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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this pertit lay be subject to "deed restrictions" which lay be lOre restrictive than City
<br />regulations. fhe undersigned assOles responsibility for cOlpliance witb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
<br />state and local regulations. If tbe contractor is not licensed as required by lil1f, both the owner and contractor lay be
<br />cited for a lisdeleanor violation under state law. If the owner or 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 DepartJent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the OIner has bired a contractor or contractors, he is advised to bave the contractor(s) 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 tbe 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 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, have been provided with a copy of "Florida's Construction Lien Law - HOIeOWDer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOJeOne other than the
<br />Rowner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to cOllencelent.
<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 cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<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 pertit and that all work will be perforJed to !eet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDJental agencies laY apply to the intended work, 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 />t Departlent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater TreatJent
<br />t Southwest Florida Water Managelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health & Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater Treatlent, Septic fanks
<br />t US EnvirODlental Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood Zone "An or "A,etc.", it is understood that a drainage plan
<br />addressing a "cOlpensating volOle" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to pertit issuance.
<br />
<br />
<br />K IJ t'ZtJ N
<br />
<br />STATE OF FLOR~
<br />COIIHTY OF jJ-S e,o
<br />The foregoing instrument was acknowledged
<br />before me this ~~, 19~ by
<br />
<br />'"I!AY '~JJA))~S
<br />who is persona Iv known to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />
<br />ta~ f
<br />ISi .~ur.) :::.r:---?F~)N
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />STATE OF FLORIDA
<br />coum OF P If .sC'-O
<br />The foregoing instrument was acknowledged
<br />before me this vLlLY -21, 19~ by
<br />
<br />(fAY 'PAJJ)EL.S...
<br />who is personall~_known to ~~.or who has
<br />produced -
<br />as identification and who did/did not
<br />
<br />t.~ ~ ~u
<br />U~. J~)
<br />(Sign blre) , . '.
<br />Kk n-l ~~ J. j <oJ ?51?#--uJ oJ
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~,>
<br />'~
<br />
<br />KATHLEEN J. BROWN
<br />S1a~e cf FkH"i13
<br />M,Comm, "cp. 1',)0' 2, 1,"95
<br />Comm..' CC C:;5t~~ 7
<br />
<br />.~?~~$>(~
<br />
<br />KATHleEN J. BROWN
<br />State 01 F'cri~3.
<br />My Comm. Etp, I,y: 2, 1995
<br />Comm. II CC 0;5617
<br />
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