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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned ,understands that.this perlit lay be subject to 'deed restrictions' which lay be lore restrictive than City
<br />regulations. The undersigned IIsules responsibility for colpllance lIith any applicable deed restrh:tions'.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the ollner has hired a contractor or contractors to undertake work, th~y'.lay be required t~ be liclnled iR accordance with
<br />Stltl Ind local rlgulltions. If, thl contractor is not" licensed' as required by lall,both' thi ollner,"ind contractor lay hi
<br />dt.,~fora ~.~~del~anor dlllat~on under state law. If. the ollner o~ intended contractor. are uncer~aino\ as ~o Ilhll licensing
<br />requlrelenb lay apply for thidntl!nded Ilork, thl!Y are advi!;l!d to 'conta'ct' the City of lephyrhiHsBuiIding Departlent,(813)
<br />788-6611.
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<br />F.ur.thl!rlo~~, if the owner hasbir.ed.a contr~ctor or contractors, ~e is advised to have :the coJitrattl(lr (s) sign portions of the
<br />'Contrattor Sl!ctions' of this lpplication for IIhich they will 'b! rl!sponsible. if'you, as the owner sign as the'contractor,
<br />you are indicating that you, ratKer .than the contractor, are responsible for the work. If the contract~r wishes you to sign
<br />as contractor that aay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrhills. ._
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<br />C. TRANSPORTATION. IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES,.~S AMENDED)
<br />I certify that I, thl! applicant, havl! bel!n providl!d with a copy of 'Florida's Construction'LienLall'- HOIl!ownl!r's Protection
<br />Suidl!' prl!parl!d by thl! Florida Departlent of Agriculture and ConsUll!r Affairs. If the applicant is sOleone other than the
<br />'ownl!r', I certify that I have obtained a copy of the abovl described doculent and prolise in good faith to deliver it to the
<br />'owner' prior to cOllencelent.
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<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 ~one in c~lpllance with all
<br />applicable laws regulating construction, zoning, and land developlent. ,'. ' :.' .','"
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<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 lIill be perforled to leet 'standards' of' all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the' jurisdic~ion. I also
<br />certify that I understand that the regulations of other governlental agencies lay apply'to the intended lIork, 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 />I Departlent of EnvirontentaI Reoulation - Cypress Bayheads, Netland Areas and Environlentally Sensitive Lands,
<br />Nater/Wastewater Treatlent .
<br />I Southwest Florida Water "anaQelent District - Wells, Cypress Bayheads, Netland Areas, Altering' Watercourses
<br />f ArlY Corps of EnQineers ~ Seawalls, Docks, Navigable Waterways
<br />I Departlent of Health 1 Rehabilitative Services, Environlental Health Unit - Wells"Wastewater Treatlent, Septic Tanks
<br />I US Environ"ntal Protection Aoency - Asbestos abatelent ":, .
<br />I also certify that, if fill latl!rial is to be used in Flood Zone 'A' or "A,etc.", it is understood that a drainage plan
<br />addressing a 'colpensating volute' will be sublitted which is prepared by a professional engineer registered in the state of
<br />Florida prior to perait issuance. .. ;' I .
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<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 8uilding.,9~f1ci~1 frOI ~h~reafter
<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 witbin six lontbs of issuance, or if work authorized by the perlit is
<br />suspended or abandoQe~ for a period of six lonths after the tile the work is cottenced. One 90 day extension of tile, lay be
<br />allowedfortheperait.;witb fee. charge.. ~f..$15..00. The extensiDn shall be requested in ~n Hng to tb~ ,B.~\l.di~) Official~;. An
<br />approved inspection IUsl. .be.l.Dgged during each six lonth period, or the project lIil,l be considered abandoned."" .
<br />WARNING TO DIINER: f.~OUR: FAILURE TO. RECORD A NDTICE OF Co.KKENCEKENT KAY RESqLT)N, Y9UR. PAVlNS TWICE. fPR.J"PROYE"ENTS TO. YOUR
<br />PROPERTY. IF YOU INTEND TO. OBTAIN FINANCING, CDNSUlT WITH YOUR LENDER DR AN ATTDRNE~ BEFo.RE RECDRDING'YOUR NOTICE DF '
<br />CO"KENCEKE~~:'~JOB~ UMDER .~2,500 I~ YALUE DO NOT NE~D TO RECORD AND POST A 'NOTICE,OF CO"~ENC~"ENI'.
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<br />SIGNATURE: OWNER DR AGENT SIGNATURE: . CONTRACTOR-' ",,' -------
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<br />STATE DF FL~~" ,
<br />COUNTY o.F ~<"""'l
<br />The foregoing instr.ument
<br />before me this ~ ^
<br />
<br />was acknowledged
<br />19~ by
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<br />,
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC 1,\ n/'i\
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<br />~.,.y p~~
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<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLI C . (
<br />~.."v pu,
<br />+~ ~(+ TARA N ALFORD
<br />. II. My Commlselon CC263392
<br />- · ExpIr.. Mar 09.1991
<br />-Ii'. iIl'- HuokIeberry Anoc:iatee lno
<br />~J: ~~ 800-422-1556
<br />tOFf'''\)
<br />
<br />TARA N ALFORD
<br />My ComrniaIon 00283392
<br />Exp\r.. Mar 09.1987
<br />Hucklebelry AMOGIates Inc
<br />100-422,165&
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