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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this pertit lay be subject to Rdeed restrictionsH which lay be lOre restrictive than City
<br />regulations. The undersigned assUles 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 work, they .ay 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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />reguirelents laY apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (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 />HContractor Sectionsu of this application for wbicb 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 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 - HOIl!OlfDer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
<br />uowner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />.0wnerH prior to cooencelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<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 developllent.
<br />
<br />Application is hereby lade to obtain a pertit 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 perfoIJed to leet standards of all laws
<br />regulating construction, City codes, Boning regulations, and land developllent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govl!IllleJltal 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 lillited to:
<br />t Departlent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDleDtally Sensitive Lands,
<br />WaterfWastewater TreatJent
<br />t Southwest Florida Water Hanagetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />t US EnviroDleDtal Protection Agency - Asbestos abateleDt
<br />I also certify that, if fill laterial is to be used in Flood Zone "AD or "A,etc.., it is understood that a drainage plan
<br />addressing a RCOlpensating voluteR will be sublitted 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 pertit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every petlit issued shall beCOle invalid
<br />unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the pertit is
<br />suspended or abandoned for a period of six IOntha after the tile the work is coaenced. One 90 day l!Itension of tille, laY be
<br />allowed for the pe~it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each six IOnth period, or the project will be considered abandoned.
<br />WARNING TO ONHER: YOUR FAILURE TO RECORD A NOTICE OF COIIHDCEHEN1' MAY RESULT IN YOUR PAYING nllCE FOR IHPROVBIIEN1'S TO YOUR
<br />PROPERlY. IF YOU IN1'EHD TO OBTAIN FIIfANCING, COISULT WITH YOUR LEIfDER 0 no BEFO co YOUR NOTICE OF
<br />C UN $2,5 I VALUE DO lOT NEED TO RECORD AIID POST A "N F C
<br />
<br />
<br />
<br />STATE OF FLORIDA '~
<br />coum OF ~
<br />The foregoing ~~t was acknowledged
<br />before me this ~, 19~ by
<br />
<br />
<br />who is~son~l~ to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />take an ~ a . J71 =Iv
<br />(Signaturel ~ A J{ j .
<br />/1 ;)." ~ v - "D ~ if
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />STATE 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 and who did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~~~~:~ Nancy A. Moody
<br />:.(Ji.'1 :*~ MY COMMISSION # CC534806 EXPIRES
<br />;~;..~.;,<(.i' FebnJary 21, 2000
<br />"f.iif.:r..~" BONDED THII\I TROY MIH 1NSUIlANCE,INC,
<br />
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