|
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A.' NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that tbis penit JaY be subject to 'deed restricti~" whicll Jay be lOre restrictive than City
<br />regulations. the undersigned assU1e8 respousibility for co.pliance witb any ap~licable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe owner bas bired a contractor or contractors to undertake lIork, tbey JaY be required to he licensed in accordance witb
<br />state and local regulations. If tbe contractor is not licensed as required by law, botb tbe owner and contractOr JaY be
<br />cited for a lisdeleallor violation under state lall. If tbe owner or intended contractor are uncertain as to what licensing
<br />reguirl!lleDts JaY apply for tbe intended IOrk, they are advised to contact tbe City of Zephyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtbeIlOre, if tbe owner has hired a contractor or contractors, he is advised to bave tbe contractor(s) sign portions of tbe
<br />"Contractor Sections" of tbis application for Ihicll tbey will be responsible. If you, as tbe mmer sign as the contractor,
<br />you are indicating that you, rather than tbe contractor, are responsible for tbe IOrk. If tbe contractor wisbes you to sign
<br />as contractor that Jay be an indicatiQD that he is not properly licensed and is not entitled to penitting privileges in tbe
<br />City of Zepbyrhills. }
<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 witb a copy of "Florida's Construction Lien Law - BoIeow.ner's Protection
<br />Guide" prepared by tbe Plorida DepartJent of Agriculture and ConsUlll!l' Affairs. If tbe applicant is 8OI8OI1e otber than the
<br />"mmer", I certify that I have obtained a copy of the above described docUIIent and premse in good faitb to deliver it to the
<br />"owner" prior to co.enCl!IeDt.
<br />
<br />(
<br />\
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infOIlation in tbis application is accurate and that all IOrk will be done in cDlpliance wltb all
<br />applicable laws regulating construction, zoning, and land developlellt.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no IOrk or
<br />installation has C31enced prior to issuance of a perlit and that all IOrk will be perfoI'led to .et standards of all laII8
<br />regulating construction, City codes, zoning regulations, and land developlellt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gGYeIIIIeI1tal agencies JaY apply to the intended work, and that it is
<br />If responsibility to identify what actions I lUSt tue to be in co.pliance. Sucll agencies include but are not luited to:
<br />I DepartJent of BnviroDll!lltal Regulation - Cypress Bayheads, lIetland Areas and Bnvirolllelltally Sensitive Lands,
<br />lIater/lfastewater lreatJent
<br />I Southwest Plorida lIater Ilanagl!leDt District - Wells, CypteSs Baybeads, Wetland Areas, Altering Watercourses
<br />I AIIY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />I DepartJent of Healtb i Rehabilitative Services, BnvirODlental Healtb lIDit - lIells, Wastewater lreatJent, Septic lants
<br />I US BnviIOlllental Protection Agency - Asbestos abatl!leDt
<br />I also certify that, if fill Jaterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "COQeJ1Sating vol_" will be sublitted whicll is prepared by a professional engineer registered in tbe State of
<br />Florida prior to peIlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed witb the IOrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent tbe Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery pmit issued shall becaIe invalid
<br />unless tbe Ifork authoriled by sucll peIlit is co.enced witbin sillOllths of issuance, or if IOrk authorized by the perlit is
<br />suspended or abandoned for a period of sixlOIlths after tbe tile tbe work is co.enced. One 90 day extension of tile, laY be
<br />allowed for tbe perlit witb fee charge of $15.00. fbe extension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eacll sillOlltb period, or tbe project will be considered abandoned.
<br />WAlUlIIG '1'0 OIlIER: YOUR FAILORI '1'0 RlCORD A NOIIO: OF aJIMBICBIIIRf MAY RESULI II YOUR PAYING nIO: FOR DIPROVIIImS '1'0 YOUR
<br />PROPBR'lY. IF YOU IImD '1'0 OBfm FIIfAtrCIIG, COISOLf IIIIB YOUR LBIIDBR OR U A!"I'ORDY BI10RB RICORDIIG YOUR fOlIO: OP
<br />COIIMElfCEMBHr. JOBS UlfDIR $2,500 II VALUE 00 lot IDD '1'0 RECORD AID POSI A "NotICE OF C(JIMDCEMBHr".
<br />
<br />
<br />~JUf 12~~
<br />.. IUIII: -11IIIII III IGIIII
<br />
<br />SrAfE OF FLORIDA
<br />coum OP () ~
<br />The foregoing instrument was acknOWledged
<br />before me this L.DJv-Q"0 19 0~ by ,
<br />
<br />".L\'.O~ >A,. ~() \\OL.-L ~ ~
<br />who is personally known to lie or who has
<br />produced \ 'o~ 0. c\ ~ ~ DI ~ Uc::.....-
<br />as identification and who did/did not
<br />tak~t~. ~
<br />
<br />(Si9I\ature)
<br />\r---o..->.~y.,.., ""5 U 'A-,~
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />NOTARY LEIGH J CLASS
<br />M " ,~T,I\ fE OF FLORIO/I
<br />. Y ....omm'sSI'.',: C"'-)"".c '..1, ", ,_ .
<br />C "'''..0 ,,'"' ""JI
<br />omm:sSJon No. (, C 2. 7. 0 :; 8- t '
<br />
<br />?::1
<br />
<br />
<br />SIAn: OF FLORIDA
<br />COOllY OP pQ~c{)
<br />The foregoing instrument was acknowledged
<br />before lie this 20 ."-zt.~ , 19~ by
<br />
<br />~"C~\. ~n~~
<br />who is personally known to me or who has
<br />produced }? c-l:L.t J D fllJC.-1- ~ 1-. \-c..
<br />as identi ication and who did/did not
<br />take an oCltb. \
<br />~ ~
<br />(Signatu~~)
<br />C'1:."'-. -S c (A~~
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC LEIGH J. CLASS
<br />NOTARY PUBLIC, STATE OF FLORIOA
<br />_My commISSion expires Mar, 21, 1.)
<br />Commission No. C C 2 7 0 3 a l
<br />
|