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CONDITIONS OF PERMIT AFFIDAVIT A_ NOTICE OF DEED RESTRICTIONS The undersigned understands that this pertit lay be subject to 'deed restrictions" which JaY be lOre restrictive than City regulations. !he undersigned assUles responsibility for cOlpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas hired a contractor or contractors to undertake work, they JaY be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor JaY be cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requireJents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building DepartJent, (813) 788-6611. FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the .Contractor SectionsH of this application for which they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that lay be an indication that he is not properly licensed and is not entitled to pertitting privileges in the City of Zephyrhills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, have been provided with a copy of 'Florida's Construction Lien Law - HOIeOMDer's Protection Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is SOIeone other than the 'owner", I certify that I have obtained a copy Df the above described docUJent and prOlise in good faith to deliver it to the "owner" prior to cOllenCeJent. E_ CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforJation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, zoning, and land developlent. Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or installation has cOlleDced prior to issuance of a pertit and that all work will be perfoIJed to leet standards of all laws regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also certify that I understand that the regulations of other goveDlJelltal agencies JaY apply to the intended work, and that it is IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to: * DepartJent of EnviroDJeDtal Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands, Water/Wastewater TreatJent * Southwest Florida Water ManageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses * ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways * DepartJent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater !reatJent, Septic Tanks * US EnvirOJllental Protection Agency - Asbestos abateJent I also certify that, if fill Jaterial is to be used in Flood ZOne HA' or "A,etc.', it is understood that a drainage plan addressing a RCOlpBDsating volUleR will be subJitted which is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official frOl thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becOIe invalid unless the work authorized by such pertit is cOllenced within sillOnths of issuance, or if work authorized by the pertit is suspended or abandoned for a period of sillOnths after the tile the work is co.enced. One 90 day l!Itension of tile, JaY be allowed for the pertit with fee charge of $15.00. The l!Itension shall be requested in writing to the Building Official. An approved inspection lUst be logged during each sixlOnth period, or the project will be considered abandoned. WARMING '1'0 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMERCEMElft' MAY RESULT IN YOUR PAYING fIIlCE FOR IMPROVEIIElft'S !O YOUR PROPER'fY. IF YOU Ilft'ERD TO OBtAIN ULT WITH YOUR LERDBR OR AI A!'fORHEY BEFORE ~CO NOTICI COMMENCEMENT. JO UNDER NEED '1'0 RECORD AND POST A 'NO'rI C S STATE COUlft'Y OF The foregoing instrument was acknowledged before me this , 19____ by STATE 0 FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19_____ by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Name Typed, Printed or Stamped) NOTARY PUBLIC