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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this per.it lay be subject to 'd~ed restrictions' which may b~ ~ore restricli\'C ~' 'r, r.i~'~
<br />regulations, The undersigned assu.es responsibility for cOMpliance with any applicable deed restrictions.
<br />
<br />Et. UNL I CENSED CONTRACTORS AND CONTRAC fpn J::E?LCJI'~J?.L!:~J.L I'LE:,:,;.
<br />If the OHner has hired a contractor or contractors to undcrta~e Nork, they may be required to he licensed in accordance With
<br />state and local regulations, If the contractor is not licensed as required by law, both the owner and contractor May be
<br />cited for a .isdeaeanor violation under state law, If the owner or intended contractor are uncertain as to what licensing
<br />require.ents .ay apply for the intended work, they are advised to contact the City of 2ephyrhills Building Department, (813)
<br />788"6611,
<br />
<br />Furtherlore, if the OHner has hired a contractor or contractors, he is advised to have the contractor(sl sign portions of the
<br />'Contractor Sections' of this application for which they Hill 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 wor~, If the contractor wishes you to sign
<br />as contractor that aay 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. TRANSPORT A T ION I MPA~J- FEES AND UT U- I.I..Y.....~Qt'l~fJ.:T)_Q~'--E.EES
<br />
<br />D. CONSTRUCTION LIEN Lfl~ (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 - Ho~eownrr's Protection
<br />ouide" pr@pared by the Florida Depart.ent of Agriculture and Consuler Affairs, If the applicant is someone other than the
<br />'owner" , I certify that I have obtained a copy of the above described doculent and promise in good faith to deliver it tc, the
<br />"owner" prior to co..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 cospliance with all
<br />applicable laws 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 worl or
<br />installation has co.aenced prior to issuance of a per.it and that all "or~ Hill be performed to meet standards of ~ll I~ws
<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 .ay apply to the intended wor~, and th"t i l is
<br />IY rtrsponsibility to identify what actions I lust talee to be in co.p1iance, Such agencies include bul ue not] J[,drorl tr,;
<br />, Oeoartsent of Environ~ental ReQulation - Cypress Bayheads, Wetland Areas and Environ:.entallv Sensitive Lands,
<br />Water/Wastewater Treat.ent
<br />, Southwest Florida Water NanaQeMent District - Wells, Cypress Bayheads, Hetland Areas, Alterlnq HatercolJrses
<br />. Ar.y Corps of EnQineers - Seawalls, Docks, Havigable Waterways
<br />f ~eoartment of Health ~ Rehabilitative Services. Environ~~ntal Health Unit - Wells, Wastewatrr Treat~ent, Septic Tan~s
<br />. ~jS fnyj(on!!ental P;-0tcr~~{\n ~q~nrv - f\!=~~r:+"<<: .:lh~~a"{)nt
<br />I alsu certify that, if fill laterial is to be used in Flond Zone 'A' or "n,etc,', it is ,understood that a dralnaqe plan
<br />addressing a "colpensating volule" will be sub.itted which is prepared by a professional engineer registered in Ihr State of
<br />Florida prior to per.it issuance.
<br />
<br />A pertit issued shall be construed to be a license to proceed with the wort 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 Building Official fr{,~ 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 co..enced within six Bonths of issuance, or if work authorized by the per~it is
<br />suspended or abandoned for a period of six .onths after the ti.e the work is cO~Denced, One 90 day extension of time, ~ay bp
<br />allowed for the per.it with fee charge of $15,00, The extension shall be requested in writing to the Building Offici"!. An
<br />approved inspection lust be logged during each six lonth period, or the project will be considered abandoned.
<br />~ARNIN6 TO OWHER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR PAYING THICE FOR IMPROYEMENTS TO YOUR
<br />PROPERTY, IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNE DEFORE RECORDING YOUR NOTICE or
<br />COHMEHCENENT. JOBS UlIIlER $2,500 IN VALUE no NOT NEEn TO RECORD MID POST '/)CE COMMENWIENT',
<br />
<br />I 1) vJ/~/~ ~ .U
<br />
<br />~Sl~: OWNER OR AGENT
<br />
<br />
<br />rnTO\ m ~Y-{)CJL"'\f"'\
<br />who is personally known to me or who has
<br />produced {!e'\,,,,<::>f'""'lCL\ \ \. ~ ~(Y\l ~(\
<br />as identification and who did/~id not
<br />tAke an. (l.:\t~. V
<br />l '11 .L. 0<") t-;,. ..sI::l ~() 'f\-
<br />
<br />~~~;,~~~~~ ~
<br />
<br />(Name Typed, Printed
<br />NOTARY PUBLIC
<br />OFF!~~~.~_~~::,.tA!~f~~ALi
<br />CHRi,~Hl', L M"l)~;. !
<br />NafARY PUBLIC STATE OF IiLORIDAI
<br />COM1'.fISSlc~r~ I'-J!J. CC~}:61D3
<br />MY COMMlSSH~~~21F~TE;;.9'.l'1 J
<br />
<br />STATE OF FLORIDA ("";\
<br />CnUtHY OF ' 1-"(LSC'.i)
<br />The foregc.ing insb-umentl-J2,s at:~~ledQed
<br />befcll-e me th i 5 ~3 Sep+. 19 by
<br />
<br />l{) . ~, l. \,.p t ... m() 0\ t')
<br />who is personally known to me Dr who has
<br />pro d ue ed COe r&O rc:L..\ '- u v.- 1"V"\ l ~ V)
<br />as identification and I-Iho di~did not
<br />ta~, an c~ath. _ "-- D
<br />l.:J:l.fl. . CI ~ .D ~ ~ V'Y\ C) ~'--
<br />(Si}\n.atul=e) ~
<br />~blS-\-"e - \,. f'Y\o~~)-
<br />(Name Typed, Printed Dr Stamped)
<br />NOTARY PU~LIC
<br />
<br />STATE OF FLORIDA ~
<br />COUNTY OF J...c:.,c. (\
<br />The foregoing instrument was acknowledged
<br />befc,re me this ~1.5~ '19.!lJ1 by
<br />
<br />.'
<br />
<br />N\C)~o'r-
<br />or Stamp d)
<br />
<br />OFFICIAL NafARY SEAL
<br />CHRISTIE L MAJOR
<br />NafARY PUBLIC GTATE 0-;; nOR IDA
<br />COMMISSiON ;;D. C::::1f-iC3 J
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