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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 wdeed restrictionsw which lay be lOre restrictive than City
<br />regulations. The undersigned assOIes responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CON'l'RAC'l'OR 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 lal be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<br />188-6611.
<br />
<br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />wContractor Sectionsw of this application for which they will be responsible. If you, as the ONDer sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If tbe contractor wisbes you to sign
<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.
<br />
<br />C. 'rRANSPORTATION IMPAC'r FEES AND U'l'ILITY CONNECTION FEES ,,{
<br />
<br />D. CONS'l'RUC'l'ION LIEN L1\W (CHAPTER 713, FLOIUDA STA'rUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided with a copy of wFlorida's Construction Lien La. _ HoIeoIoer'a Protection
<br />Guidew prepared by the Florida Departlent of Agriculture and Consu.er Affairs. If tbe applicant is lOIeone otber 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 />wownerw prior to COllenCelent.
<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 cOIpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />I
<br />
<br />Application is hereby .ade to obtain a perlit to do work and installation as indicated. I certify that no wort or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perforled to Jeet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I alIa
<br />certify that I understand that the regulations of other governaental agencies lay apply to tbe intended work, and that it il
<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 Envirofilental Regulation - Cypress Bayheads, Wetland Areas and Envirofilentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />I Southwest Florida Water Hanagetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />* Ar.y Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* Deparllent of Healtb & Rehabilitative Services, Envirofilental Healtb Unit - Wells, Wastewater Jreallent, Septic lanks
<br />I US EnviroDlental Protection Agency - Asbestos abate.ent
<br />I also certify that, if fill laterial is to be used in Flood Zone "AW or wA,etc.., it is understood that a drainage plan
<br />addressing a "colpensating volOle" will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit. issuance.
<br />
<br />. A perlit issued sball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />Bet aside any provisions of the technical codes, nor shall is~u~ce of a perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery'petlit issued shall beca.e invalid
<br />unless the Nork authorized by such perlit is cOllenced within six IODths of issuance, or if work authorized by the PlClit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day 81tension of tile, 181 be
<br />allowed for the perlit with fee charge of $15.00. Tbe extension shall be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eacb sil IOnth period, or tbe project will be considered abandoned.
<br />WAMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COIIHKIICKHlRT HAY RBSULJ IN YOUR PAYING !lUCK FOR IMPROVIIIDl'S TO YOUR
<br />PROPERTY. IF YOU IIITEND TO OBTAIN FINANCING, CONSULT WITH YOUR LIIIDIR OR AN ATTORRIY BIFORB RiCORDIMG YOUR MO'lICE OF
<br />COHMENCIHINT. JOBS UNDIR $2,500 IN VALUI DO NOT NEED TO RICORD AND POST A wNOTICI OF COHMINCIHIMT".
<br />
<br />SIGNATURI: OWHIR OR AGENT
<br />
<br />, I
<br />
<br />SIGIIATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COURTY OF
<br />The foregOing instrument
<br />before me this
<br />
<br />was acknowledged
<br />I 19_ by
<br />
<br />STATI 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 Oath.
<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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