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<br />~ CONDITIONS OF PERMIT AFFIDAVIT
<br />.' A. NOTICE OF DEED RESTRICTIONS
<br />lb. und.r.igned under.tands thot tbl. per.lt .ay b. ..bject t. 'deed r..tricti.... shieh oay 10 ..ro r..trlctl.. l60s City
<br />regulations. The undersigned assUles responsibility for co.pliance with any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If lbe ..... bun bired a cootractor or contractor. t. und'rtal. worl. tb.,.., Ie reg.ired to be 11....01 10 accordauca .111
<br />.Iate and local reg.latl.... If lbe contractor I. not Ilcen.ed a. r",lred by I... boll lbe ..... and CODlraclor .., 10
<br />cited Cor a Iled"'..,r oColatlon WId.r .tat. la.. If lb. ....r or intended contractor are "cortala as to abat II....jqg
<br />regolr....t. .., appl, Cor lb. intended 8Orl. lboy are adolsed t. contact lbe City of Zepbrrblll. Building Oeparlooot, (813)
<br />788-66J1.
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<br />Furtb.r..re. If tie o.nor baa bired a cootractor or cootractor.. b. i. adoiaed to bao. the contractor(.) .Iga portl... of 1Io
<br />'Cootractor Se<:ll.... of Ibis applicall" for shieh tb., .iII he r"_lbl.. If roo. as 1Io ...or alga as 1Io ....tractor.
<br />you are lodlcatlng !bat you. ratb.r than lbe contractor. are r'.po"lbl. for the aorl. If 1Io ....tractor llabea IOU to .Iga
<br />as contractor !bat oa, be .. indication that b. i. not proper I, liceosed ..d I. not entillol to peraitllog privileges In lbe
<br />City of Zephyrhills.
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<br />C. TRANSPORTATION IMPACT FEES AND U'l'ILITY CONNECTION FEES
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<br />, t'
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<br />D. CONSTRUCt'ION LIEN L'l\W (CHAPTER 713. FLORIDA STATUTES, lIS lIHIlNDED)
<br />I certify that I, the applicant, have been provided with a copy of wFlorida's Construction Lien Law _ BOIeOMDer's Protection
<br />Guidew prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
<br />........ I certlC, that I bao. obtai oed a copy oC lb. alo.. d..crlbed docuoent ..d prOlI.. In good lallb to dol I v.. It to 1Io
<br />wownerw prior to COalenceJent.
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<br />E. CONTRACTOR r S/OWNER' S AFFIDAVI'l'
<br />I certify that all the infor.ation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land develop.ent.
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<br />Application is hereby .ade to obtain a per.it to do work and instailation as indicated. I certify that DO worl or
<br />lnotallatlon baa COIIOROed prior tn I.....ce of a perolt aDd that all IOrl will be perCD<8Oi to ...t llaodorda nf all Iaoo
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the iurisdiction. I also
<br />certify that I understand that the regulations of other governtental agencies .ay apply to tbe intended worl, and that it is
<br />,y responSibility to identify what actions I .ust take to be in cOIpliance. Such agencies include but are not lilited to:
<br />· DepartJent of BnviroDlental Regulation - Cypress Bayheads, Wetland Areas and Bnvirontentally Sensitive Lands,
<br />Water/Wastewater Treattent
<br />· Southwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />· Ar.y Corps of Engineers - Seawall's, Docks, Navigable Waterways
<br />· De arttent of Healtb & Rehabilitative Services HnviroDlental Health Unit - Wells, Wastewater rreallent, Septic rants
<br />· US EnviroDlental Protection Agency - Asbestos abat8lent
<br />I also certify that, if fill .aterial is to be used in Flood Zone wAw or wA,etc.w, it is understood that a drainage plan
<br />addreSSing a wco.pensating VolUleN will he sub.itted which is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it. issuance.
<br />
<br />. I perllt IBlUOd shall b. cno'lrued tn be a lice... to prncoed wllb the warl and ont as aulbnrlt, to 'Inlatn. cancel BIter, or
<br />set aside any provisions of the technical' codes, nor shall is~u~nce of a per.it prevent the Building Official frUl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ever, petlit issued &ball beCOll invalid
<br />unless the worl authorized by such per.it is cOlIBnced within six IOnths of issuance, or if wort authorized b, the petlit is
<br />suspended or abandoned for a period of six IOnths after the tite the wort is couenced. One 90 day eatension of tille, II' be
<br />allowed for the per.it with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection .ust be logged during each six IOnth period, or the project will be considered abandoned.
<br />WARNING TO OWRER: YOUR FAILURR TO RRCORD A NOTICR OF COHHBNCBHHNT HAY RBSUn IN YOUR PAYING nlIa FOR DIPROVIIIm's ro YOUR
<br />PROPRRTY. IF,.OU IIfTRND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDRR OR AH AnORIBr IEFORB RlCORDING YOUR BorlCl 01
<br />COHHINCBHINT. JOBS UNDRR $2,500 IN VALUR DO NOT NERD TO RRCORD AND POST A wNOTICI OF COMMDCKHIlfrN. .
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<br />SlGNArURE: ONKRR OR AGRNT
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<br />SIGNATURE: CONTRACTOR
<br />
<br />srArB OF FLORIDA
<br />COURTY OF
<br />The foregOing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATB OF FLORIDA
<br />COUNTY 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 />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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