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<br />CONDITIONS OF PEI~IT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to "deed restrictions" which ~y be lOre restrictive than City
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner 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 contractor is not licensed as required by law, both the owner and contractor aay be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<br />788-6611.
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<br />Furtherlore, if the owner has hired a contractor or contractors, he 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 tbe contractor wisbes 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.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES {&
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<br />D. CONSTRUCTION LIEN unw (ClmPTER 713, FLORIDA STATUTES1 AS AMENDED)
<br />I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law _ HOIeONDer's Protection
<br />Guide~ prepared by the Florida Deparllent of Agriculture and ConsUler Affairs. If tbe applicant is sOleone otber than the
<br />"owner", I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the
<br />"owner" prior to co..enCelent.
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<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.
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<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no wort or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perforled to l8et 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 otber goverDlental agencies ~y apply to tbe intended wort, and that 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 />* Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />* Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />* ArlY Corps of Bngineers - Seawalls, Docks, Havigable Waterways
<br />* Departlent of Healtb & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treattent, Septic lanks
<br />* US EnviroDleDtal 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 "colpensating volUleR will be sublitted which is prepared by a professional engineer registered in tbe State of
<br />Florida prior to perlit. issuance.
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<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 />Bet aside any provisions of the technical codes, nor shall is~u~nce of a perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becoIe invalid
<br />unless the worl authoriled by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day eJtension of tile, laY be
<br />allowed for the perlit 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 tbe project will be considered abandoned.
<br />WAMING TO OWHER: YOUR FAILURB TO RECORD A NOTICE OF COHHEHCEHRHT HAY RESULT IH YOUR PAYIHG fNICK FOR IHPROVBllBlrS TO YOUR
<br />PROPRRTY. IF YOU INTRHD TO OBTAIH FIHAHCING, COHSULT WITH YOUR LEHDBR OR AH ATTORRRY BEFORE RECORDIHG YOUR HOIICI OF
<br />COHHEHCEHENT. JOBS U DBR $2,500 IN VALUR DO HOT NEBD TO RECORD AHD POST A KNOTICE OF COHHBNCEHKHTI.
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<br />SIGHATUR
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<br />SIGHATURE: COHTRACTOR
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<br />STATE OF FLO~
<br />COUHTY OF ~~
<br />The forego1ng instrument was acknowledged
<br />before me this ...s - 13 , 19.!l2. by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was aCknowledged
<br />before me this , 19___ by
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<br />who is personally known to me or w>>o has who is personally known to me or who has
<br />produced MfJs-J6d-SI:,-IJJ.s-o ))~l..;:; produced
<br />as identification and who did/did not as identification and who did/did not
<br />take ~t". Ci:. )jz~_ take an oath.
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<br />(SignatureJ~ . .A }f 7' (Signature)
<br />tL~ It. c.. V L=b ' {) tJ ~
<br />(Name Typed, Print<<;(() or Stamped) (Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC NOTARY PUBLIC
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<br />..,''..'J..~U~'"'' Nancy A. Moody
<br />/4?-Y:"'~~
<br />,*; I'JJ;,~:*E MY COMMISSION' CC534808 EXPIRES
<br />;;~~. February 21, 2000
<br />",'If.,n.~ IIONDED 'IlRI TROV FAIN INSlNNCE.IIfC,
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