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<br />CONDIfIONS OF PERMIT AFFIDAVIT
<br />A. ~OTICE OF pEED 8~STRICTION~
<br />lhe undersigned understands that this per.it lay be subje(t to "deed restri(tions" whi(h lay be .ore restri(tive than City
<br />regulations. The undersigned assules responsibility for co'pliance with any applicable deed restrictions.
<br />
<br />El . ,=-=!!~JL I CENSED CONTR{~CTqR9-_..B.N!LJ;:P!JT.81ll;:TJJR J3~$.E:.PN9-L!n LL:L!~_9.
<br />If the owner has hired a contractor or contractors to undertake work, they may 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 law. If the owner or intended contra(tor are uncertain as to what licensing
<br />require.ents .ay apply for the intended work, they are advised to contact the City of Zephyrhills Building Depart.ent, (8131
<br />788-bbll.
<br />
<br />Further.ore, if the owner has hired a contractor or contra(tors, he is advised to have the contractor!sl sign portions of the
<br />.Contractor Sections" of this application for which they will be responsible. If you, as the owner sign as the contra(tor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
<br />as contra(tor that .ay be an indication that he is not properly licensed and is not entitled to pertitting privileges in the
<br />City of Zephyrhills.
<br />
<br />c. If.:AN!:?F-ORTAT I ON I r'lF-ACT FEE9. I-)Nl)_lJLL~TLJ~.QNltECTJ m'LF E E.?.
<br />
<br />D. ~ONSTRUCTION LIEN LAij (CHAPTER 713~ FLORIDA STATUTES~ AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of .Florida'~ Construction Lien Law - Ho.eowner's Prote(tion
<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 have obtained a copy of the above described doculent and pro.ise in good faith to deliver it to the
<br />"owner" prior to cot.encelent.
<br />
<br />E. CONTRACTOR 1 S/m.Jt-lER 's AFF I DQ~J..I
<br />I certify that all the infor.ation in this application is accurate and that. all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land develop.ent.
<br />
<br />Application is hereby tade to obtain a pertit to do work and installation as indicated. I certify that no work or
<br />installation has co..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 lhe jurisdiclion. I also
<br />certify that I understand that lhe regulations of other govern.ental agencies .ay apply to the intended w~rk, and that it is
<br />~y responsibility to identify what actions I aust take to be in co.pliance. Such agencies include but are not li.ited to:
<br />. Departtent of Environ.ental ReQulation - Cypress Bayheads, Wetland Areas and Environ.entally Sensitive Lands,
<br />Water/Wastewater TrealMent
<br />I Southwest Florida Water ManaQelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />. Ar.y Corps of EnQineers - Seawalls, Docks, Navigable Waterways
<br />I Depart_ent of Health ~ Rehabilitative Services, Environ_ental Health Unit - Wells, Wastewater Treat.ent, Septic Tanks
<br />. US Environ.ental Protection AQency - Asbestos abate.ent
<br />I also certify that, if fill .alerial is to be used in Flood Zone "A" or "A,etc.", it is understood thal a drainage plan
<br />addressing a "co~pensating volule" Kill be sub_itled which is prepared by a professional engineer registered in the state of
<br />Fl~rida 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, Dr
<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, construction, or violations of any code. Every per.it issued shall beco.e invalid
<br />unless the work authorized by such pertit is cOI.enced within six lonths of issuance, or if work authorized by the pernit is
<br />suspended or abandoned for a period of six lonths after the tile the work is co..enced. One 90 day extension of ti.e, .ay be
<br />allowed for the per.it Hith fee charge of tI5.00. The extension shall be requested in Hriting to the Building Official. An
<br />approved inspection lust be logged during ea(h six .onlh period, or the proje(t 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 />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD A '"NO F CO lCE"
<br />
<br />
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA (),
<br />COUNTY OF ~~t\ S
<br />The foregoing instrument was acknowledged
<br />before me this ~~ 19~r- by
<br />
<br />STATE OF FLORIDA
<br />COUtITY OF B.~e1A"'J
<br />The foregoing instrumentlwas acknowledged
<br />befc.re me this ~\ ~~19 ~(\ by
<br />
<br />who is pe me or who has
<br />pl-oduced
<br />as identification and who did/did not
<br />take an oath. . ./
<br />V '-4//
<br />
<br />
<br />
<br />who is ersonally or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath. I / ,/
<br />,V =::-' ({
<br />
<br />(Signatw-e)
<br />
<br />~V/ I\. 1<(?J.se;;:
<br />m ed)
<br />l' LN AR 5
<br />I C KEVIN KiWSF.
<br />NorARY PUBLIC STATE OF FLOPJDA
<br />COMMISSiON NO. CC19'1050
<br />MY COMMISSION EXP. APR. 28,1996
<br />
<br />(Signature)
<br />
<br />
<br />(Name Typ
<br />NOTARY PU
<br />
<br />(Name Ty
<br />NOTARY
<br />
<br />ed. <P1'!1~\!eiiDtt:1\~~
<br />
<br />MY ,,,. ,f~:;",:~~tr;;;;~"C1" I
<br />.". .~.,,'.h' .". A"': """<I{j
<br />----..:;:,~~~~~
<br />
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