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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this petlit laY be subject to Ideed restrictionsu whieb laY be lOre restrictive than City
<br />regulations. !be undersigned assUJes 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 IfOrk, they JaY be required to be licensed in accot'dance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor>IaY be
<br />cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />reguireJents laY apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<br />, 788-6611.
<br />
<br />Furthe1'lOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />uContractor Sectionsl of this application for whieb they will 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 IfOrk. 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 peraitting 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 - BoIeowDer'sProtection
<br />Guideu prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is 8OIl!OJIe otberthan the
<br />"owner", I certify that I have obtained a copy of the above described dOCUJent and prCJlise in good faith to deliver it to the
<br />"owner" prior to COIIenCeJeDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforJation in this application is accurate and that all work will be done in cOJpliance with all
<br />applicable laws regulating construction, zoning, and land developunt.
<br />
<br />Application is bereby Jade to obtain a perIIit to do work and installation as indicated. I certify that no work or
<br />installation has ~ced prior to issuance of a perlit and that all work will be perforJed to Met standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develo(lleJlt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveI1lIIeIltal agencies laY apply to the intended wort, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in COIpliance. Sueb agencies include but are not liJited to:
<br />t DepartJent of EnvirODleDtal Regulation - Cypress Baybeads, Wetland Areas and Envirolllentally Sensitive Lands,
<br />Water/Wastewater TreatJent
<br />t Southwest Florida Water ManageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArIy Corps of Engineers - Seawalls, Docks, Xavigable Waterways
<br />t Departlent of Health' Rebabilitative Services, InvirOJlll8Jltal Health Unit - Wells, Wastewater !reatJent, Septic tanks
<br />t US Envirouental Protection Agency - Asbestos abateJent
<br />I also certify that, if fill Jaterial is to be used in Flood ZOne -A- or "A,etc. I, it is understood that a drainage plan
<br />addressing a lCOJpenSating volUJe- will be subJitted wbieb is prepared by a professional engineer registered in. the State of
<br />Florida prior to petlit issuance.
<br />
<br />A PerJit 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 ffOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall beCOle invalid
<br />unless the work authorized by sueb perlit is co.enced within sillOntbs of issuance, or if work authoriJed by the perJit is
<br />suspended or abandoned for a period of six IOOtbs after the tile the work is ~ced. One 90 day eJtension of tile, IaJ be
<br />allowed for the perlit with fee charge of $15.00. !be extension shall be reguested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillOOth period, or the project will be considered abaDc1onec1.
<br />W1RJfIIfG TO ODER: YOUR FAILURE TO RECORD A 1f0000ICI OF COIIBICIIlBIfI MAY RESULt 1M YOUR PAYIIfG DICI FOR ,IMPROVIIIBIItS TO YOOB
<br />PROPERtY. IF YOU IIlmD to OBfAIM FIWCIIG, COJISOLt WIrs YOUR LODER OR 11 AttORDY BBFORB RBCORDIMG YOUR IfO'I'ICI OF
<br />COIlMEIfClMm. JOBS lOOlER $2,500 II VALUE 00 110'1' IfIED to RECORD AID POSt A llfO'I'ICE OF C(JIlDCBIIIIf'lI.
<br />
<br />SIGIIA'fURB: OOIR OR AGm
<br />
<br />SIGU'fURB: COI!IIAC'fOR
<br />
<br />STATB OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19_. by
<br />
<br />STA!B 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 arid 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 didTdid not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Sta.mped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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