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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perlit laY be subject to -deed restrictions- wbieb laY be lOre restrictive than City
<br />I regulations. !he undersigned asSUlt!S responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertake work, they laY 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 lisdeJeallOr violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />reguireJents laY apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />Furthel'lOre, if the owner bas hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections- of this application for wbieb 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 wisbes you to sign
<br />as contractor that laY be an indication that be is not properly licensed and is not entitled to peraitting privileges in the
<br />City of Zepbyrhills.
<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, bave been provided with a copy of -Florida's COnstruction Lien Law - lkIIeoImer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsWler Affairs. If the applicant i8 SOMODe other than the
<br />-owner", I certify that I have obtained a copy of the above described dOCUlll!llt and pfOlise in good faith to deliver it to the
<br />"owner" prior to COllellCeJent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforlation 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 i8 bereby Jade to obtain a pmit to do wort and installation as indicated. I certify that no work or
<br />installation bas ~ced prior to issuance of a perait and that all wort will be perfol'led to leet stanc1ards of all laws
<br />regulating construction, City codes, loning regulations, and land develo(llBllt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gOYerDIIl!Jltal agencies laY apply to the intended wort, and that it is
<br />If responsibility to identify wbat actions I lUst take to be in COIpliance. Sueb agencies include but are not lilited to:
<br />Ii Departlent of EnvirOlllelltal Regulation - Cypress BaybeacJs, lIetland Areas and Envirollllelltally Sensitive Lands,
<br />Water/llastewater !reatlent
<br />Ii Southwest Florida Water KanageJent District - lIells, Cypress Dayheads, Wetland Areas, Altering Watercourses
<br />Ii Al'IJ Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />Ii Departlent of Health i Rehabilitative Services, BnvirODllel1tal Health unit - lIells, Wastewater !reatlent, Septic '1anks
<br />Ii US EnvirODlelltal Protection Agency - Asbestos abatl!lel1t
<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 -COIpeJlSating wIllie- will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perait 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 ffOl thereafter
<br />reguiring a correction of errors in plans, construction, or violations of any code. Ivery perJit issued shall beCClle invalid
<br />unless the work authoriJed by sueb perlit is ~ced within SillODtbs of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of sillODtbs after the tile the work is C08eDced. One 90 day eltension of tile, lay be
<br />allowed for the perlit with fee charge of $15.00. '1be eltension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillODth period, or the project will be considered abandoned.
<br />wmIllG 'rO (JfIIR: YOUR FAILORB 'rO RECORD I IO'I'ICE OF aJIKDCBIlBI'f lilY RESUL! IK YOUR PIYIK' niCE FOR IKPROVIIIIIfS to YOUR
<br />PROPIRft. IF YOU IIlDRD 'rO OB'fIIJ FIIIIRCING, COISUL! WID YOUR LIRDER OR AI 1!'fORIiY BEFORE RICORDIKG YOUR JIO!ICI OF
<br />C(IIKINcmm. JOBS OlDER '2 SOO A VALUE DO N~~!O RECORD AND" POS'I A -NO'flCE OF aJlKBlCIKD'f, '.
<br />
<br />W~ I(J~ .
<br />"at . '~If'-
<br />
<br />SIGJIA'fURI: OR P"'~fN\L Kj\.Owb~E:' SIGlA'fURI: COI'f R f'C:::;R="-AL ~~
<br />
<br />
<br />S'IA!I OF FLORIDA .
<br />coum OF \,\ \ \\ s \
<br />The foregoing instrument was acknowledged
<br />before me this 14 "'"f~8'1 ' 19.1.l1=-- by
<br />
<br />\K '
<br />\'J. ~ r.\, " '- ,
<br />....." !'~}ct~ " Lt:..t/v
<br />who is ersonally known to ~r who has
<br />produced
<br />as identification and who did/did not
<br />~an oath.
<br />\r<~ .~~t^A ~
<br />(SigIiature f '
<br />RAY~
<br />(Name Typed,-Prirlted or Stamped)
<br />NOTARY PUBLIC
<br />
<br />SUfi OF FLORIDA
<br />coum OF ~ ~\\f:. .
<br />The foregoing instrument was acknowledged
<br />before me this ILl.... 'V __,' 19 $. by
<br />
<br />~l.ll.1iZP~ R\lSGitil ~l~\:\~. ~iA~dL
<br />who i ersonally known to me r who has
<br />produced
<br />as identification and who did/did not
<br />
<br />~~oa~
<br />
<br />(Signature) ~~
<br />'MY
<br />(Name Typed . r St ed)
<br />NOTARY PUBL C OFFICIAL NOTA, Y SEAL
<br />N;\Y Gi\FF~'JP",\,' ~.
<br />r~arAP.Y PUBL1C 5TI..TF:- i.:YF rLC\p.{DA~
<br />l."XJ~A\'fISE.!ON NO c: ')?1 ,t'"TIj ;
<br />~iY ~o~frvnSS!O!\l.gxj~. ~,j~j:;Tri:,17:~r:61
<br />
<br />OFFICIAL NOTA Y SEAL
<br />P/\ Y Gi\FF-;",iE"'f
<br />'\ 1;-jTl..p'{ !'~.,:?>;_l(_~ (';r/\'T':~ OF FLORIDA
<br />" . . " IVC <'C')14:cil I
<br />,', i j j iQ<G.'Ss'.l2:1?'!6..
<br />
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