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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The und~rsigned understa~ds that this pertittay be subject to "deed restrictions. which tay be lore restrictive thin City.
<br />regulatIons. The undersIgned 'SSUltS responsibility for cOlpliance with any applicable deed restrictions. ' ,
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner h.s hired a contractor or contr.ctors to undertake work, they tay 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 tisdeteanor violation under .state law. If the ONner or intended contractor are uncertain as to what licensing
<br />requirelents tay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departtent, (813)
<br />788-111111 .
<br />
<br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractorls) sign portions 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 pertitting 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 - HOleoNner's Protection
<br />6uide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
<br />"owner., I certify that I have obtained a copy of the above described docutent and protise in good faith to deliver it to the
<br />"owner" prior to cOltencetent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infortation in this application is accurate and that all work Mill be done in cotpliance with all
<br />.pplicable laws regulating construction, zoning, and land developtent.
<br />
<br />Application is hereby lade to obtain a pertit to do work and installation as indicated. I certify that no work or
<br />installation has cottenced prior to issuance of a pertit and that all Nork will be perforted to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developtent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governtental agencies lay apply to the intended work, and that it is
<br />IY responsibility to identify what actions I tust take to be in cOlpliance. Such agencies include but are not litited to:
<br />I Deoart.ent of Environeental Regulation - Cypress Bayhe.ds, Metland Areas and Environlentally Sensitive Lands,
<br />Water/Wastew.ter Treatlent
<br />I Southwest Florida Water "anaqe.ent District - Wells, Cypress Bayheads, Metland Areas, Altering Watercourses
<br />I Arty Corps of Engineers - Se.walls, Docts, N.vigable Waterways
<br />I Departlent of Health & Rehabilitative Services. Environlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />I US Environaental Protection Agency - Asbestos .batelent
<br />I also certify th.t, if fill laterial is to be used in Flood Zone "A" or "A,etc,", it is understood that a drainage plan
<br />addressing a "colpensating volule" will be subtitted which is prepared by a professional engineer registered in the State of
<br />Florid. prior to per.it issuance.
<br />
<br />A perlit issued shall be construed to be . 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 sh.ll issuance of a pertit prevent the Building Official frol thereaft,r
<br />requirinq a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beco.e invalid
<br />unless the work authorized by such perlit is cot.enced within six lonths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six lonths after the tite the work is cO.lenced. One 90 day extension of tile, lay be
<br />.llowed for the pertit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during e.ch six lonth period, or the project will be considered abandoned.
<br />WARNIN6 TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO""ENCE"ENT "AY RESULT IN YOUR PAYING TWICE FOR I"PROVE"ENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN fINANCIN6, CONSULT WITH YOUR LENDER DR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />CO~E"ENT. JOBS UNDEU::2'500 IN VAlUE DO NOT NEED TO RECORD AN.D POST A "NOTICE O.F CO""E. NCE"ENT..
<br />x'J~~d. .
<br />
<br />~a'1,;j tZ r/J O-lVa ~J- ;J'l-u~
<br />
<br />SI6NATURE: OWNER OR AGENT SI6NATURE: CONTRACTOR
<br />
<br />STATE Of FLORID~
<br />COUNTY Of t' A. S (., b
<br />The foregoing instrument was acknowledged
<br />before me this ::::u\y I ~, 19''1~ by
<br />
<br />~~r\~ <C- A(Lt\ol ~ '"B~~r )t'LlS'~~S
<br />who is personallY known to me or who has
<br />produced
<br />as identification and'who did/did not
<br />
<br />ta~hf1. fYl (~~
<br />
<br />A'S~nature) "'^ C 1'//
<br />~l.cr,.,J ~ 'I' U UWl
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />STATE Of FLORIDA A
<br />COUNTY OF ~.5 C. ()
<br />. The foregc.ing insifument
<br />befc.re me this - ~ 'jj
<br />
<br />was aC~~Wledged
<br />, 19 by
<br />
<br />D t{jllft oJ. 0-rt J E
<br />who is personally known to me or whO has
<br />produced DR' lJ ti!..S J....-J (!a~JJ6 C-
<br />as identification and who did/did not
<br />take~o~th.1 n. ~i..J-I--
<br />!/jIB # ~ -+. '/fA.-
<br />(Sig Irf?)
<br />, AJ /J II-- ;T 0 -r,-
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />....~.~..\ OFFICIAL SEAL
<br />I ~ SUSAN A, McCOLLUM
<br />: ! My Commission Expires
<br />\ I April 16. 1997
<br />.~'tQoF\.d'-~... Comm. No. CC 268679
<br />........
<br />
<br />
<br />LINDA J. QTT
<br />Notary Public. State of Florida
<br />My Comm. Exp, June 5. 1998
<br />Comm. No. CC 378684
<br />
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