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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />. A. NOTICE OF DEED RESTRICTIONS
<br />rhe undersigned understands !hat tbis ....it ..y be subject to "deed restrictions" 'hleb ..y be lOre restrlctl.. than City
<br />regulations. The undersigned assUles responsibility for co.pliance with allY applicable deed restrictions.
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<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 />.tate aDd local regulations. If lbe contract.r is not licensed as required by I.., botb the ...er and CODtroclor JOy be
<br />cited f.r a .I.d......r vi.lati.. u.der state I... If 1Io "'er or i.teeded cuntractor are ..certain as to oIot licensing
<br />requlresents lOy apply for lbe Intended oorl, they are ad,ised to cootact tbe City of Zephyrhill. Building Deparlsont, 1813)
<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 Section." of Ibis application for .hleb they .ill he responsible. If you, a. the ...er sign as lb. CODtractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. 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 Zephyr hills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. CONSTRUC'l'ION LIEN LflW (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 _ HOIeOMner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConSUler Affairs. If the applicant is SOleDne 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..eIlC8lent.
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<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, zoning, and land developlent.
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<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no wor1 or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perfoCled to leet 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 goverDlental agencies lay apply to the intended wort, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not li.ited to:
<br />t Departlent of EnviroDlental Regulation - Cypress Bayheads, Netland Areas and EnviroDlentally Sensitive Lands,
<br />Nater/Wastewater Treallent
<br />I Southwest Florida Nater Hanag8lent District - Wells, Cypress Bayheads, Netland Areas, Altering Natercourses
<br />I ArlY Corps of Engineers - Seawalls, Docks, Navigable Naterways
<br />t De arllent of Health & Rehabilitative Services EnviroDlental Health Unit - NeIls, Nastewater Treatlent, Septic rants
<br />t US EnviroDlental Protection Agencl - Asbestos abat8lent
<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 "colpensating voIUle" will be sublitted whicb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit. issuance.
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<br />.:;< (> ....
<br />, OJ /I ~id
<br />\J SIGHATURE: OWHRR OR A &t ..
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<br />. A perlit issued shall be construed to be a license to proceed with tbe work and not as authority to violate, cancel alter, or
<br />Bet aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or vioiations of any code. Bvery peClit iSBUed shall beCOle invalid
<br />unless the wort authorized by such perlit is cOllenced within six IOntha of issuance, or if work authoriled by the per.it is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day 81tension of tile, l8y be
<br />allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<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 NOTICR OF COHHEHCBHRH'l HAY RESULT IN YOUR PAYING DICK FOR IHPROVBIIII1'S TO YOUR
<br />PROPERTY. IF YOU IH'lEHD TO OBTAIN FINANCING, CONSULT NITH YOUR LEHDER OR AN AnORIIRY BEFORE RECORDING YOUR .0001CK OF
<br />COHHRNCEHRNT. JOBS UNDER $2,500 IN VALUE DO NOT NERD TO RECORD AND POST A "NOTICR OF COHHENCBHEH'l".
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<br />A ~
<br />~~A/L/ . //
<br />~IGlIAfIIRE: ~ 011
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<br />STATE OF F~ I...... v
<br />COUNTY OF . Z) _'"--
<br />The foregOing i~: .... .cknowledged
<br />before me this I I , 19? 7 by
<br />
<br />J-., 8e ,d~+I-
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />take~n~~ / ~
<br />
<br />(Signalbre) .
<br />
<br />STATE OF FLORII}A)O. J. v'
<br />COUNTY OF (-( "- f.--
<br />The foregOing instrument was acknowledged
<br />before me this 12-- Ii 2-, 192.Z.. by
<br />I
<br />
<br />~t) -;;',?J16 /J?ocL-
<br />who is personally known to me or who bas
<br />produced
<br />as identification and who did/did not
<br />take an o~~ . -;: &AtJ
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />.,.....~-_...
<br />y P OFFICIAL NotARY 510"..
<br />:\p..~ u~<: FRANK T CRUM
<br />~'\n.,SS7T "0 COMYSSION NUMBER
<br />1:. ~! ~ CC596868
<br />7~~;:;jJ S MY COMMISSION E_RES
<br />~ OF F\.oq; OCT. 2820'0
<br />
<br />. ..~Y Pu OF'-JCIAL NOTARY SEAL
<br />I Qto ~<;., FRANK T CRUM
<br />.,~ ('l COMIUSloN NUMBER
<br />~ . ~ ~ CC596869
<br />~ ~ MY ~ EXPIREs
<br />~ OF FI.Oq:. OCT. 28,2(j(\r)
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