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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Ilo und'rolgoed .od,r.l.nds !bal lbl. per.ll oay be .obJecl Lu 'deed r,.lrlellno.' wbleb 10, he .... reolrlcll" tban til,
<br />regulations. fhe undersigned assUles responsibility for co.pliance with any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CON'l'RAC'l'On RESPONSIBILITIES
<br />If the ....r baG blred · COOlr'cLur Dr CUDlr,clor. 10 "d'rlal, warl, !bey.., he regulrei Lu be Ilcoooed 10 accordloce .111
<br />.l.le and loc.1 regul.ll.... If the cootr.clor I. .01 llceo.ed .. reguired IT I.., boll the ..... and coolroclor 10, he
<br />cited for · .Ied......, viol.llno onder Slal, I.w. If lb, ....r or Isl..ded coolraclor are nocerlaio .. la oIot 11....lng
<br />regolr....l. .., appl, for lb. IOl'nded oor1, lb., .r. .dvlsed 10 coolact lb. CIl, of Zepbyrblll. Building Departoo,t, (811)
<br />788-6611.
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<br />Fortlor..r., if lb. ....r bas blred · coolr,cLur Dr ...tr.clor., b. I. advlood Lu ba,. lbe contraclar(s) .Igo porli... of tIo
<br />'Cootraclor Socii.... of lbl. application for oblch lbey will he r"_lbl.. If JOU, .. tIo OlDer Gigo .. tIo cootr_,
<br />/OU are I.dlcaling !bal roo, rather thao the CDSlraclor, are re._Ibl. for lb. rorl. If 1Io cootr'Clar .iaheo you la .Iga
<br />a. COOireclor that 10, b. an ladic.ll.. lb.l b. I. 001 properl, IIC!OGed and I. 001 ..titled la P8C.lttiog prlvll.... 10 lb.
<br />City of Zephyrhills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. .cONSTRUCTION LIEN LAW (ClfAPTER 713, FLORIDA STATUTES~ AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law _ HOIeOMDer's Protection
<br />Guide- prepared by the Florida DepartJent of Agriculture and Consuaer Affairs. If the applicant is SOIeDne other than the
<br />"owner", I certify that I have obtained a copy of the above described docu.ent and pro.ise in good faith to deliver it to the
<br />"owner" prior to co..enCelent.
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<br />E. CONTRACTOR' 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, laning, and land developlent.
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<br />Application is hereby .ade to obtain a per.it to do work and instailation as indicated. I certify that no wort or
<br />installation bas COllenced prior to issuance of a per.it and tbat all work will be perfor.ed to leet standards of all laws
<br />regUlating construction, City codes, loning regUlations, and land developlent regulations in the jurisdiction. I also
<br />certify tbat I understand that the regulations of other governaental agencies .ay apply to the intended wort, and that it is
<br />.y responsibility to identify what actions I .ust take to be in co.pliance. Sucb agencies include but are not li.ited to:
<br />· Deparllent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />· Southwest Florida Water Hanage.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />· Ar.y Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />· De arllent of Healtb , Rehabilitative Services Bnvironlental Health Unit - Wells, Wastewater Treatlent, Septic ranks
<br />t US InviroDlental Protection Agency - Asbestos abatelent
<br />I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "clllpensating volUle" wiII be sub.itted which is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it. issuance.
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<br />. I per.it lsoued .b.11 be ....trued 10 b. . lice... to prooeed 11th !be rorl and 001 .. autburity to violate, caooeJ alter, or
<br />set aside any provisions of tbe technical codes, nor shall is~u~nce of a perlit prevent the Building Official frUl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code, Bvery peIlit issued shall becoIe invalid
<br />unless tbe work authoriled by sucb perlit is cOllenced witbin sil IOntha of issuance, or if work authoriled by the peIlit is
<br />suspended or abandoned for a period of Sill IIOntbs after tbe tile the work is couenced. One 90 day I!Itension of tile, .y 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 Sill IOntb period, or the project will be considered abandoned.
<br />WARNING TO OWNBR: YOUR FAILURE TO RBCORD A NOTICE OF COHHENCEHBNT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVIlllftS TO YOOB
<br />PROPBRTY. IF YOU IJfTIND fa OBTAIN FINANCING, CONSULT WITH YOUR LINDER OR All ATTORIBY BIFORB RBCORDING YOUR MorICI OF
<br />COKMENCEHENT. JOBS UNDER $2,500 IN VALUE DO NOT NIBD TO RECORD AND POST A -NOTICE OF COHKENCIMEHr".
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<br />XfJJJaJ<l//< #'~-L~->
<br />s'IGNATURB: OWlfER OR AGENT
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<br />In
<br />(Name Typed, Printed or
<br />NOTARY PUBLIC
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<br />STATE OF FLERI~ STATE OF FLORI~A
<br />COUNTY OF ~S CO COUNTY OF . 'C 0
<br />The foreqoin~ i~trument was acknowledged The foregoi ~ ~strume~~ was aCknowledged
<br />befor. me tb..~ <.!>..fIt, 19!17- by before .. tb'~<r J" HI , I9~ by
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<br />CiJI) 1?J es W . G::>e4SS'1 c.. QONi4'-d ..j.. ,c..k::.ere < I
<br />who is peionallX-.V1own to m~ or who ha~ who is~sonally knolOl to m~'ln! who bas
<br />produc .--! D~ll:..~ fo::lo-ISq-~~.j(t;J-OJroduce
<br />as ident' ication 'and who did/did not as iden ification and who did/did not
<br />take a.' tb. tak. oatb. ill..
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<br />: ' 'A ... ComIaiaiaa No. CC 317675
<br />.: '!>,,;..~ Myo-iuloe ExpiJa 05123198
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<br />(Name Typed, Printed or
<br />NOTARY PUBLIC
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