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CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS The undersigned understands that this perlit lay be subject to Bdeed restrictions" which JaY be lOre restrictive than City regulations. !he undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas bired a contractor or contractors to undertake workr they lay be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by lawr both the owner and contractor JaY be cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireJents JaY apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJentr (813) 788-6611. FurtherlOrer if the owner has hired a contractor or contractorsr he is advised to have the contractor(s) sign portions of the "Contractor Sections" of this application for which they will be responsible. If your as the owner sign as the contractorr you are indicating that your rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that lay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that Ir the applicant, bave been provided with a copy of uFlorida's Construction Lien Law - HOIeOWDer's Protection Guide" prepared by the Florida DepartJent of Agriculture and Conslller Affairs. If the applicant is sOleone other than the "owner", I certify that I have obtained a copy of the above described docUJellt and prolise in good faith to deliver it to the "owner" prior to COllenceaent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has COIIeDced prior to issuance of a perlit and that all work will be perfoIJed to leet standards of all laws regulating construction, City codes, zoning regulationsr and land developJeDt regulations in the jurisdiction. I also certify that I understand that the regulations of other governJental agencies JaY apply to the intended work, and that it is IY responsibility to identify what actions I lUst take to be in cOlpliance. Such agencies include but are not lilited to: * DepartJent of HnviroDlental Regulation - Cypress Bayheads, Wetland Areas and HnviroDJentally Sensitive Lands, WaterfWastewater !reatlent * Southwest Florida Water HanageJent District - Wellsr Cypress Bayheads, Wetland Areasr Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways * DepartJent of Health & Rehabilitative Services, EnvironJeDtal Health Unit - Wellsr Wastewater !reatJent, Septic ranks * US Environaental Protection Agency - Asbestos abateJent I also certify thatr if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan addressing a uCOlpensating volUle" will be suhlitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to violater cancel alter, or set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOle invalid unless the work authorized by such perlit is cOlIBnced within six IOnths of issuance, or if work authorized by the perlit is suspended or abandoned for a period of six IOnths after the tile the work is c~ced. One 90 day extension of tiler JaY be allowed for the perlit with fee charge of $15.00. !he extension shall be requested in writing to the Building Official. An approved inspection lUst be logged during each six IOnth period, or the project will be considered abandoned. WARNING TO OlUfER: YOUR FAILURE TO RECORD A NO'l'lCE OF COMMEIICEHEII! MAY RESULT IN YOUR PAYING nICE FOR IMPROVEMBIt'S TO YOUR PROPERTY ~ IF YOU III!EIID TO OBTAIN FINANCING, CONSULT WI'l'H YOUR LEllDER OR All A'l"l'ORREY BEFORE RECORDING YOUR NOTICi OF COMMENCEMENT. JOBS UNDER $2r500 IN VALUE 00 NOT NEED TO RECORD AND POST A DNOTICE OF COHMENCEMD'I'". SIGNATURE: CONTRACTOR SIGNA'l'URE: OWNER OR AGENT STATE OF FLORIDA COUII'lY OF The foregoing instrument was acknowledged before me this , 19____ by STATE OF FLORIDA COUIlfY OF The foregoing instrument was acknowledged before me this , 19_____ by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC