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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The .nde<.lgn.d und.r.tands th.t thl. per.lt BO, b. ..bject t. 'd..d r..tricti.... obleb .., be our. r..trlctl.. tbeo Clt,
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the ....r bas hired · rontr.ctor .r contr.ctors to .odert... worl. they .., he required to he licensed in 'ccordaaes .Ilb
<br />.t.t. and local regol.tl.... If tb. contr.ctor I. not Ilc....d as regolred h, I... bolb the ..... and contractor .., be
<br />cited for · .iodose.nor .lol.tion und.r .t.t. I... If the osn.r or Intended contractor are UDCe<tain as to .Iot licensing
<br />requlr....t. .., 'ppI, for the Intend.d BOrl. the, .r. .d.l.ed to contact th. Clt, of Zephyrblll. Building Departseot. (Bll]
<br />788-661J.
<br />
<br />Further..... If the osner h.. blred · contr.ctor or contr.ctor.. he i. .d'lsed to 10.. the contr.ctor(.) .Ign porti... of lb.
<br />'C..,tractor SecUoo.' of thl. .ppllcation for ""Ieb the, .ill he r"ponslbl.. If.... as the ..... .Ign as lb8 contractor.
<br />you .r. lndlc.tlog that fOO. r.ther than tbe contr.ctor. .r. r..ponslbl. for the 1Or1. ff the contractor .Iabes IOU to sign
<br />as contr.ctor that .., he .n indication th.t b. I. not Properly Ilc....d and I. not entitled to psrslttlng prl,llegeo in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND Ul'ILITY CONNECTION FEES
<br />
<br />, ~'
<br />,
<br />
<br />D. CONSTRDC'UON LIEN LAW (CHAPTER '113. FLORIDA STATDTES, AS AMEBDED)
<br />I certify th.t I, th. .ppllcant. 10.. h... provided .Ith . cop, of 'Florlda'. C...tructlon Lieu Lao _ ........... Protection
<br />Guld.' prepared by the Ylorid. Departseot of Agrlcoltur. .od C...oser Aff.lrs. If lb8 .ppllcant is ....... other tbeo the
<br />.....r., f certify that I love obtaloed . copy of the above descrihed doc....t and prosl.. In good faith to dell... It to lb8
<br />"owner" prior to co..enca.ent.
<br />
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI'l'
<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, Joning, and land developlent.
<br />,
<br />
<br />Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no worl or
<br />l08tall.tl.., has """,,ced prior to I....oc. of . per.lt and that .11 ..rl .111 be perfOlSOd to 808l .tooiards of all lOBI
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
<br />c.rtlfy tIot I .oderst.od th.t the regul.tlon. of other gn.ernsental agenCies ..y apply to th. luteoled lOr.. and tIot It I.
<br />IY responsibility to identify what actions I lust take to be in COlpliance. Such agencies include but are not li.ited to:
<br />· Oelort&e.t .f En.I,,",,"tal ReguI.tlon - Cypress Ba,head.. NeUaoI Are.. and En,lronoeotally S...ltlve Lando.
<br />Water/Wastewater TreatJent
<br />t Southwest Florida Water Hanaga.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Havigable Waterways
<br />t De artJent of Health & Rehabilitative Services EnviroDlental Health Unit _ Wells, Wastewater TreatJent, Septic 'anks
<br />t US En,iroDlental Protection Agency - Asbestos abateJent
<br />I .1.. ..rtlfy tIot. If fill ..t.rl.1 Is to he u80l In Floud Zon. ... or ....tc... It I. onder8tood lIot . draluaga pi..
<br />addressing · 'COIpOn..tlug ..I.... .111 he 'oIoltted .bleb I. prepared by . Professioo.1 euglneer regl.leroI I. tIo Stats of
<br />Florida prior to perlit. issuance.
<br />
<br />. A peroit I".ed sb.11 be con.trued to h. · lice... to Proceed .Ith the ..rl ani not as autborltr to ,Iolats. caaoeI alter, or
<br />set aside any pro,I.lon. of the technlc.1 codes, nor .ball I.,,,"ce of . perait pr....t tIo BuIlding Official f... tIorasfter
<br />reqoirlng a ourrectlon of 'rror. I. pi.... con.trnctlon. or ,101.11... of .., oode. B'", perslt Issuol sIol1 beonoo Inoalld
<br />unles. tbe ..rl ..lIorl.ed by such perolt I. """,,ced .Itbln .iI IORth. of IBBUancu. or If ..r. ..tborllol by !be FORIlt I.
<br />.~ or ahaocIoned for · period of .is ...tIo .ft.r lb. Use tIo IOrIIs _. Doe 90 lIa, eswlon of tile. la' 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 />WARRING TO OWHER: YOUR FAILURE TO RECORD A NOTICE OF COtlHEHClHIlfI' HAY RlSULT IN YOUR PAYIHG f1fICK FOR IHPROVIIIBD'S TO YOUR
<br />PROPERTY. IF YOU INTEHD TO OBTAIN FlltAHCING, COHSULT WnH YOUR LEltDER OR AH ATTORlBY BEFORI RiCORDIltG YOUR RorICK OF
<br />COHHEHCEHENT. JOBS UNDIR $2,500 IN VALUE 00 HOT NEED TO RICaRD AHD POST A "HOTICE OF COHHENCIHIlfI'".
<br />
<br />SIGHATURE: OWHER OR AGEHT
<br />
<br />STATE OF FLORIDA
<br />COUlITY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 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 />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />__ ~JJ
<br />SIGHATURE: COHTRACTOR
<br />
<br />rn. r:B~
<br />
<br />. I
<br />
<br />STATE OF FLO~A
<br />COUNTY OF 't!-.tCsCv
<br />The foregoing instrument was acknowledged
<br />before me this t, - to , 1912- by
<br />
<br />I? /isse// /'r1. tlUJlVoV
<br />who is personally own to me or who has
<br />produced FL #- b ~ 733- 52- 3'7/-0
<br />as identific on and who d' /did not
<br />take an oat . va
<br />t7L :::.a.t.LP.
<br />(Siglljljture ~. /
<br />l'T~e(4 L, i-"enl1uii~/}
<br />(Name T ed, Printed or St ped)
<br />NOTARY PUBLIC
<br />
<br />
<br />
<br />....~)f.~:i';:~< ANGELA l. PENNINGTON
<br />:o:;A to, MY COMMISSION II cc 522369
<br />~t ,~.J EXPIRES; January 3, alOO
<br />.~.."
<br />1J.tRf...~~." Sonlled Thru NoIaIy Public Undslwrftara
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