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<br />, CONDITIONS OF PERMIT AFFIDAVIT
<br />'A. NOTICE OF DEED RESTRICTIONS .
<br />fbe undersigned understands that this perlit lay be subject to Ideed restrictions I which laY be lOre restrictive than City
<br />regulations. Ihe undersigned asSUles responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas birecJ a contractor or contractors to undertake work, they JaY 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 lisdl!leanoi:' violation under state law. If the owner or intended contractor are unc~tain as to what licensing
<br />requirl!lents lay apply for the intended work, they are advised to contact the City of Zephyrhills' Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the'owner has hired a contractor or contractors, he is advised to have the conUactor(s) sign portions of the
<br />IContractor Sections I of this application for which they will be responsible. It you, 8Ilthe-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 lilY be an indication that he 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 - BcIIeowner's Protection
<br />Guidel prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is SOROll8 other than the
<br />lownerl, I certify that I have obtained a copy of the above described dOCUleDt and prOlise in good faith to deliver it to the
<br />lownerl prior to COlleDCeJellt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, laning, and land developlent.
<br />
<br />~M~_
<br />!UJIB: 0IfJIBR
<br />
<br />Application is hereby lade to obtain a penit ~o do work and installation as indicated. I certify that no work or
<br />installation has cmleDced prior to issuance of a perlit and that all work will be perforJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developllent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govl!IDl8lltal agencies laY apply to the intended wort, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lillited to:
<br />t Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and Envirollll!lltally Sensitive Lands,
<br />Water/Wastewater Ireatlent
<br />t Southwest Florida Water HanageJellt District - Wells, Cypress Bayheac1s, Wetland Areas, Altering Watercourses
<br />t Any Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Ireatlent, Septic rants
<br />t US EnviroDleDtal Protection Agency - Asbestos abateJeDt
<br />I also certify that, if fill aaterial is to be used in Flood Zone IAI or IA,etc.l, it is understood that a drainage plan
<br />addressing a ICQlpensating volUlel will be subJitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A Perlit issued shall be construed to be a license to proceed with the IfOrk~d 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 frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall beCOlB invalid
<br />unless the work authorized by such perlit is cODenced within six IOnths of issuance, or if work authoriJed by the perlit is
<br />suspended or abandoned for a periOd of sillOnths after the tile the work is C08eDCed. One 90 daJ eltension of tile, IIJ be
<br />allOlfed for the penit with fee charge of $15.00. Tbe l!ltension shall be requested in .riting to the Building Official. An
<br />approved inspection 8118t be logged during each sillOnth period, or the project will be considered abandoned.
<br />WARHIlfG fa OIfHER: YOUR FAILURE fa RiCORD A HOTICB OF COHHBIfCEHm' HAY RESULI IN YOUR PAYIHG rwlCE FOR IHPROVIHDrS 10 YOUR
<br />PROPERlY. IF YOU IJlJEID 10 OB1'IIIf FIWCIIG, COHSULT WITH YOUR LEIDER OR All AnORm' BEFORE RECORDING YOUR )arICE OF
<br />COHHBNCEHm'. JOBS UNDER $2,500 IN VALUE DO NOT NEED 1'0 RECORD AlfD POST A fHOTICE OF COHHBHCBHEJIJw.
<br />
<br />
<br />~-j6~
<br />SIGUfURll: COIl'llllClOR .
<br />
<br />STAlE OF FLORIDA ~
<br />coum OF. /l--J L 0'
<br />The foregoing nstrument was acknowledged
<br />before me this ( cJ -3 {~ 19 -!1}! by
<br />
<br />~cJ A iLl /lIl1(e;L~
<br />who is personally known to me or wile has
<br />pr-ecluced
<br />as identification and ~e did/did not
<br />take an oath.
<br />
<br />Sf ArE OF FLORIDA
<br />COUNTY OF
<br />The foregoin instrument was aCknowledged
<br />bsfor me thiG , 19~ by
<br />
<br />I' J I:!'IJ- '-"-'
<br />who s personally known to Bl' WIlB hair
<br />pr9dY.eed
<br />as identification and Mke did/did not
<br />take an oath.
<br />
<br />
<br />(Signature)
<br />
<br />(Name ~ed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Sta.ped)
<br />NOTARY PUBLIC
<br />
<br />
<br />...,-.- , ....~.,....
<br />
<br />
<br />Ie11'Y ....lCILLy
<br />.... cI FIortdI
<br />_~-!~ ElrI>>.Aua. 14, 1.
<br />\oIUITI1l. , CC 21...
<br />
<br />~.
<br />
<br />-.
<br />
<br />BETTY IL-.L.Y
<br />SIIIt cI FbIdI
<br />My Comm. Exp. Ala. 14, ,.
<br />Comm, # CC 214508
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