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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONf;
<br />The undersigned understands that this perlit lay be subject to "dl?ed restrictions" which lIIay hI' lIore restrictive V "'f, ':1 t":'
<br />regulations. The undersigned assules responsibility for cOMpliance with any applicable deed restrictions.
<br />
<br />E<. UNL I CENSED CONTRACTo.RS AND CONTRAC Tor, PESPONS I B IL I TIE:;
<br />If the Olmer has hired a contractor or contractors to uml!'rtake '-':;;;;:"i~y~~y'b;~Q~ed to--h-~-']';"crnsed in accHrl;>,ncr WI th
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor ~ay be
<br />cited for a lisdeleanor violation under state law. If the OMner or intended contractor are uncertain as to what 1 jcpnsino
<br />reQuirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building D~partment! (813)
<br />786-6611.
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<br />FurtherMore, if the owner 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 "ill 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 Mork. If the contractor Hi shes I~U to sign
<br />as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrhills.
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<br />C. TRANSPORTAT ION IMPACT FEES AND UT LL I T~~gl':l~,!:::J;:TJ_QtL.EEES
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<br />D. CONSTRUCTION LIEN U.!_~ (CHAPTER 713, FLOF:IDf4 STATUTES~ f:1S At'1n,JDEDi
<br />I certify that I, the applicant, have been provided Hith a copy of "Florida's Construction Lien Law - Ho~eowner's PrDtection
<br />auide" prepared by the Florida Departlent 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 document and promise in good faith to deliver it te' the
<br />"owner" prior to cOI.ence.ent.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVII
<br />I certify that all the inforlation in this application is accurate and that all wDrk will be done In cOlpliance with all
<br />applicable laws regulating construction, zoning, and land deveIoplent.
<br />
<br />Application is hereby /lade to obtain a perlit to do !fork and installation as indicated. I cprtify that no work e,r
<br />Installation has cOllenced prior to issuance of a perlit and that all Hork will be performed to meet standards of all law5
<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 goyern.ental agencies lay apply to the intended work, and th"t it is
<br />IY rfrsponsibility to identify "hat actions I lust take to be in cOlpliance. Such agencies include but are not J ir.i trrl te,:
<br />· Deoartlent of Environ~ental ReQulation - Cypress Bayheads, Wetland Areas and Environ:.entallv 2ensitive Lands,
<br />Water/Wastewater Treatllent
<br />· Southwest Florida Water ManaQl'lent District - Wells, Cypress Fayheads, Wetland Areas, AlterIng WatercOllrses
<br />f ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />f r~~arh..t'nt of Health 1. Rehabilitativl? ~eryices, EnYiron'll'~"111~.LHl'alt.!l.JJ~iJ_ - Wells, Wastrwatrr heat",rnt, Srptlc r,lli'S
<br />i ~iS Ern'jronttental P;-0tcr~:r.r: r;~t'nrv - ~1:~C?t=""''': ~h;'!~n~tJnt
<br />I alSt, certify that, if fill lIIaterial is to be used in Fl~{ld Zone 'n' or ";),etc,', it is .understc'{ld t~,;lt a draJrldfll' pl"n
<br />addressing a "colpensating volute" Ifill be sublitted which is prepared by a professional engineer regIstered In Ihr Sidle of
<br />rlorida prior to perlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with the work and not as authority to viDlate, cancel altEr, e,r
<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 becQ~e invalid
<br />unless the work authorized by such per.it is cON,enced within six lonths of issuance, or if work authorized by the per~it is
<br />suspended or abandoned for a period of six lonths after the tile the Hork is comeenced, One 90 day extension of \i~e, ~ay be
<br />allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing tD the Building Offici"!, An
<br />approved inspection ~ust be logged during each six lonth period, or the project Hill be cDnsidered aband~ned.
<br />WARNING TO OIlNER: YOUR FAILURE TO RECORD A NOTICE OF COIIMENCEI'IEHT MAY RESULT IN YOUR PAYING TIIICE FOR IHPROVEMEtHS TO 'lOUR
<br />rROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT IIITH YOUR LENDER OR AN ATTORNEY DEFORE RECORDING YOUR NOTICE or
<br />COM"EHCE"~~~BS UNDER $2 0 IN DO NO D TO RECORD AND POST A 'NOTICE OF COMMENCEMENT',
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<br />j// // -1J2() 4
<br />.'/ / / (/ ./
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<br />SI6NlHlIRE: TRACTOR
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<br />STATE OF FLORIDA (/J
<br />COUNTY OF In -5~ {J
<br />The fC1rego i ng i nvrument
<br />before me thi5~ /7
<br />
<br />was acknowledged
<br />, 19 ~ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF ('j;b .y->??
<br />The foregc.ing instrument vJlO1,S dtknc;vdedged
<br />befc,re me th i s ) / / ) ~ 19 95 by"
<br />.
<br />
<br />:
<br />
<br />who is personally known to me or who has
<br />produced (J/'r-<'Jonf'? /// / /,,(/),.;',)(0
<br />as identification and w~o did/did not
<br />
<br />take~:~~.;_ X 02?r~
<br />
<br />(Signature)
<br />
<br />who is personally known to me or who has
<br />produced ~h-<J/)no /J~( /<!/)/lC~/)
<br />as identificatic,n and Jho did/did m,t
<br />take an o~J1. ' . tP
<br />~, ~ -' ~ ;/?? /J ,/"'1C
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PlJ.flLIC
<br />
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<br />f~~1~q:~~j6'Ff.--~j
<br />
<br />NOTARY punu..: :,:,:'l,'lE DF FLORIDA
<br />COMMlc.:",rn~'.T)" ','0 L"r"."l', '"(~' "
<br />.....~l.......'l .~'" ................\).1'. (~;
<br />MYCOMMlSS!ON EXP -:':1'''' 1'" H"Yl'
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<br />L~, ~}~~ttii:H~~~:~~;~~,~;~.t;~A!
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