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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS'
<br />The undersigned understands that this per.it .ay be subject to "deed restrictions" which may be ~ore restrictive th," City
<br />regulations. The undersigned assules responsibility for co~pliance with any applicable deed restrictions.
<br />
<br />B. UNL I CENSED CONTRACTORS AND CO"ITRACTqfLE:ESE:.m~~L[-J..I.1::..LI.Lsf'.
<br />If the owner has hired a contractor or contractors to undertake work, they may 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 ~ay be
<br />cited for a .isdeleanor violation under state law. If the owner Dr 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 Depart~ent, (813)
<br />788-bb 11 .
<br />
<br />Further.ore, if the Dwner has hired a contractor or contractors, he is advised to have the 'contractor(sl sign porti[lns of the
<br />'Contractor Sections" of this application for which 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 per.itting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY _COl':lNECT)O.t:!. 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 - Homeowner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and Conslller Affairs, If the applicant is someone 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 tel the
<br />"owner" prior to cOI.ence.ent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVII
<br />I certify that all the infor.ation in this application is accurate and that all work will be done in compliance with all
<br />applicable laMS regulating construction, zoning, and land develop.ent.
<br />
<br />Application is hereby lade to obtain a per.it to do work and installation as indicated. I certify that no worr. Dr
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perfor.ed to meet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. ! 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 />'y r!rsponsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li~ited to:
<br />J Departlent of Environ.ental ReQuIation - Cypress Bayheads, Wetland Areas and Environmentally Sensitiye Lands,
<br />Water/Wastewater Treat.ent
<br />f Southwest Florida Water ManaQement District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />f Department of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treatment, Septic Tanks
<br />j ~S Fnviron~ental PTDtEE~jon nq~n[v - A~h!5In~ ~h~.p~ent
<br />I als~ certify that, if fill laterial is to be used in Flood Zone 'A" or "A,etc.", it is understDod that a draInage plan
<br />addressing a "compensating yolule" Mill be sublitled which is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it issuance.
<br />
<br />A perait issued shall be construed to be a license to proceed with the worr. and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every per~it issued shall beco~e invalid
<br />unless the worK authorized by such perlit is cOM.enced within six Donths of issuance, or if worr. authori~ed by the permit is
<br />suspended or abandoned for a period of six lonths after the tile the work is com~enced. One 90 day extension of time, may bE
<br />allowed for the perait with fee charge of fI5.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection must be logged during each six month period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCE"ENT 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 />COM"ENCE"ENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMMENCEMENT".
<br />
<br />~IO~ J110.~
<br />
<br />SIGNA URE: OIlNER OR ENT SIGNATlIRE: cot'll TOR
<br />
<br />STATE OF FLORIDA (j.). l)
<br />COUNTY OF .. ('),:5(1
<br />Theforegoin? ~;t;r~ment
<br />before me thIS!.. '-1
<br />,
<br />
<br />was acknowledged
<br />, j 9!i.!J. by
<br />
<br />STATE OF FLORIDA ~
<br />COUNTY DF / (l "5(10 __
<br />The foreC)C1int] instr"ument. v.t2~ ,aCif4iledged
<br />befcll-e me th i s ,7/ I q . ~ 1 C;' by
<br />
<br />w, ~ ~P\ lLSY"'Cl (\1')
<br />who is personally known to me Dr who has
<br />produced
<br />as identification and who did/did not
<br />I
<br />take an oath. /)} . J 4YJ .
<br />(J2./j /)*" .s:L- ~ '
<br />(Signature)./?, . I. L .r1/)..
<br />(;L]n~-rIF _ - Lllo IOJ
<br />(Name Typed, Printed Dr Stamped) J
<br />tJOTARY PUBLIC
<br />
<br />l 0 C\ W P_U-C'Y\ 0 " r"J
<br />who is personally known to me Dr who has
<br />pl-oduced
<br />as identification and who did/did not
<br />take an oath../J/ .. . U --:?"Y?
<br />~ --'" Z ~ czL- L../LL' /~
<br />(SignatLl1-e) /1, . I. L /'
<br />~J -')r.Jr- _ - /}X.-~ ,c")r
<br />(Name Typed, Printed Dr Stampe~) U
<br />NOTARY PUBLIC
<br />
<br />.;;":
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