<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lOre restrictive than City
<br />regulations. rhe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRAC'I'On 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 Zephyrbills 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 the 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. CONSTRUC'I'ION LIEN L'.I\W (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 - HoIeowner's Protection
<br />Guide" prepared by the Florida Deparllent 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 docolent and prolise in good faith to deliver it to the
<br />"owner" prior to COMenCelent.
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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, laning, and land developlent.
<br />I
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<br />Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no worl or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perforted 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 governlental agencies lay apply to tbe intended worl, and that it is
<br />Iy responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not 11lited to:
<br />I Deparllent of Bnvironlental Regulation - Cypress Bayheads, Metland Areas and EnviroDlentally Sensitive Lands,
<br />Nater/Mastewater Treallent
<br />t Southwest Florida Mater Hanagelent District - Mells, Cypress Bayheads, Netland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Kavigable Materways
<br />t Deparllent of Healtb & Rehabilitative Services, EnvirODlental Health Unit - Mells, Vastewater TreatleRt, Septic ranks
<br />t US Environlental Protection Agency - Asbestos abatelent
<br />I also certify that, if fIll lateriaI is to be used in Flood Zone "A" or "A,etc.., it is understood that a drainage plan
<br />addressing a .cOlpensating volOle" will be sublitted whicb is prepared by a professional engineer registered in the 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 />set aside any provisions of the technical codes, nor shall is~u~nce of a perlit prevent the Building Official lrUl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery pellit iSBUed sball beCOl8 invalid
<br />unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authoriled by the pellit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day 81tension 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 the project will be considered abandoned.
<br />MARNING TO ONKER: YOUR FAILURE TO RHCORD A NOTICH OF COHHENCKHBKT HAY RESULT IN YOUR PAYING !VICE FOR IHPROVIKBIIS TO YOUR
<br />PROPERTY. IF YOU INTEKD TO OBTAIK FIKAKCIKG, COKSULT WITH YOUR LEKDER OR AI AnORRKY BEFORE RECORDIKG YOUR MO'lICH OF
<br />COHHHKCBHHKT. JOBS UNDHR $2,500 IK VALUH DO KOT KEHD TO RHCORD AND POST A "KOTICE OF COHHEKClKBNT".
<br />
<br />~w~~
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<br />SIGKATURE: OWNER OR AGENT
<br />
<br />~ tJ~~
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<br />SIGKATURE: COKTRACTOR
<br />
<br />, I
<br />
<br />STArE OF FWRIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATH OF FLORIDA
<br />COUKTY 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 bas
<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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