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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />the undersigned understands that this penit Jay be subject to IIdeed restrictions II which lay be lOre restrictive than City
<br />regulations. !he undersigned assUleS responsibility for CCIIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED 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 OlDer and contractor laY be
<br />cited for a lisdsanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!lents laY apply for the intended work, they are advised to coptact the City of Zepbyrbi11s Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />llContractor Sections II of this application for which they will be responsible. If fOU, 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 wishes you to sign
<br />as contractor that laY be an indication that he is not properly licensed and is not entitled to perJitting 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 IIFlorida's Construction Lien Law - lmeoImer's Protection
<br />Guidell prepared by the Florida Departlent of Agriculture and CoIlSUlel' Affairs. If the applicant is aeone other than the
<br />lIownerll, I certify tbat I have obtained a copy of the above described docuIent and praUse in good faith to deliver it to the
<br />"owner" prior to co.enCeleDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infolliltion in this application is accurate and that a11wort will be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land developleDt.
<br />
<br />Application is hereby lade to obtain a pewt to do work and installation as indicated. I certify that no wort or
<br />installation has C31eDced prior to issuance of a perJit and that a11work will be perfoX'led to .et standards of all laws
<br />requ1atingconstruction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gov8IDl8J1tal agencies IilJ apply to the intended wort, and that it is
<br />., responsibility to identify what actions I lUSt take to be in COIpliance. Such agencies include but are not luited to:
<br />t Departlent of BnvirOllleDtal Regulation - Cypress Baybeads, Wetland Areas and BnvirOllleDtally Sensitive Lands,
<br />Water/Vastewater !reatlent
<br />t Southwest Florida Water ManaqeleDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Bnqineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health' Rebabilitative Services, BnvirODlental Health Unit - Wells, Wastewater !reatleRt, Septic ,ants
<br />t US Bnvil'ODll!Jltal Protection Agency - Asbestos abateleDt
<br />I also certify that, if filllaterial is to be used in Flood Zone IIA" or "I,etc. II, it is understood that a drainage plan -
<br />addressing a llC01pe11Bating vol_II will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A ~it 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 peIlit prevent the Building Official fIQI thereafter,
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery penit i88Ued &ball ~ invalid
<br />unless the IIOrk authorized by such peIlit is ~ced lIithin sillODths of issuance, or if IOrk authoriled by the peIlit is
<br />suspended or abandoned for a period of sillODths after the tile tbe work is ~ced. One 90 day atension of tile, laY be
<br />allowed for the perJit with fee charge of $15.00. the atension shall be requested in writing to the Building Official. In
<br />approved inspection lUSt be logged during each sillODth period, or the project will be considered abaDdoned.
<br />WAIUlING 'fO (IIJD: YOUR FAlLlJRB 'fO RlCORD A DICE OF C(lMRCIIIBH lilY RlSUL! II YOUR PAYIHG !IIICE FOR DIPROVIIIDIS 'fO YOUR
<br />PROPBm. IF YOU IImD 'fO OBlAIN FIJIUCIBG, COIfSDL' WID YOUR LIIDIR OR AI II'fOBDY BI10BB RICORDIBG YOUR BOIICE OF
<br />COIOIIICEIIm'. JOBS lIHDD '2,500 Iff VALUE DO NOIIiDD 'fO RECORD AID POS! I IINOIICE OF COIOIIICBMlllw.
<br />
<br />SIGllAfUHI: (JfJD OR AGIN1'
<br />
<br />SIGlAIDRI: COftRACIOR
<br />
<br />S!UB OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknOWledged
<br />before me this , 19____ by
<br />
<br />S!AII OF FLORIDI
<br />COUftY OF
<br />The foregoing instI'UII8Dt was acknowledged
<br />before me this , 19_ by
<br />
<br />-"
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oCJth.
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or StiUllped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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