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<br />(Nam~ Typed, Printed or Stamped)
<br />NOTARy'.PUBLIC
<br />~tAY ~
<br />W^ DONNA M SINCLAIR
<br />* * My Commission CC382619
<br />~ "..., _,$ Expires Jun. 14, 1998
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<br />CONDITIONS OF PERMIT AFFI'::'",~\lIT
<br />A. NOTICE OF DEED RESTRICTIONS _ .
<br />The undersigned understands that this peait lay be subject to "deed restrictions" which lay be lOre restrictive than City
<br />regulations. the undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
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<br />B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake 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 .isdeaeanor violation under state law, If the owner or intended contractor are uncertain as to what licensing
<br />requ!reaents'lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (613)
<br />788-6611.
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<br />Furthermore, if the owner bas hired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />I Contractor Sections I of this application for which 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 JaY 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. ,TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<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 uFlorida's Construction Lien Law - Hoaeowuer's Protection
<br />Guideu p~epared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
<br />.owneru, I' certify that I have obtained a copy of the above described docUlent and prolise in good faith to deliver it to the
<br />uowneruprior.to cOllenceaent.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infor.ation in this application is accurate and that all work will be done in compliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
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<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOIIenced prior to issuance of a perlit and that all work will be perfoaed to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land development regulations in the jurisdiction. I also
<br />certify that I understand that the/regulations of other governaental agencies lay 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 />.'Departlent of EnviroOlental Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands,
<br />Water/Wastewater TreatJent
<br />· Southwest Florida Water Kanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />. Arly Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />. DepartJent of Health & Rehabilitative Services, EnvironJental Health Unit - Wells, Wastewater Treataent, Septic Tanks
<br />. US EnvirODlental Protection Agency - Asbestos abatement
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or "A, etc. ", it is understood that a drainage plan
<br />addressing a ucOlpensating volUleu will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
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<br />A perait issued shall 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 shall issuance of a permit prevent the Building Official frCl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall becOIe invalid
<br />unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day extension of tile, JaY be
<br />allowed for the pmit 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 />VAllHIHG TO .MER: YOUR FAILURE TO RECORD A NOTICE OF COHKENCEKENT MAY RESULT IN YOUR PAYING TWICE FOR IHPROVEHEHTS TO YOUR
<br />PROPERTY. IF YOU INTEND 'fO OBUlK FIHAHCIHG, CONSULt IU'fH YOUR LENDER OR AN AnORHBY BEFORE RECORDING YOUR NOTICE OF
<br />COKHEHCEKKH'l. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A uNOTI OHKENCEHEHTu.
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<br />SIGNATURE: COll'l
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<br />STATE OF FLORIDA
<br />coum OF.- f AS C 0
<br />The foregoing instrument was acknowledged
<br />before me this fJPf(IL tf ' 19~ by
<br />
<br />STATE OF FLORIDA ~
<br />COUll'lY OF 'fl 5 G 0
<br />The foregoing i>>strument was acknowledged
<br />before me this tlPf( J L 'I ' 19 9.s- by
<br />
<br />(iho is personally ~~~~or who has
<br />producea
<br />as identification and who did/did not
<br />take an ~ '-'}yJ'~./J .
<br />
<br />(Signature)
<br />
<br />~i~ p~r~onallY ~ or who has
<br />produced'
<br />as identification and who did/did not
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<br />~.'" . oath. . ~'
<br />.' --' VWt.
<br />(Signature) .
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~tAY ~
<br />ii DONNA M SINCLAIR
<br />* * My Commission CC38261g
<br />Expires Jun. 14. 1998
<br />'''''tor,..'
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