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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit .ay be subject to Rdeed restrictions- which lay be lOre restrictive than City
<br />regulations. rbe 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 with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and Contractor lay be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirBlents lay apply for the intended work, they are advised to contact tbe City of Zephyrhills Building Departlent, (813)
<br />788-~61l.
<br />
<br />FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have tbe contractor(s) sign portions of the
<br />"Contractor Sections" of this application for whicb 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 worl. 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 Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
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<br />D. CONSTRUC'I'ION LIEN LnW (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 _ BoIeoIoer's Protection
<br />Guide- prepared by tbe Florida Deparllent of Agriculture and Consuter Affairs. If the applicant is sOllODe other than the
<br />"owner", I certify that I have obtained a copy of the above described docWlent and prOlise in good faith to deliver it to the
<br />"owner- prior to COllenCBlent.
<br />
<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
<br />
<br />Application is hereby lade to obtain a perlit to do wort and instailation as indicated. I certify that no worl or
<br />installation has cOlleDced prior to issuance of a perlit and that all work will be perforted to lIet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of otber governtental agencies lay apply to the intended worl, and tbat it is
<br />IY responsibility to identify what actions I lust tate to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />* Deparllent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Nater/Nastewater Treallent
<br />* Southwest Florida Water Hanagetent District - Wells, Cypress Bayheads, Netland Areas, Altering Watercourses
<br />* ArlY Corps of Engineers - Seawalls, Docks, Navigable Naterways
<br />* Departtent of Health & Rehabilitative Services, InviroDlental Health Unit - Wells, Wastewater Treattent, Septic ranks
<br />* US EnvirODlental Protection Agency - Asbestos abatBlent
<br />I also certify that, if fill laterial is to be used in Flood Zone RAn or "A,etc.-, it is understood that a drainage plan
<br />addressing a "cOlpensating volUle" will be sublitted which 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 tbe work ana not as authority to violate, cancel alter, or
<br />set aside any provisions of tbe tecbnical 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. Bvery pertit 188ued shall beCOll invalid
<br />unless the wor~authoriled by such perlit is cOllenCed within sil IOnths of issuance, or if wort authoriled by the perlit is
<br />suspended or abandoned for a period of sil IOnths after the tiae the wort is COlleDCed. One 90 day 81tension of tiae, III be
<br />allowed for the per.it with fee charge of $15.00. The extension sball be requested in writing to the BUilding Official. In
<br />approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned.
<br />NAMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHENCEllBN1' MAY RESULT IN YOUR PAYING TIIICE FOR IHPROVIlIIDl'S 10 YOUR
<br />PROPERTY. IF YOU IHTElfD TO OBTAIN FlHAlfCllfG, COHSULT IfIlB YOUR LODER OR All ATTORlEY BEFORE RlCORDING YOUR HOTICI OF
<br />COMMEIfCEHENT. JOBS UNDER $2,50'0 IIf VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COIIHEIICIIIBIlT-.
<br />
<br />~/j,~
<br />
<br />SIGNATURE: COIfTRACTOR
<br />
<br />SIGlfATURE: OWNER OR AGElfl
<br />
<br />" I
<br />
<br />STATE OF FLORIDA
<br />COUIllY OF
<br />The foregOing instrument
<br />before me this
<br />
<br />who is personally known to me or who has
<br />produced
<br />8S identification and who did/did not
<br />take an oath.
<br />
<br />
<br />STATE OF FLORIUA
<br />COUNTY OF '#'1St t)
<br />The foregoing instrument was acknowledged
<br />before me this d/.H- [Jer, 19..JL by
<br />
<br />)~ I+M.!) ~.&e J(
<br />who is ersonally known to m or who bas
<br />produced
<br />as identificatio not
<br />take an oath.
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />, t!
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC ~OFFLORIDA
<br />NOTARV=.i~
<br />COMMIII\OM' C(l5rGI6
<br />EXPlftES~
<br />eONDED THRIJ ASI\ 1
<br />
<br />"$Jf~~
<br />t!.~:~l
<br />"4t,1,19~;f:-%'"
<br />
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