petlit lay be subject to "deed restrictions" wbich laY be lOre restrictive than City
<br />, regulations. !be undersigned assues responsibility for cmpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the orner bas bired a contractor or contractors to undertake work, they lilY 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 lilY be
<br />cited for a .isd_anor violation under state law. If the orner or intended contractor are uncertain as to wbat licensing
<br />requirl!lellts lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherJOre, if the orner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for which they will be responsible. If you, as the orner 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 pmitting privileges in the
<br />City of zephyrhills.
<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 provided with a copy of "Florida's Construction Lien Law - lIOIl!OlIJler's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and COI18Uller Affairs. If the applicant is 8OftOJIe other than the
<br />"orner", I certify that I have obtained a copy of the above described docUIent and pralise in good faith to deliver it to the
<br />Romer" prior to COII8J1CeleJlt.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land develoPEDt.
<br />
<br />Application is hereby lade to obtain a pmit to do work and installation as indicated. I certify that no work or
<br />installation has CCJIIeIlced prior to issuance of a pmit and that all work will be perforJed to .et standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlellt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goVeI1llenW agencies lilY apply to the intended work, and that it is
<br />If responsibility to identify what actions I lUst take to be in COIpliance. Such agencies include but are not Iilited to:
<br />t Departlent of EnvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and Invirolll8Jltally Sensitive Lands,
<br />Water/lfastewater freal:lent
<br />I Southwest Florida Water HanageleJlt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />I Ally Corps of Engineers - Seawalls, Docks, Kavigable Watenays
<br />I Deparl:lent of Health i Rehabilitative Services, InvirOl1l8J1tal Health Unit - Wells, Wastewater freatlent, Septic fanks
<br />I US EnviroDlental Protection Agency - Asbestos abatl!lent
<br />I also certify that, if fIll laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "COIpeJl8ating volllle" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to petlit issuance.
<br />
<br />A petlit issued sball be construed to be a license to proceed with the wod: and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a pmit prevent the Building Official fral thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perli~ issued shall becoIe invalid
<br />unless the work authorized by such perIIit is COII8J1ced within sillOJlths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sil IOIItbs after the tile the work is co.enced. One 90 day I!Itension of tile, lilY be
<br />allowed for the petlit with fee charge of $15.00. !be I!Itension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned.
<br />limING to MER: YOOR FAILURE fO RICORD A KOlICH OF C<IIMDCIIIDf MAY RESUL! IN YOOR PAYIIfG DICH FOR DlPROVIIIDfS fO YOOR
<br />PROPERtY. IF YOU IIIfBIfD to OBtAIK FlIfDCIIIG, COIfSULf WID YOOR LlllDER OR 111 AnomY BEFOBI RICORDIIG YOOR IIOfICH OF
<br />COMMEKCBMBNf. JOBS UKDER $2,500 IN VALUE DO IfOf KEID to RECORD AIfD POS! A "KOlICH OF C<JlIlIICBIIDf'.
<br />
<br />~~~-
<br />
<br />SIGlfAfURB: c~._ )\ -
<br />
<br />~~
<br />SIGlfAfURB: CMIER OR AGEJIf
<br />
<br />SfAfE OF F~
<br />COUNfY OF ~s; cO
<br />The foregoing i"tfUDlent was acknowledged
<br />before me this ~. \ ( , 19q1f by
<br />
<br />\:)\' (\ ~~ ~t1~~tJ -
<br />who is personally known to me or who has
<br />produced t-J ~ ]), .".Ie r~ L, ~ N;;; ~
<br />as identific ion and who did/did not
<br />
<br />taif~ m(~
<br />~ atur:> 11 }11 ( ~ II L{ ff1
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />SfAfE OF FLORIDA IJ
<br />coom OF r,/",~'c_d
<br />The foregoing instrument was acknowledged
<br />before me this J::J.rv....r8 /7, 19.1L by
<br />
<br />LAu(vY'\C-e, A. A. /J.,. /505'1
<br />who is personally known to me or who has
<br />produced fL-r'd..h {:J (""""5 L,'(.(l Y'I~
<br />as identif'cation d who did/did not
<br />take an t.
<br />
<br />.~~.. OFFICtAL SEAL
<br />(~\ SUSAN At. McOO\LUM
<br />1 My Com.......lxpires
<br />to : Aprll.8,1997
<br />\.~,-' rlr~l Comm. No. CC 268679
<br />'"It,;.~CP ~.~
<br />..........
<br />
<br />
<br />JOSEPH BIENGARDO
<br />NorARY PUBUC Sf ATE OF FLO
<br />COMMISSION NO. CC211686
<br />....;.,'\W CS!:'rtMlSSION EXP. UNE 25,1996
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