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<br />CONDlfIONS OF PERMIT AFFIDAVIT
<br />A . t~!.QI.IJ,:E OF _'pEEQ..SiS..STB U;J::1QtJf:~.
<br />The undersigned understands that this per.it lay be subject to "deed restricti~ns. which .ay be .ore restrictive than City
<br />regulations, The undersigned assu.es responsibility for co~pliance,with any applicable deed restricti~ns,
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<br />B _ Wl~JL I CENSED CONTR{~CTORS _.B.N!LJ;;.Q!:JT8jl~_lQR J3~J?.E~QJ~.9IJH LI:Lt~_f.~~
<br />If the owner has hired a contractor or contractors t~ undertake Mork, 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 .isde.eanor violation under state IaN. If the owner or intended contractor are uncertain as to what licensing
<br />require.ents lay apply f~r the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, IBI3)
<br />7BB-bbll,
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<br />Further.~re, if the owner has hired a contractor ~r contractors, he is advised to have the contract~r(s} sign portions ~f the
<br />"C~ntractor 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 work. If the contractor wishes you to sign
<br />as contractor that .ay be an indication that he is n~t properly licensed and.is n~t entitled to per.itting privileges in t.he
<br />City of Zephyrhills,
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<br />c _ ]F:ANt?F'ORTAT ION I t'lF'ACT FEEq,_j-)N~LJJLI...!-~ TL..~Q~HECIJ OJ:.LFEE.~.
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<br />D. ~ONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I,.the applicant, have been provided with a copy of "Florida's Construction Lien LaM - HOleowner's Protection
<br />Guide" prepared by the Florida Depart.ent of Agriculture and Consuler Affairs. If the applicant is sOleone other than the
<br />"owner", I certify that I have obtained a copy of the ab~ve described docu.ent and pro.ise in g~od faith to deliver it tD the
<br />'oNner" prior to cOI.ence.ent,
<br />
<br />E. ~ONTRACTOR' s/m'JN.E~~_BfJ:_!.D(lY_LL
<br />I certify that all the infor.ation in this applicati~n is accurate and that all w~rk Hill be done in co.pliance with all
<br />applicable laws regulating construction, z~ning, and land develop.ent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no w~rk or
<br />installation has cOI.enced prior to issuance of a per.it and that all work will be perfor.ed to .eet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of ~ther govern.ental agencies .ay apply to the intended work, and that it is
<br />.y responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not li.ited to:
<br />, Departlent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands,
<br />Water/Wastewater Treat~ent
<br />t Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />, Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways .
<br />f Depart.ent of Health l Rehabilitative Services, Environ.ental Health Unit - Wells, Wastewater TreatMent, Septic Tanks
<br />, US Environ~ental Protection AQency - Asbestos abate~ent
<br />I also certify that, if fill .aterial is to be used in Flood Zone "A" Dr "A,etc,", it is understood that a drainage plan
<br />addressing a "co.pensating volu.e" will be sub.itted which is prepared by a professi~nal engineer registered in the state of
<br />Florida prior to per.it issuance,
<br />
<br />A per.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 per.it prevent the Building Official fro. thereafter
<br />requiring a correction of errors in plans, constructi~n, or violations of any code. Every perlit issued shall beco.e invalid
<br />unless the work authorized by such perlit is co.tenced within six .onths 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 w~rk is co..enced. One 90 day extension of ti~e, .ay be
<br />allowed for the per.it with fee charge of fl5,OO, The extension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six .onth period, Dr the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY, IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />CO"ENCE'ENI. JODS ONOER '2,500 IN VALOE DO NOI NEED 10 RECORD ..~~
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<br />SIGNATURE, O'NER ~~ SIGNAIURE, CONIRACTOR
<br />
<br />h"\€>wrl to me or l"lho has
<br />
<br />
<br />STATE OF ~A
<br />COllNTY OF ~() ~--"5
<br />The foregoing in5t~ument was acknowledged
<br />befcq-e me this0\) \.1 \~, lcLK. by
<br />\. .~
<br />
<br />
<br />or Nho has
<br />
<br />did not
<br />
<br />Typed, Prin d_...5:~,_~~.S!
<br />}~i~rrT7~~0~?:~.L " IT '.'
<br />"afARY FUm.JC 5'; IU" \'.". .,WR_D,.\
<br />J'I C..o. ~ni1""'SlON NO. c.'..""7Jn, J2,?6
<br />. ,1,....~~,,_L.<, , " "I', l- Y 5 1998
<br />M.1 s:s:::~F'{~~~~P. .>;,,",'..
<br />
<br />(Name yped, Prln
<br />NOTARY PUBLIC
<br />
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