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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to .deed restrictions. wbich lay be lOre restrictive than City
<br />regulations. fhe undersigned assUles responsibility for cOlpliance 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 witb
<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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirelents lay apply. for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner has hired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections. of this application for which they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating tbat you, ratber than the contractor, are responsible for tbe work. If the contractor wisbes you to sign
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to perlitting 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, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOIfDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
<br />"owner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to cooenceJent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance witb all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas cOllenced prior to issuance of a peClit and that all work will be perfoCled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governtental agencies laY apply to the intended work, and tbat it is
<br />IY responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />t Departlent of KnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic fanks
<br />t US KnviroDlental Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood Zone .A" or "A,etc. n, it is understood that a drainage plan
<br />addressing a .cOlpensating volUle" will be sublitted which 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 work 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. Every perlit issued shall beCOle invalid
<br />unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six IOntbs after the tile the work is cOllenced. One 90 day extension of tile, laY be
<br />allowed for the perlit 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 six IOnth period, or the project will be considered abandoned.
<br />WARlHHG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING !WICK FOR IHPROVEMENTS TO YOUR
<br />PROPERTY.. IF YOU INTEND '1'0 OmAIN FIIWICING, CONSULf WIfH YOUR LENDER OR All AnORIIEY BEFORE RECORDING YOUR NOTICE OF
<br />COMHKICBHKNT. JOBS UNDER $2,500 II VALUE 00 NOT NEED 1'0 RECORD AND POSI' A .IOTI~E OF COMMENCBHEN'I"I.
<br />
<br />Qc:eL7~it-
<br />
<br />SIGNATURE: OWNER OR AGEN'l SIGNATU~
<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 />STATK OF FLORIDA
<br />coum OF -\-l '. \, s)'Dy-() \,)(J....
<br />The foregoing instrument'was acknowledged
<br />before me this \5 S<pl , 19SI- by
<br />
<br />'"R OC'J!..< t .rv..." vY"cr\ t
<br />who is personally known to me or who has
<br />produced l~,~
<br />as identification and who did/did not
<br />
<br />
<br />t~~~~~'dU
<br />(S1gn!!1ure &. h<.:... ' Q L~
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />,"'!I'lll!... TABATHA J. BLACKWELL
<br />.,'W'..'>'/t... MY COMMISSION' CC 309986
<br />~.: :.~ EXPIRES: AuQUIt 19. 1991
<br />~ Bonded TIllU NoWY NlIC lJndeIWlI'III
<br />
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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