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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this penit lilY be subject to "deed restrictions I which lilY be lOre restrictive than City
<br />regulations. !be undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner hai hired a contractor or contractors to undertake wort, they lilY be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as reguired by law, both the OlDer and contractor lilY be
<br />cited for a lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />_ reguireaents lilY apply for the intended wort, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />Furthenore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections I 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 wort. 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 penitting 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 "Plorida's Construction Lien Law - JIoIeowner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUlel' Affairs. If the applicant is SOleOlla other than the
<br />"owner", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to COIIeIlceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforliltion in this application is accurate and that all wort will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developleDt.
<br />
<br />Application is hereby lade to obtain a perlit to do wort and installation as indicated. I certify that no wort or
<br />installation has c~ced prior to issuance of a peIlit and that all wort will be perfoIJed to _t standards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIIIIeDtal agencies IilJ apply to the intended wort, and that it is
<br />.y responsibility to identify what actions I lust take to be in COIpliance. Such agencies include but are not Iilited to:
<br />t Departlent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and EnvirollleDtally Sensitive Lands,
<br />lIater/Wastewater Treatlent
<br />t Southwest Florida lIater Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t AllY COIllS of Engineers - Seawalls, Docks, Havigable Waterways
<br />t Departlent of Health & Rebabilitative Services, EnvirODleDtal Health Unit - ~ells, Wastewater 'freatlent, Septic ,ants
<br />t US EnvirODleDtal Protection Agency - Asbestos abatl!leDt
<br />I also certify that, if fill Iilterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "~sating VOlOl8" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Plorida prior to peIlit issuance.
<br />
<br />A PeIlit issued shall be construed to be a license to proceed with the wort 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 frol thereafter
<br />reguiring a correction of errors in plans, construction, or violations of any code. Ivery peIlit issued shall beaIIe invalid
<br />unless the wort authoriled by such perlit is COIIeDced within sillODths of issuance, or if wort authoriled bJ the pmit is
<br />suspended or abandoned for a period of sil IOnths after the tile the work is COII8Dced. One 90 day utension of tile, IilJ be
<br />allowed for the penit with fee charge of $15.00. fhe utension shall be reguested 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 />WARlfIKG TO 0IIKiR: YOUR FAILURE 'f0 RECORD A HO'flCH OP CC>>IHDCBIIBIft' HAY RESUL'f IH YOUR PAYlRG 'fIIICH FOR IHPROVIHIIII'S 'fO YOUR
<br />PROPIRn. IF YOU IJft'BRD 'f0 OB'fIIH PIWCIHG, CORSUL'f 111m YOOR LIIIDIR OR U AIIORDY BIFORI RICORDIKG YOUR ROIICI OP
<br />C(JDIINCIHIN'l. JOBS OIDIR $2,500 IN VALUI DO HOI HIID fO RECORD AND POS'f A -NOIICI OF CCJIIIINCBIIIII..
<br />
<br />SIGJlAfURE: lIfNBR OR AGm
<br />
<br />SIGlfA'fURE: COIft'RAC'fOR
<br />
<br />STATE OF FLORIDA
<br />COUN'lY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'fATI 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 />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an o~th.
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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