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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 to "deed restrictions" which lay be lOre restrictive tban City
<br />regulations. The undersigned assWles 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 Mith
<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 lisde.eanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />require.ents lay apply (or the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<br />188-6611.
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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 wiabes you to aign
<br />as contractor that lay be an indication that he is not properly licensed and Is not entitled to per.itting 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 />I ~!
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<br />D. CONSTRUC'fION LIEN L'I\W (CHAPTER 713, FLORIDA STATUTES I AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of .Florida's Construction Lien Law _ HoIeoIoer'l Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConSWler Affairs. If the applicant is sOleone other 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..ence.ent.
<br />
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the infoClation 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
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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 cOIIenced prior to issuance of a perlit and that all work will be perfoIlBd to I88t standards of all 1111
<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 other governlental agencies laY apply to the intended work, and tbat 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 RnviroDlentally S8D8itive Lands,
<br />Water/Wastewater rreallent
<br />* Southwest Florida Water Hanage.ent District - Wells, Cypress Bayheads, Wetland Areas, AlteifnglNatercourses
<br />* ArlY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />* Deparllent of Health' Rehabilitative Services, EnviroDlental Health Unit - Wells, Vastewater Ireatlent, Septic ranks
<br />* US EnviroDlental Protection Agency - Asbestos abateJent
<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 volOle" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit. issuance.
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<br />. A per.it 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~ce of a per.it prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perait iS8ued shall beCOll invalid
<br />unless the work authorized by such per.it is cOll8nced within six IOnths of issuance, or if work authorized by the petlit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOll8Dced. One 90 day 81tension of tile, III be
<br />allowed for the perlit with fee charge of '15.00. The extension shall be requested in writing to the Building Official. In
<br />approved inspection lust be logged during each six IOnth period, or tbe project will be considered abandoned.
<br />IfARJUHG TO 0II11R: YOUR FAILURE TO RICORD A 10TICI OF COHIIEICEHBIfT HAY RESULT II YOUR PAYING TWICK FOR IHPROVIIIBIl'S 10 YOUR
<br />PROPERTY. IF YOU IITKID TO OBTAII FINANCIIG, COISULT WITH YOUR LEIDER OR AI ATTORRKY BEFORE RKCORDIIG YOUR JlorlCK OF
<br />COMMEICEHB . JOBS UNDER '2,500 II VALUE DO lOT liED TO RECORD AID ~A .IOTICE OF COHHKNCEHEHIR. . ._ " _
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<br />-----f .. ~--T ~R .1
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<br />GIATURI: OWIIER OR AGENT y. SIGIATURI: COIfTRACTOR
<br />
<br />
<br />STATE OF FLORIDA
<br />COUIfTY OF
<br />The foregOing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATK OF FLORIDA
<br />COUNTY 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 oatb.
<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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