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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this peIlit lay be subject to udeed restrictionsu which tay be lOre restrictive ~ City .
<br />regulations. !be undersigned assUles responsibility for coapliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertake work, they lay 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 lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requireaents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner bas hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />RContractor 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 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, have been provided with a copy of RFlorida's Construction Lien Law - HOIeOw.Der's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and Consuaer Affairs, If the applicant is sOleone other than the
<br />"owner", I certify that I have obtained a copy of the above described docuaent and prOlise in good faith to deliver it to the
<br />"ownerR prior to couenceaent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and tbat all work will be done in coapliance with all
<br />applicable laws regulating construction, zoning, and land developieDt.
<br />
<br />Application is bereby lade to obtain a peIlit to do work and installation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of a pertit and that all work will be perf OIled to teet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developtent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gove:rnJelltal agencies tay 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 lilited to:
<br />* DepartJent of Environaental Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands,
<br />Water/Wastewater !reatJent
<br />* Southwest Florida Water Managelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />* ArJy Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* DepartJent of Health & Rebabilitative Services, Environaental Health Unit - Wells, Wastewater !reaOOt, Septic rants
<br />t US Environaental Protection Agency - Asbestos abateleDt
<br />I also certify that, if fill taterial is to be used in Flood Zone "AD or "A,etc. R, it is understood that a drainage plan
<br />addressing a .cOJpensating volute" will be subtitted 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 peIlit prevent the Building Official frCl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall becOle invalid
<br />unless tbe work authorized by such peIlit is cOllenced within six IOnths of issuance, or if work authorized by the peIlit is
<br />suspended or abandoned for a period of six IOntbs after the tite the work is coaenced. One 90 day l!Itension of tite, Jay be
<br />allowed for the peIlit with fee charge of $15.00. !he extension shall be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each sil IOnth period, or the project will be considered abandoned.
<br />WARNING '1'0 OWNER: YOUR FAILURE !O RECORD A NO!ICE OF COMHDCElfENt' MAY RESUL! IN YOUR PAYING !VICE FOR IMPROVEIIBIfS '1'0 YOUR
<br />PROPERTY. IF YOU IUEID to OBtAIN FINANCING, CONSUL! IIIfH YOUR LENDER OR lJI AnomY BBFORE RECORDING YOUR 1f00ICE OF
<br />COMMEN UNDER $2,500 IN VALUE DO NO! NEED TO RECORD AND aJOlBlfCBMBUR.
<br />
<br />
<br />11" YO" 7 J.D ~;..f(,l
<br />
<br />
<br />~ iIW ., ~ ~/irV
<br />
<br />STATE OF FLORIDA
<br />COUlfTY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY 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 and 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 did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />(Hame Typed, Printed or Stamped)
<br />HOTARY PUBLIC
<br />
<br />(Hame Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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