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<br />CON~ ,.ONS _ SRMIT AFFIDAVIT
<br />A.' NOT~CE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlitlay be subject to "deed redrictiomo" 1I;'lich liy'bl'urerestrictive thin City
<br />regulations. The undersigned allutes responsibility for co.pliance Nith any applicable deed r~strictiDn5.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the Ollnlr has 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 conthctor is nDtlicensed as required by lall, both the ONner and contractor lay be
<br />cited for a lisdeleanor violation under state lall~ If the ONner or intended contractor are uncertain as to "hat licensing
<br />requirelents lay apply for the intended work, ther are advised to contact the City of 2ephyrhills Building Departlept, (813)
<br />788-6611. .
<br />
<br />Furtherlore, if the ONner has hired a contractor Dr contractors, he is advised to have the contractor Is) sign portions of the
<br />"Contractor Sections" of this application for which they will be responsible. If you, as the ONner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the lIork. If the contractor IIi shes you to sign
<br />as contractor that lay be an indication that he 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 Nith a copy of "Florida's Construction lien Lall - HOleollner's Protection
<br />6~de" prepared by the Florida Departlent of Agriculture and Consuler Affairs.- If the applicant is sOleone other than the
<br />"owner", I certify that I have obtained a copy o:f the above described doculent and proaise in good faith to deliver it to the
<br />"owner" prior to cOllencelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all Nork Nill be done in coapliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby lade tQ obtain a perlit tD do work and installation as indicated. I certify that no Nork or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perforled to aeet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governlental agencies lay apply to the intended lIork, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li.ited to:
<br />f Departlent of Environlental Reaulation - Cypress Bayheads, Yetland Areas and Environaentally Sensitive Lands,
<br />Water/Wastewater Treataent
<br />f Southwest Florida Water "anagelent District - Yells, Cypress Bayheads, Yetland Areas, .Altering Watercourses
<br />I ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />f Departlent of Health & Rehabilitative Services. Environlental Health Unit - Wells, Wastellater Treatlent, Septic Tanks
<br />f US Environaental Protection Agency - Asbestos abatelent
<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 "cotpensating volule" will be sublit~ed 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 Nith the lIork and not as authority to violate, 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. ~very pertit issued shall becole invalid
<br />unless the work authorized by such perlit is cOllenced within six lonths of issuance, or if Nork authorized by the perlit is
<br />suspended Dr abandoned for a period of six lonths after the tile the Nork is co.aenced. One 90 day extension of tile, lay be
<br />allowed for the pertit 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 lonth period, or the project Nill be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CoKKENCE"ENT KAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER DR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COM CEKENT. JOBS UNDER S2'~ UE 00 NOT NEED TO RECORD AN POST A "NOTICE DF COHKENCEK' '--'
<br />
<br />
<br />
<br />was acknowledged
<br />, 19Q<o by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF fA S (.0
<br />The foregoing instrument
<br />befclre me this () d- lY-
<br />
<br />STATE OF flORIDA
<br />COUNTY OF PA56.::>
<br />The foregoing instrument
<br />before me this fXJr'~
<br />
<br />was acknowledged
<br />, 19 '1l'a by
<br />
<br />
<br />not
<br />
<br />o ~ He;, w. PAteK.-t/L
<br />wAe-- ~::I> "'1::'1 =\..'1 JaIl ~ kR6~Jh to un::...... lJR(z~ hila.
<br />pF6e1tll..ed ~~ (~
<br />as identificatiol and who ~/did not
<br />take an oath.
<br />
<br />J eQ.br--t ~
<br />who is personally
<br />prQliih:lECd
<br />a
<br />take an oath.
<br />
<br />W. P~be-
<br />~mown to me or uhe ha:;
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBL lC- -~--
<br />NATALIE SWAN
<br />Notary Public. State of Florida
<br />My.Comm. Exp. Oct. 12, 1999
<br />Comm. No. CC 501333
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />NATALIE SWAN
<br />Notary Public. State of Florida
<br />My Comm. Exp, Oct. 12. 1999
<br />Comm. No. CC 501333
<br />
<br />
<br />::w..~~..-
<br />
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