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<br />CONDITIONS OF PEHMI'I' AFFIDAVIT
<br />A. NOTICE OF DEED RESTHICTIONS
<br />The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lOre restrictive than City
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONT.Rl\C'I'ORS AND CON'l'.Rl\C'l'OH HESPONSIBILI'I'IES
<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, botb the owner and contractor laY be
<br />cited for a lisdeleanor violation under state law, If the owner or intended contractor are uncertain as to what licensing
<br />requirl!.lents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (813)
<br />788-6611. .
<br />
<br />Furtberlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for which they will be responsible. If you, as the owner 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 perlitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />,.:
<br />.
<br />
<br />D. CONSTRUC'l'ION LIEN L'AW (CHAPTER 713, FLOHIDA STATUTES I AS AMENDED)
<br />I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOWDer's Protection
<br />Guidft" prepared by the Florida DepartJent of Agriculture and ConSUler Affairs. If the applicant is sDleone 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 COllenCl!.Ient.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforlation in tbis application is accurate and tbat all work will be done in cDlpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />I
<br />
<br />Application is hereby lade to obtain a perlit to do worl and instailation as indicated. I certify that no vorl or
<br />installation bas COllenced prior to issuance of a perlit and that all work will be perfofled to l8et standards of all law8
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of otber goverRlental agencies ISy apply to tbe intended work, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />t DepartJent of BnviroDlental Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />. Water/Wastewater Treatlent
<br />t Southwest Florida Water Hanagl!.lent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health & Rehabilitative Services, EnviroRlental Health Unit - Wells, Wastewater Treattent, Septic Tanks
<br />t US EnviroDlental Protection Agency - Asbestos abatl!.lent
<br />I also certify that, if fill laterial is to be used in Flood Zone "AM or "A,etc.", it is understood tbat a draInage plan
<br />addressing a "cOlpensating volUle" will be sublitted whicb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit. issuance.
<br />
<br />. A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall is~u~nce of a perlit prevent the Building Official frot thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery perlit issued sball beCOlB invalid
<br />unless the work authorized by such perlit is cOllenced within six IOntha of iSSUance, or if work authorized by the peClit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day 81t808lon of tite, lIy 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.tbe project will be considered abandoned.
<br />WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKHENCRHENT HAY RESULT IN YOUR PAYING TWICE FOR IHPROVIMINTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORR RECORDING YOUR RorICE OP
<br />COHHRNCRHENT. JOBS UNDER $2,500 IN VALUE DO NOT NERD TO RECORD AND POST A "NOTICE OF COHMENCKKRNT".
<br />
<br />, I
<br />
<br />SIGNATURE: ONKER OR AGENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATK OF FLORIDA
<br />COUIflY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATK OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 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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