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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />fbe undersigned understands that this pel'lit lilY be subject to .deed restrictions. wbieb lilY 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 bired a contractor or contractors to undertake wort, they lilY 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 lilY be
<br />cited for a .isd_anor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requireleJlts lilY apply for the intended wort, they are advised to contact the City of Zephyrhills Building Deparuent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />.Contractor Sections. of this application for whieb they lIill 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 wort. If the contractor lIishes you to sign
<br />as contractor that lily be an indication that be is not properly licensed and is not entitled to peraitting privileges in the
<br />City of Zepbyrbills.
<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 lIith a copy of .Florida's Construction Lien Lall - BOJeOWJler's Protection
<br />Guide" prepared by the Florida Deparuent of Agriculture and ConsUJer Affairs. If the applicant is sOJleOne other than the
<br />Downer", I certify that I have obtained a copy of the above described docuIent and prOlise in good faith to deliver it to the
<br />Downer. prior to COlllenCeIeJlt. -
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all wort viII be done in cOlpliance lIith all
<br />applicable lalls regulating construction, loning, and land developlellt.
<br />
<br />Application is bereby Jade to obtain a perlit to do wort and installation as indicated. I certify that DO vortor
<br />installation has COMenced prior to issuance of a pel'lit and that all IIOrt lIill be perforJed to Het standards of all laws
<br />regulating construction, City codes, loning regulations, and land developJent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIDlental agenCies lily apply to the intended wort, and that it is
<br />IY responsibility to identify what actions I lust take to be in COIpliance. Sueb agencies include but are not lilited to:
<br />t Deparl:lent of BnvirODJeJltal Regulation - Cypress Baybeads, Vetland Areas and EnviroDJentally Sensitive Lands,
<br />Vater/Wastewater Ireauent
<br />t Southwest Florida Vater Managetent District - VeIls, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seallalls, Docks, lavigable Vatenays
<br />* DepartJent of Health i Rebabilitative Services, EnvirDDJeDtal Health Unit - VeIls, Vastellater Ireatlent, Septic !anks
<br />t US EnvirOJlleDtal Protection Agency - Asbestos abateleJlt
<br />I also certify that, if fill Iilterial is to be used in Flood ZOne .AD or .A,etc.., it is understood that a drainage plan
<br />addressing a .COIpensating vol_" lIill be sublitted IIbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perait issuance. .
<br />
<br />A perait 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 pel'lit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perait issued shall bealle invalid
<br />unless the work authoriled by sueb perait is COII8Jlced within sillOntbs of issuance, or if wort authorized by the pemit is
<br />suspended or abandoned for a period of sil IODths after the tile the work Is COIIenced. One 90 day eltension of tile, lily be
<br />allowed for the perait with fee charge of $15.00. fbe eltension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillODth period, or the project lIill be considered abandoned.
<br />WARNIMG TO OIINER: YOUR FAILURE !O RECORD A NOIICI OF COIfMIKCBIIBNf MAY RESUL! II YOUR PAYIIG filCl FOR IMPROVEMBIfS fO YOUR
<br />. . . ~
<br />PROPERlY. IF YOU IIft'BIiD 'fO OBIAIN 'FIIWICIIlG, CONSULI vIm YOUR LINDER OR AM AftORNBY BEFORE RECORDING YOUR NOIICI OF
<br />COHHENCIMBN1' . JOBS U 50 lED fO RECOJlD AIfD POSf A DMOIICI OF COMMEJlCBMEN'lI.
<br />
<br />
<br />
<br />SIWI~- ~
<br />
<br />
<br />SrATE OF FLORIDA
<br />COUNfY OF ; j.J oS e..o
<br />The foregoing instrument was acknowledged
<br />before me this ~ S 193.!t by,
<br />
<br />KAy' .D J} JJ J P"l_ s:
<br />who is personally known to me Dr ~D has
<br />p.Luduced
<br />as idefttific:ati~11 and who .ai4/did not
<br />
<br />take~~ . ~
<br />
<br />(Signature) Jt
<br />j( II Tl-i L--EE:.-,J .:I, :b/lt;.w JJ
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />SrAfE OF FLORIDA
<br />COUNTY OF (J/-J.sc D
<br />The foregoing instrument was aCknowledged
<br />before me thisJk:.~~ ,K, 19~ by
<br />
<br />A L$ER.T SIMS
<br />who is personally known to me Dr ~3 haa
<br />prsd&eed
<br />aD IdeuLlr~C8tieB and who ~did not
<br />take an o~ r-/J- 12)
<br />~~!}J ~
<br />(Signature) 72
<br />k:ATl-lu.-~ 0. J2~ \ AJ
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />t1(::~
<br />.\
<br />
<br />KATHLEEN J. BROWN
<br />S~E\te of Florida
<br />My CQmm, Elr/.l. A&ri 2. 1995
<br />CclmIt., tc 095617
<br />
<br />~Je. '''~.
<br />2 jJft. 1,
<br />
<br />KATr\L~"" ',~:,)WN
<br />...;)t.::Le ,iQ(IJ-:.1
<br />My Co/mI. Exp.JlpriI2. 1991
<br />er.rnm. , CC ClI66t 7
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