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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A~ .' NOTICE OF DEED RESTRICTIONS
<br />,the undersigned understands that this penit lay be subject to -deed restrictions- which lay be lOre restrictive than City'
<br />regulations. the undersigned assUles responsibility for COIpliance 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 .ay 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 OIJIer and contractor .y be
<br />cited for a lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!lents aay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherJlOre, if the owner has hired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
<br />-Contractor Sections- of this application for which they will be responsible. If you, as the OIJIer sign as the CODtractor,
<br />you are indicating that you, rather than the contractor, are responsible for the worl. 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 -Florida's Construction Lien Law _ BOIeOImer's Protection
<br />Guide- prepared by the Florida DepartJent of Agriculture and CODSUIer Affairs. If the applicant is SOleOlle other than the
<br />-owner-, I certify that I bave obtained a copy of the above described docUJeDt and prOlise in good faith to deliver it to the
<br />-owner- prior to COlleDcl!lent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all wort will be done in COIpliance with all
<br />applicable laws regulating construction, Joning, and land developllent.
<br />
<br />Application is hereby lade to obtain a perlit ~o do worl and installation as indicated. I certify that no work or
<br />installation has couenced prior to iSsuance of a penit and that all worlvill be perforaed to leet standards of all laws
<br />regulating construction, City codes, Joning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govl!I1lJental agencies lay apply to the intended wort, and that it is
<br />IY responSibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lllited to:
<br />t DepartJent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater freatJent
<br />t Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t Arl' Corps of Engineers - Seawalls, Docks, Havigable Waterways
<br />t DepartJent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, lIastewater freatJent, Septic rants
<br />· US EnviroDlental Protection Agency - Asbestos abateJent
<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 -cOlpensating volUle- will be sublitted whieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with the Ifork 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 the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery petlit issued shall beCOle invalid
<br />unless the work authorized by such perlit is cOllenced within Sil IOnths of issuance, or if work authoriled by the perJit is
<br />suspended or abandoned for a period of Sil IOnths after the tile the Iforl is cOllenced. One 90 day eJtensioD of tile, .y be
<br />allolfed for the peIlit 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 sillOnth period, or the project Ifill be considered abandoned.
<br />WARlfIHG TO OIIRiR: YOUR FAILURE TO RBCORD A HOrICH OF COHHDCBHBRf HAY RESULt IH YOUR PAYING BICB FOR IHPHOVEHms fa YOUR
<br />PROPBRrY. IF YOU IJIIEHD fa OBUIR FIIWlCIRG, CORSun NUH YOUR LEIIDER OR AM AfTORIKY BEFORE RECORDIRG YOUR HOTIe! OF
<br />COKHElfCBHBRf. JOBS URDER $2,500 IH VALUE, DO HOT HEED TO RECORD AND POST A -HOTICK OF COHHHRCBHBRf-.
<br />
<br />slmmr: ~~~
<br />
<br />~ c..~~
<br />SIG TURI: COlfJRACTOR .
<br />
<br />StATE OF FLORIDA
<br />coom OF
<br />The foregOing instrument was aCknowledged
<br />before me this , 19____ by
<br />
<br />STArE OF FLORIDA
<br />coum OF
<br />The foregOing instrument was acknowledged
<br />before me this , 19_____ by
<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 oijth.
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name. ~ed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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