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<br />CONDITIO~E ~F PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this per.it ~ay be subject t[ 'deed restrictions" which lay)e lore .restrictive than City
<br />regulations. The undersigned assu.es responsibility for co.plia.,ce with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS I"~r. CONTRAC10R RESPONSIBILITIES
<br />If the owner has hired a contracto~ or contracto~s to u~dertake work; thpy aay be required to be licensed in accordance with
<br />state and local regulations. If tlircbntractor is nDr.,li!"ens~d i:S required by law, both the Oliner and contractor .ay be
<br />cited for a .isde.eanor violation under state laN. !f the ~w~~r or intended contractor are uncertain as to what licensing
<br />requirelents lay apply for the intended work, they are ljv~eJ to.~ontact the City of Zephyrhills Building Depart.ent, (8131
<br />788-6611.
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<br />Further.ore, if the Oliner has hired a contractor or contrac~ors, he is advised to h~ve the contractor(s) sign portions of the
<br />'Contractor Sections' of this applic~tion for which they Will be responsible. If you, as the Oliner .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 per.itting privileges in the
<br />City of Zephyrhills.
<br />
<br />c. TRANSPORTATION IMPACT .EJifS_ ~1'!D UTILITY CONNi~CTION FE_!;.~.
<br />
<br />D. CONSTRUCTION LIEN LAw {C~AFrER. 13, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction lien law - Ho.eowner's Protection
<br />Guide' prepared by the Florida Depart.ent of Agr.culture and Consu.er Affairs. If the applicant is so.eone other than the
<br />'oNner', I certify that I have obtained a copy of the above de~=ribed document and promise in good faith to deliver it to the
<br />'owner' prior to co..ence.ent.
<br />
<br />E. CONTRACTOR I S/O\.oJNER' S AFFrr:~VIT
<br />I certify that all the infor.ation in this application is accurate and that all work will be done in cD.pliance with all
<br />applicable laws regulating construction, zoning, ann land develop.ent.
<br />
<br />Application is hereby lade to obtain a per_it to do NorK and installation as indicated. I certify that no work or
<br />installation has co..enced prior to issuance of a per_it and ~hat all work will be perforled to leet standards of all laws
<br />regulating constructiun, City codes, zoning regulations, and ~;<nd developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govern~ental agencies lay apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lust t~ke to be in cOlpliance. Such agencies include but are not li.ited to:
<br />f Departlent of Environlental ReQulation - Cypress Bayheads, w~tland Areas and Environmentally Sensitive lands,
<br />Water/Wastewater Treatment
<br />f Southwest Florida Water ManaQelent District - Wells, CYrress Bayheads, Wetland Areas, Altering Watercourses
<br />f Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterway~ '
<br />f Depart.ent of Health ~ Rehabilitative Services, Ervlronlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />f US Environ.ental Protection AQency - Asbestos aba~elent
<br />
<br />I :15D certify that, :f fill =~~~r~~l is t~ ~t ~;~~ i~ ~~::d ~"i~~ .~. ~~ a~,2t~..5 ~t is ~nd2r5t0Gd th~t a Jr~ifiig~ pl~~
<br />addressing a 'colpensating volule' will be sublitied which is rrepared by a professional eng.ineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />
<br />A pertit issued shall be construed to be a license to proceed Nith 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 per.it prevent the Building OffiCIal frol fhereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall bee ole invalid
<br />unless the work authorized by such per.it is coamenced within six Bonths of issuance, or if work authorized by the permit is
<br />suspended or abandoned for a period of six lonths .fter the tile the work is com~enced. One 90 day extension of t}le, lay be
<br />allowed f~r 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 eact. six ,on,h period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YllUR FAILURE TO RWlilD k NOi!tE J~ UJiiMENCEMENT tlAY RESULT IN YOUR PAYING TIIICE FOR HIPROVEtlEtHS 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 VAlU 0 NOT NEE~ TO RECORD AND POST A "NOTICE OF COMMEtlCEKENT'.
<br />
<br />
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<br />
<br />STATE OF FLORIDA
<br />COUNTY O( __._.~SCf>_. _ .
<br />The foregoing instrument ~a~ ...~, -L l~
<br />befc.re me this 41/),7 , 199-L/ by
<br />
<br />STATE OF FLORIDA ~
<br />COUNTY OF __. __ _.l..}.s.(:.CL._ _ .. _'___" __ __.
<br />r.l~ foregcinG instrument W25 ac~r~wledged
<br />befcl}-e me th i 5 LJ I:J,? , 19..5!L- by
<br />
<br />who is personally known to me or who has
<br />produced \Pf'YStO.'"'\Cll\l~ ~\~_.____
<br />as identification and lhc. dld/dld n~'
<br />t?l~e an oath.
<br />L'j..,. _roo" ~. --rY'tn v'"
<br />(~ignature)
<br />L.hr~,~-\\ e L. f'r\a ~ 1=-
<br />(Name Typed, Printed or amped)
<br />NOTARY PUBLIC
<br />
<br />w . A . ~\e umo.rd'\
<br />who is personally known to me Dr who has
<br />pl-oduced <\)eT~ ,,,\0.\ \ d.. ~ ('\6 \...a. '>~
<br />as"identification and who did/did not
<br />"5..ake an oath. .
<br />t~h... Q.C'- : ~. 1Ylf1~
<br />(SignatLr:-e)
<br />C.h.t.L.."i...-tl.~ L . N\~c"\ r-
<br />(N~me Typed~ Printed Dr amped)
<br />NOTARY PUBLIC
<br />
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