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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />rhe undersigned upd.r.t.ads tbat Ibl. P.roft oa, be subJ.ct to 'deed r.strlctIOP" oblcll oa, he .... restrictive than Clt,
<br />regolatlons. 110 UDd.r.lgood ....... t08pOOSlblllt, lor cooplf.pc. ollb any appllcubl. deed restrlcll....
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tb. ....r bas blr.d · cootr.ctor or cootr.ctors to upd.rlal. oorl, Iber oa, be r"lulred 10 be Ilcesosi 10 accordanc. olth
<br />at.t. andloeal reg.l.tI..... If tb. cootractor f. pot lleeaoed as regolred by I.., bolb the 0tIIIer and __ .., he
<br />cited for a .Ied.....or vfof.tl.. UPd.r .t.t. I.., ff the UIOer or ioteaded cootractor are oocert.iD as to oIot 11....I.g
<br />r.gulr....t. .., .pply for the fpt..d.d oorl, the, .r. .d'lned to conl.ct tb. Clt, of Z'ph,rhlll. Bulldlog Departo,qt. 1813)
<br />788-6611.
<br />
<br />Furtberoore, If the ON'" bas hired · contr.clor or cootr.ctor., be i. .dvlsed to have the cootractorl') .Ign portions af the
<br />'Cootractor Sectloo.' 01 thl. .ppllealloo for lIblclllb.y 011I b. responslbl.. If JOU, as the ...er sign as the coolractar.
<br />roo are Indlc.tlng that fOu, r.tber tban the cootr.ctor, are r"POnslbl. for the sorl. If the contr.clor .iahes ,.. to .Ign
<br />.. cootractor that oay be an Iodlcatloo that he I. not properly IlcOP.ed and Is not OPtllled 10 peroilllog pelrllages I. tI,
<br />City of Zephyrhills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES ",~
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<br />D. CONSTRUCTION LIEN UAW IClmPTER 713. FLORIDA STATUTES, AS AH8HDED)
<br />I c.rllfy thai I, the appllcanl, have bOOP Provided olth . copy of 'Florlda's COnstrucllon LlOP Lao _ Buoeoeuer', Prolectloo
<br />Gulde~ prepared by lb. Florida Deparbleul of Agricuilur. aad Coo'WI.r 8ff.fr., If tho appllCOPt I, ....... other than 1Io
<br />.....r., I cerllfy tbat I ha,. ohlal.ed a copy of the 'bove described doc....t and prOlI.. la good f.lth 10 deliver II 10 1Io
<br />"owner" prior to couence.ent.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I cerllfy Ibal .11 th. Infor..lfOP I. Ibl. appIfeation I. accural. aad Ibal all ..rl 0111 be dnoe I. coopJl.... .ltI .11
<br />applicable laws regulating construction, loning, and land developlent.
<br />I I
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<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no wari or
<br />I..lallall.. has ......ced prior 10 Issuanc. of . per.11 .od thel all oorl 0111 be perf,,"", 10 ...t .laadarde of all 1aea
<br />regulating con.lrucllon, City codes, .onlog regulation., aad laoi devolo,","1 regulatloo. 10 the jor1ollclloo. I al..
<br />cerllfy thel I uDderslaud th.1 the tegulalfOP' of other gorernaesl.1 .gencies oay .pply 10 1Io ioteoded sorl. and thet It Is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />· Deparbleul 01 IDrironaenlal Regul.llo. - Cypr.s. Ba,beads, NOtland Areas and Kn'lr.....lally 8eosltive lauds,
<br />Water/Wastewater Treatlent
<br />I Southwest Florida Water Hanage.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />I ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />· De arbleul of Health , Rehabllllatlve S",I... Envlronoenlal Beallb Unll - H.II.. Rasleoaler rreableul, Septic rants
<br />I US BnviroDlental Protection Agencl - Asbestos abatelent
<br />I al.o cortlf, 'Iot, If fill oaterl.f I. to be used in Flood Zoo. '1' or 'I,.tc.', it I. uoder.lood thai a drainags piau
<br />addresalag a 'COIpeP.allng '01.... 'III be 'oIaltted ,bleb I. prepared by a prof...louaI engineer reglateroi In tie Slat. of
<br />Florida prior to perlit. issuance.
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<br />. I perllt I.sued shall be oonstrued to be · Iicens. 10 proceed 'ith tbe ..rl sod not as sutlerlly to violate, caaoaJ aller, or
<br />set "Ide .ny provl.ions of tbe tecbnlcal cod.., nor shall Is,","" of . per.il pr....1 the Building Official froe lheoeofter
<br />requiring a correction of error. io plans, conslroctlon, or Ylol,II... of auy code. Seery perait IBBUOd shall becoee !oIalld
<br />unles. tbe IOrl aullorl.ed br sucb peralt i. ........a .Ilblo .1. 100110 of lasu..... or If IOrl sutlorlsol by the peralt I.
<br />...peodoI or ahandooed for · period of .is 100110 after the U.. 1Io sari I..........s. Doe 90 dar 08teDsl... of tlas, .., be
<br />.llooeI for lb. perolt ,ilb f.. cb,rge of $15.00. rb. 08lenslon shall be requesled I. 'rltlog to the Building Official. 80
<br />approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned.
<br />RBBIIJG TO 0IBIIlI: YOOII FAlLURll TO RICOIlIlI 10TieD 01 CllllllilCBllRlIIIY IIISULr II _ PIYIJG TIlleD !llII iIll'IIOYIIIIII TO IOOlI
<br />PROPllRTY. IF YOU IHTBND TO OBTAIN FINANCING, CONSULT WITH YOUR LBIDllR OR AN AnORlllY BBFORll RllCORDING YOUR "orlCB OF
<br />COHHIiNCBHIiHr. JOBS UNDIiR $2,500 II VALUIi 00 NOT NIiIiO TO RIiCORD AND POST A "NOTICB OF COHHllNCEHBHT".
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<br />SIGNATURB: ONlfBR OR AGENT
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<br />" I
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<br />SIGNATURE: COHTRACTOR
<br />
<br />STATB OF FLORIDA
<br />counl OF
<br />The foregOing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATIi OF FLORIDA
<br />COUHTY 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 oath.
<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
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