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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perait aay be subject t~ "dEed restrictions' which may be lore restrictive than City
<br />regulations. The undersigned assuaes responsibility for co.pl:anc~ with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR F:ESFJ)~~S,IB)LIlIE~i
<br />If the ON"er 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 co~tractor is not licensed as required by law, both the owner and contractor lay be
<br />cited for a lisdeaeanor violation under state IaN. 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 Zephyrhills Building Depar~~ent, (813)
<br />788-6611.
<br />
<br />Furtherlore, if the owner has hired a contractor or contractors, he 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 that you, rather than the contractor, are responsible for the work. 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 ZephyrhilIs.
<br />
<br />c. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LA~ (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 - Ho.eowner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If the applicant is someone other than the
<br />'owner', I certify that I have obtained a copy of the above described document and promise in good faith to deliver it tel the
<br />'owner' prior to cOllencelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVII
<br />I certify that all the inforlation 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 lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be performed to seet standards of all laws
<br />regulating construction, City codes, zoning reg~lations, and land developlent regulations in the jurisdiction. ! also
<br />certify that I understand that the regulations of other govern~ental agencies lay apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not limited to:
<br />. Departlent of Environlental ReQulation - Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands,
<br />Water/Wastewater Treatment
<br />. Southwest Florida Water ManaQeaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />. ArlY Corps of EnQineers - Seawalls, Docks, Navigable Waterways .
<br />. Departlent of Health ~ Rehabilitative Services, Environmental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />. US Environ.ental Protection AQencv - Asbestos abatement
<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 volume' will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />"
<br />
<br />A pertit issued shall be construed to be a license to proceed with the work and not as authority to yiolate, 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 co..enced within six months of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six tonths after the tile the work is comaenced. One gO day extension of ti~e, lay be
<br />allowed ~or the perlit with fee charge of lI5.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six month perioD, vr the project will be consider abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCE1ENT MAY RESULT IN YOUR PAYING T FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE E RDINb YOUR NOTICE OF
<br />COMMENCEMENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A 'NOTICE OF COMM /~nENT" ~
<br />
<br />
<br />X €~~~
<br />SIGNATURE: OWNER OR AGENT S 6NATURE: NTRACTOR
<br />
<br />was ackno~"lledged
<br />. 19 b'/
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF III L L S ,; (/ /l cJ t.{ C /-t_
<br />The foregoing ins'rument was acknowledged
<br />befcq-e me th i s I 2 . 19..2.L- by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />It (Ct-llf~L
<br />
<br />/.J
<br />
<br />/..JA y' E J
<br />
<br />who is personally known to me or who has
<br />pl-oduced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />\o',ho i SCEel-sona 11 y knowEJ7t:o me or ~'Jho has
<br />produced
<br />as identification
<br />
<br />and who did/did
<br />
<br />t/AanZh~ A~/Lrft
<br />
<br />(Sig~ure)
<br />DOUG t-~ H, G /L- '-- <:> rrr.=
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />not
<br />
<br />(Signatlll-e)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />Official"" ~
<br />DOUGLAS M. GILLOTTI!
<br />Notary PubUc. Stale of FlorIda
<br />l My Cllmm, expires Feb. 24.1998
<br />1_, ..___NO, CC350394
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