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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 'deed restrictions' wbich lay be lOre restrictive tban City
<br />regulations. The undersigned assDles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they laY be reguired 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 lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requiruents lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />188-6611.
<br />
<br />FurtherlOre, if the owner has bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />.Contractor 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 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 'Florida's Construction Lien Law - BOIeOWDer's Protection
<br />Guide" 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 of the above described dOCUleDt and prOlise in good faith to deliver it to the
<br />"ownerl prior to COlleDCeleDt.
<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, loning, and land developlent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas COBenced prior to issuance of a Perlit and that all IIOrt will be perforted to Jeet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gO'erDJeDtal agenCies JaY apply to the intended IIOrt, and that it is
<br />If responsibility to identify what actions I lUst tate to be in cOlpliance. Such agencies include but are not lilited to:
<br />t Departlent of BnviroDlental Regulation - Cypress Baybeads, Wetland Areas and BnviroDJeRtally Sensiti,e Lands,
<br />Water/Wastewater !reatlent
<br />t Southwest Florida Water HanageJellt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health i Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater !reatJent, Septic Tanks
<br />t US BnvirODJental Protection Agency - Asbestos abatl!leDt
<br />I also certify that, if fill laterial is to be used in Flood Zone IA' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'cOJpeDsating volUJe' will be snblitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />
<br />A p~lit 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 frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCale invalid
<br />unless the wort authoriled by such peIlit is co.enced within sillODtbs of issuance, or if wort authoriled by the perlit is
<br />suspended or abandoned for a periocJ of sil IODtbs after the tile the wort is coaenced. One 90 day eltension of tile, laY be
<br />allowed for the perlit with fee charge of $15.00. !be eltenaioD shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sil IODth period, or the project will be considered abandoned.
<br />"mIlie '1'0 lMIR: YOUR FAILURE TO RECORD A NorICI! OF COIMBRCIlIIDIIlAY RESUL! Iii YOOK PAYING !IIICI! FOR IMPROVIIImS TO YOUR
<br />PROPER'IY. IF YOU mIlD '1'0 OBIAIN FIIlAKCIIG, CONSOLI WIm YOUR LlllDIR OR 111 AnoRIIY BIFORE RECORDING YOUR liorICI OF
<br />COHHINCIHIIft'. JOBS UNDIR $2,500 VALUE DO 10'1 tIUD fO RECORD AlfD POST A "NorICI! OF C(JlHINCIlIIIMTII.
<br />
<br />
<br />VUc/cetif
<br />SIGIA!URI: COII!RAC!OR
<br />
<br />
<br />~~O~FFLORIDA &/i
<br />The foregoing i~~rument was acknowledged
<br />before me this ~ ~ ?' , 19.fL by
<br />
<br />
<br />w~iy ~ wbo bas
<br />produced
<br />as identification and who did/did not
<br />take an 3thJj , _# ;; /J
<br />~LL.L.eJ\.-{2 ~
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />,''J.-:;'~:'f~t. FELICE I. ROWLAND
<br />{!'li..\;% MY COMMISSION /I GC390799 EXPIRES
<br />~.~{~f September 18. 1998
<br />....7f.'if.:;...'<f...'" BONDED THRU TROY FAIN INSURANCe, INC.
<br />
<br />S!A!B OF FLORIDA // ;1 I~
<br />coum OF / o.-GIZ
<br />Tbe foregoing instrument was acknowledged
<br />before me this.,r-: ;2 g , 19i7- by
<br />
<br />'-/J~ ~
<br />wbo is persaiallY known to me or wbo has
<br />produced
<br />as identification and who did/did not
<br />
<br />ta~h:~' ~ ~~~
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />FELICE I. ROWLAND
<br />MV COMMISSION II GC390799 EXPIRES
<br />September 18, 1998
<br />',C~OEr THRU 'T1\OY FAIN INSURANCe. INC.
<br />
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