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<br />CONDJ.tIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perait lay be subject to Ideed restrictions" whieb aay be lOre restrictive than City
<br />regulations. Tbe undersigned assUles responsibility for coapliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertale work, they lay 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 lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirements lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherllOre, if the owner bas hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sectionsl of this application for wbieb 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 fie is not properly licensed and is not entitled to perlitting 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 IFlorida's Construction Lien Law - HOIeowner's Protection
<br />Guide" 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 docUlent and prO.lise in good faith to deliver it to the
<br />"owner" prior to couencl!lent. .
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in coapliance 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 bas COIIenced prior to issuance of a perait and that all work will be perforaed to aeet 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 goverDlental agencies lilY 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 />· Deparblent of Environmental Regulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />· Southwest Florida Water Managl!lent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />· ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />· Departlent of Health & Rebabilitative Services, Environaental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />· US Bnvironmental Protection Agency - Asbestos abatement
<br />I also certify that, if fill .aterial is to be used in Flood Zone "An or "A,etc.", it is understood that a drainage plan
<br />addressing a "cO.lpensating volUle" will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perait issued sball 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 sball issuance of a perlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery perait issued shall becOle invalid .
<br />unless the work authorized by such per.it is cOllenced within six IIOnths of issuance; or if work authorized by the perlit is
<br />suspended or abandoned for a period of six IOnths after the tiae the work is cOllenced. One 90 day extension of tile, lilY be
<br />allowed for the perlit 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 each six IOnth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A, NOTICE OF COMMBNCEMENT HAY RESULT IN YOUR PAYING TWICB FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN 'FIXAHCING, COHSULT WITH YOUR LENDER OR AN Ar'fORNBY BEFORE RECORDIHG YOUR NOTICE OF
<br />ClIlIlIlIICIIlEIIT. JOBS IIHDER 12,500 .IN VALUE 00 NO! NEND TO REClIIID ~ 'NO!ICIl OF ClIlIlIlIICIIlEIIT',
<br />
<br />1J/ta/}~ " YLR~
<br />
<br />: 0WMmI OR S GKATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA ,
<br />COUNTY OF : .J~
<br />The foregoing instrument was acknowledged
<br />before me this Ocr ;(7 , 19-Z..i. by
<br />
<br />ZJ~ 4, /3:uL
<br />~ho is personal1y~o~ to me or who has
<br />~produced . ' . . .
<br />as identification and who did/did not
<br />ta~~~ILoat9. A I~ k ~A
<br />
<br />(Signature)_ . __ _
<br />-pr:/i/} R cS II L S T/f E..c./ ..s
<br />(Name, Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~u~~
<br />~ho is ~erSOnallY
<br />produce
<br />as identification and who did/did not
<br />..... .- - "
<br />take an o~th. t L ~~, L-
<br />A ~ .:- DL-L.L-E-,7
<br />(Signature) " ~ _ __ ~ _ _
<br />- D [/'.3/\' /I ,~ t( L "s / /? CL /S
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />STATE OF FLORIDA /J
<br />COUNTY OF t/2.~;-
<br />The foregoing instrument was acknowledged
<br />before me this /J..~ ,';;'7 ' 19~ by
<br />
<br />AD. ~
<br />known to ~e or who has
<br />
<br />
<br />DU8ASUr; $'ffiEtTS
<br />
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<br />No. t:,,:--
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