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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject Lo "deed restrictionsW which lay be lOre restrictive than City
<br />regulations. The undersigned as sOles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<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 lar be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licenSing
<br />requirelents lay apply (or 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 />WContractor SectionsW of this application for which they will be responsible. If rou, 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 he is not properly licensed and is not entitled to perlitting priVileges in the
<br />City of ZephyrhilIs.
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<br />C. TRANSPORTATION IMPACT FEES AND U'1'ILI'fY CONNECTION FEES ,,<'
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<br />D. CONSTRUCTION LIEN LnW (ClmPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law _ HOIeOMDer's Protection
<br />Guidew prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant is sOIeone other than the
<br />wowner", I certify that I have obtained a copy of the above described doculent and prolise in good faith to deliver it to the
<br />"ownerW prior to COllenCelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVI'f
<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 />I
<br />
<br />Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no wor1 or
<br />installation has cOllenced prior to issuance of a perlit and that all worl will be perfOrled to leet 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 goveCDIental agencies lay 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 />t Departlent of Environaental Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Havigable Waterways
<br />t Departlent of Health i Rehabilitative Services, Environaental Health Unit - Wells, Wastewater Treablent, Septic Tanls
<br />t US Environaental Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood Zone WA" or "A,ete.w, it is understood that a drainage plan
<br />addressing a wCOlpensating volUle" will be sublitted wbicb 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 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 perlit prevent tbe Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or vioiations of any code. Bvery pt[Iit issued shall beCOl8 invalid
<br />unless the worl autborized by such perlit is cOllenced witbin six IOnths of issuance, or if work authorized by the peIlit is
<br />suspended or abandoned for a period of sil IOnths after tbe tile the worl is COllenced. One 90 dar 81tension of tile, IIr be
<br />allowed for the perlit with fee cbarge of $15.00. The eltension shall be requested 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 />WARHING TO ONHiR: YOUR FAILURE TO RECORD A HOTICE OF COIDIHNCKHBlfT HAY RESULT IH YOUR PAYING TWICE FOR IHPROVIIIm'S TO YOUR
<br />PROPERTY. IF YOU IIITHND TO OBTAIH FIHAHCIHG, COHSULT WITH YOUR LENDER OR AH AnORNEY BHFORK RHCORDIHG YOUR HOliCK OF
<br />COHHEHCEHEHT. JOBS UHDER $2,500 IH VALOH DO HOT HiED TO RECORD AHD POST A wHOTICH OF COHMEHCKHKHTw.
<br />
<br />SIGHATURH: OWNER OR AGENT
<br />
<br />, I
<br />
<br />SIGHATURi: COHTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregOing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATE 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
<br />
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