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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The under.lgned und.r.Llnd. lb.t thi. p.ralt oa, b. .ub].ct to 'deed r..triclion.' -bieb .., be IDr. r..trictive tbau Cit,
<br />reg.l.ti.... Tb. und.r.ign.d ....... respon.ibilily ior COIpliance -itb an, .ppllcabl. deed r..tricti....
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the ....r b.. hired · contr.ctor or contr,clor. to ond.rLlI. worl, th.,.., he req.ired to be licen.ed In accooIaoce _ith
<br />.t.t. and loc'l r.gui.tion.. If the contr.ctor i. nol licensed .. required b, ],_, buth the owner and CODtr.ICtor 10, be
<br />c]led ior · .ied.....'r 'io].linn und.r .t.t. I... If the ONn.r or Intend.d contr.ctor .r. """,rt'in .s to .Iot licensing
<br />reguir....ts lOy .pply ior tbe intended ..rl, th., .r. 'd,i.ed lu cont'cl the Cit, of Z.ph,rbill. Building Deparlseot, CBI3]
<br />788-6611.
<br />
<br />Furtbersor., if tb. ....r b.s hir.d · contr.ctor or contr.ctor., h. i. .d'ised to 10,. tb. cootractor(.) .ign porti... of the
<br />'Contr.ctor Secti.... oi thi. .ppiication ior .hich tb., _il] be responslb].. ii rou, as lb. ..... .ign a. lb. contractor,
<br />roo are indicating thal mo, rather lhan lhe COntr.clor, .r. r.sponsib]. for the worl. If tb. contractor .i8los mo to .iga
<br />.. contr.clorthat 10, be an indlc.tion that h. i. nnt proper], licensed .nd i. not entitled to P!<Iittiog pri'lleges 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 ~I
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<br />D. CONSTRUCTION LIEN L"IIW (CHAPTER 'IB, FLORIDA STATUTES. AS AHElmED)
<br />I c.rlif, thet I, the applicant, he,. b." provided .Ith a cop, of 'Florid.'. eoo.truction Lies Lis _ .........'. Fcotecti..
<br />Guid.' prepar.d bt the Florid. Deparlleut of Igricuitur. .nd eon....r Aff.lra. If th. appllcaot I. ....... other tbau the
<br />.....r", I certif, that I he" obt.ined · cop, of tb. ahove d..cribed doclllOllt and Prosi.. io !IDOd faith to deliver it to the
<br />"owner" prior to co..enCelent.
<br />
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI1'
<br />I cerllf, tlot all tb. inforlOti.. 10 tbi. .ppiicatlon i. 'ccur.t. .nd lb.l .11 ..rl .111 be don. In OOIpIi.... .Ilb .11
<br />applicable laws regUlating construction, zoning, and land develop.ent.
<br />I
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<br />Appllcalion i. hereb, lade to obLlin · p.r.It to do ..rl and inst.ilalinn as indicaled. I cortif, that on IOrl nr
<br />insLlII.tinn baa CDIIenced prior to i..nance nf a per.lt and that .11 IOrl .ill he perfnlled to seet .tsoIarda of all laos
<br />regulating construction, Cit, cod", loning regul.tions, .nd iand d.,.IDpIOnt regul.tions in the jurisdiction. I al..
<br />certify th.t I und.r.t.nd th.t th. regul.tions nf other gov.rns"t.1 agencies .., .ppl, to tbe intended 10(1, and that It i.
<br />., re.ponsibliit, tu identlf, -hat .ctions I .unt t.l. lo be 10 CUSpli.uc.. S.eb agencies Include bat are nnt IIsJIed to:
<br />· Deparlleut of En'ir.....LlI Regul.tlnn . C,pr... Ba,beada, W.tland Ar... and Bn'irnnsentally Sensitive land.,
<br />Water/Wastewater Treatlent
<br />· Soulhweat Flnrld. W.t.r ftanageaont Di.trlct - Well., Cypr... Ba,ho.d., W.tl.nd hrea., Altering watercourses
<br />I Arl' Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />· De artsent of Reallb , Rehabilitative Service. Iollronseotal Heallb Bult . W.II., W'.l...t.r rrealleut, Septic TanIa
<br />I US EnviroDlental Protection Agency - Asbestos abatelent
<br />I al.o c.rtlf, that, If fl]] ..t.ri.] I. to be ..ed In Flood Zon. 'A' or 'A,.tc.', it I. under.tood lIot . drainage pi..
<br />addre"lng · 'COIpen..ting ..I.... .ill be ..Io]tted -hicb I. pr.pared b, . prof...ional esgln... regl.tered 10 tbe Stat. of
<br />Florida prior to per.it, issuance.
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<br />. A per.it i..ued shall b. COO.trued to he · lic.... to proc.ed .ith the ..rl and nnt as ..tbority to 'inlat., .....1 alter, or
<br />..t asid. .n, Provl.ions of lb. tecbnicai end.., nor sh.il i.,n!"". of . per.lt pr....t the Building Offlc1al flOl tlerearter
<br />requiriog · correcti.. of .rror. in pi..., con.tructlnn, or ,iol.tlons of an, cod.. 8ferr IOIIit i8SuoI 8ha11 becooe inYalid
<br />un]... lb. worl authorlled by sueb peCljt I. COIIenced .itb]n .i. IOOlha of I..uance, or if IOrl autbnri.oI by the P!<Iit il
<br />.ulpend.d or .bandoned for · period of ail ..ntio .ft.r the tile lb. ..rl i. COIIOOcoI. Doe 90 dap "tens].. of tIss, so.! be
<br />all...d for lb. peeslt .ith f.. eb.rge of $15.00. Tbe "t.nsi.. .ball be r.quested in .ritinq to tbs Buildiog Official. Au
<br />Ipproved inspection ...t b. logged during eacb .i. sonlb period, or lb. proj.ct .ill be considerol abandonod.
<br />-IIG TO llIiIIEll: fOOR FlIILIJRI TO RRCDRD A /lO'fICl OF CfJIIlEIcRJmJI, IlAY IlASIILT 1ft _ FUlIG IIilCllDll1llPllDflllms TO TOUII
<br />FlIOFmr. IF 10U IIITRIlD TO DIIrm FiIlAIICIRG, l1llIS1lLT wm rllDR LRilDIR DR All Anomr _ IIRCIIIDIIG _ IOTICI OF
<br />COHHINCEHINT. JOBS UNDIR $2,500 IN VALUI DO NOT NilD TO RICORD AND POST A II TICI OF COHM 1Hilft''' .
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<br />
<br />
<br />. I
<br />
<br />OR AGR
<br />1'e-
<br />
<br />STATR OF FLORIDA n
<br />COUNn OF l~
<br />The foregoing instrument was acknowledged
<br />before me this NDV- d ~ , 19~ by
<br />
<br />& "','it-' It. Ale ..J:!5#v ~,
<br />who is per onally known to me or who has
<br />prOdUced
<br />as iden not
<br />take n
<br />
<br />STATR OF FLORID~
<br />COUNn OF Q....dl' .LJ
<br />The foregoing instrument was acknowledged
<br />before me this )/-dY , 192.Z- by
<br />
<br />~~~ ~;~CJ
<br />
<br />who is personally known to me or wbo bas
<br />produced Jf b$/~""" - 'l<f-d-- ~<f-~~-()
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />
<br />c
<br />(Name Typed, Printe or
<br />NOTARY PUBLIC
<br />
<br />
<br />(Signature)
<br />
<br />~m '3:>N~l/{ISHfH/VHOll.LllIlH.LlI3ONO& ,~~'.~:t.
<br />0Im '!~ ~ .>~:1if'\t:.
<br />J3i:1/dX3 ~ * NOlSS/WWO:) AW ~"\"y',,/.j
<br />,{pOOW 'V kIwN "~.. AIJ<W
<br />"'Ill'"
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