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<br />CONDI'fIONS OF PERMI'l' AFFIDAVIT
<br />1\. f-iOTICE Cr' DEED RESTRICTIONS
<br />. ----~._._.._-. -.
<br />i k c"Jersiyned uIlou3tands that this perlit lay be subject to "deed restrictions" which /lay be more !
<br />, l ions. The ,::, '~[signed assu.es responsibility for cOlpliance with any applicable deed restricti,
<br />
<br />JNLICEN~.<!) CONTRACTORS AND CONTRAC'l'OR RESPONSIBILITIES
<br />-~ .., -"------."--- - ._~--,--
<br />j,/ner has hil Q contractor or contractors to undertake work, they lay be required to be licen~
<br />';LLt dlld local reYUdtions. If the contractor is not licensed as required by law, both the owner and
<br />_'leu lur a llisdelledi!Jr violation under state law. If the owner or intended contractor are uncertaill
<br />,t~uilelients !lay ap~_ for the intended work, they are advised to contact the City of Zephyrhills Bui:
<br />
<br />t'('.-..rli,
<br />
<br />!'U LJIe!IJOre, if the vliller has hired a contractor or contractors, he is advised to have the contractor(s
<br />r enor Sections" uf this application for which they will be responsible. If you, as the owner sig
<br />.:r" indicating ll,,:c you, rather than the contractor, are responsible for the work. If the contract.
<br />j:i ~Ui:Udctor that lid) oe an indication that he is not properly licensed and is not entitled to penit!
<br />-iLl 01 Zephyrhills.
<br />
<br />Co 'l'HANSPOROl'A'fION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONS'fRUC'l'[ON LIEN LAW (CHAPTER 713, FLORIDA STATUTES I A~
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - Hl
<br />Guide" prepared by thl! rIorida Departllent of Agriculture and ConsUler Affairs. If the applicant is SOIlI
<br />"u,,::er", I certify tL:. I have obtained a copy of the above described docUlent and prolise in good fait!
<br />-"".,' ~rior to COlli.,. :cement.
<br />
<br />.iCliYd than City
<br />
<br />J in accordance witl
<br />iltractur .ay be
<br />J what licensing
<br />; Oepartment, (813)
<br />
<br />sign portions of th,
<br />JS the contractor,
<br />~ishes you to sign
<br />privileges in the
<br />
<br />i\MENDED )
<br />'owner's Protection
<br />other than the
<br />deliver it to tb,
<br />
<br />" , "':ON'I'RAC'((jl{ I SjOWNER' S AFFIDAVIT
<br />1 (ellily that all till; infor.ation in this application is accurate and that all work will be done in COIl iance with all
<br />"'F! j ,.]~le laws regu L, ing construction, zoning, and land developlent.
<br />
<br />" ;Je: iH L Issued shall elL construed to be a license to proceed with the work and not as authority to violu
<br /><d -';.(1" Jny provisic: of the technical codes, nor shall issuance of a peuit prevent the Building Offi
<br />;~c.,"ii'J tl correction cf errors in plans, construction, or violations of any code. Every peflit issued
<br />JllieSS Ule work author.i~ed by such peuit is cODenced within six lonths of issuance, or if work authori~
<br />:3uspellded or abandoned for a period of six .unths after the tile the work is couenced. One 90 day extel:
<br />JjJu~ed for the penit with fee charge of $15.00. The extension shall be requested in writing to the Bu;
<br />-.:; . - : ',specLioiJ ..c, ue logged during each six lonth period, or the project will be considered abandl
<br />",:\li"'l.. dWliEh: ,)!'AILUHE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FUH lM'/EHENTS TO YOUR
<br />: ;,FL:'; iF YOu jifHr, TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING tL. ilOTICE OF
<br />/""1.1":'1'.1"1'1'. JUBS UN!::' $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />
<br />
<br />:,;"",'UHf:: 0"" OR 1>,,<,,0 diAl!!( ~ U~
<br />
<br />:;,,: l i Jfl is nl~[I:L i .Jde to obtain a peuit to do work and installation as indicated. I certify thaL
<br />_LJLioIl iiilS cowa, ",;ed prior to issuance of a peuit and that all work will be perfofled to lIeet st::
<br />":.,>; COliSlrucL. City codes, zoning regulations, and land developllent regulations in the jurise.
<br />'I, .; lliat i under::; ,,,d that the regulations of other governIlental agencies lay apply to the intended.
<br />..-;ibility Lc "intify what actions I lust take to be in compliance. Such agencies include but oi
<br />.. :.;,~n_LQf J~.trui"._ental Regulation - Cypress Bayheads, Wetland Areas and Enviroilllentally Sensitive
<br />Water/Wastewater TreatJent
<br />A ,d"ls~-IlLJ.[0L'i0LI~r Manage.llent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watereo
<br />^ 0F~L;()~Q~J~L Engi~l:d~ - Seawalls, Docks, Navigable Waterways
<br />^ ~~P?J~~!.ent of BeallL .~. Rehabilitative Services, EnvirOll.lental Health Unit - Wells, Wastewater TreatIaeJl
<br />^ ~L~Il~irolllental Pr<:r~~ction Agency - Asbestos abateJent
<br />J1SU 'Jertify that, if fill lIaterial is to be used in Flood Zone "A" or "A, etc. ", it is understood that
<br />JiJdressiIlg a "compensilt ing volUle" will be sub.itled which is prepared by a professional engineer regisl
<br />~lo[ida prior to perlit issuance.
<br />
<br />
<br />~IAlt ~i !LUHIUA
<br />,'UUlff: Ji
<br />_.__._-~-+- -
<br />Tile foregoing illt; Lrwnent
<br />~'c:tu,-~ HIe this
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />was d,
<br />, 19
<br />
<br />..110 is personally known to me or who has
<br />produced ____
<br />:.t", iJentificatioll and who did/did not
<br />luke ,w oath.
<br />
<br />"ork or
<br />:rds of all laws
<br />~[l. 1 also
<br />ex, and that it is
<br />not lillited to:
<br />Jnds,
<br />
<br />~s
<br />
<br />.ieptic Tanks
<br />
<br />,rainage plan
<br />'J in the State of
<br />
<br />cancel alter, or
<br />.Jl fro~ thereafter
<br />,,all be cOile invalid
<br />by the per.it is
<br />In of ti.e, lay be
<br />,Ilg Official. II!:
<br />
<br />tlowledged
<br />by
<br />
<br />who is personally known to me L who has
<br />produced
<br />as identification and who did/\ j not
<br />take an oath.
<br />
<br />lSignature)
<br />
<br />(Signature)
<br />
<br />d :.J.W(~
<br />
<br />'.'yped i Pr I ,~d or Stamped)
<br />,JjBLll'
<br />
<br />(Name 'I'yped, Printed or Stampl'c
<br />NOTARY PUBLIC
<br />
<br />., '_'- . .I..... .
<br />
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