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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />rho und.r.ign.d und.r.tands tb.t thi. p.rait .., he .ubJect to 'deed r.,triction,' wbieh .., he lOre restricti.. tbao elt,
<br />regulations. The undersigned assUles responsibility for co.pliance with any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the osner b.. hired · cootr.ctor or eo'tr'ctor, to uod.rlal. sorl, th.,.., he reg,ired 10 he lices,ed 10 acoordance with
<br />.t.t. and loc.1 regul.tions. If th. contr'ctor i. not licen.ed .. reguir.d b, I,., bolb the "'er and cootr.ctor .., be
<br />cited for · .i.d....,or viol.tion uod.r .t.t. I.w. If the ....r or iotended cootraclor .r. uncertaio .. 10 slot li....1ng
<br />r.guir....t' .., .ppl, for th. int.oded sorl, lb., .r. .dvised to contact th. Cit, of Z.pbyrbill. Building Deparlsont. (813)
<br />788-66U.
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<br />Furtb'tsnr.. if the o.n.r has bired · contr.ctor or contr,clor.. he I. 'd'i.ed 10 hav. the contractor(.) .ign portions of tbe
<br />'Coutr.clor S.cti.... of thi. application for .bieb lb., .iii be responsihi.. If roo. a. the ....r sign as 1Io ...tractor.
<br />you ar. indic.ting that you, r'lIor than the cootr.ctor, ar. responsibl. for the worl. if tbs "'lrictor wishes roo 10 .ign
<br />a. cootractorthat .., be .n indication that h. i, not praperly licensed .nd i. not entitled to PBraitting pri'ilegos io th.
<br />City of Zephyrhills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. CONSTRUC~'ION LIEN LAW (CRAPTER 713. FLORIDA STATUTES, AS llMENDEDJ
<br />I certify that I. the .pplicant, b... been provid.d with. copy of "Iorida'. Construction Lien Lao _ Booeosoer'. Protection
<br />Coid.' prap.red by tb. 'Iorid. O.parboeot of Agricultur. .od C......r Aff.ir.. If tb. applicant i. ....... other tbao the
<br />.....r'. I certif, that I b.v. obt.ined . eop, of tb. abo,. d..cribed doc....t .od prosi,. in good f.ith 10 dsllver it 10 tbs
<br />"owner" prior to co..ence.ent.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infor.ation in tbis 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 instailation as indicated. I certify that no vorl or
<br />Install.tion has COSSOOced prior to issu.oc. of . poralt and that .11 worl will be perfO<lOi 10 ...t .laodards of all laos
<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 other governaental agencies lay apply to tbe 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 lilited to:
<br />· Deparllent of BnviroDlental Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />Water/Wastewater !reallent
<br />· Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />· ArlY Corps of Engineers - Seawalls, Docls, Navigable Waterways
<br />· De arllent of Health & Rehabilitative Services EnvirODlental Healtb Unit - Wells, Wastewater freatlent, Septic lanls
<br />· US EnviroDlental Protection Agency - Asbestos abatelent
<br />I .Iso certlf, tb.t, if fill ..teri.i i. to b. used in 'iood &on. 'A' Dr ....tc.., it i. ooderslood that . draloage plan
<br />addressing a .......'.ting voi.... will b. .oboitted whlcb i. prepared b, . ,"of...iou.i engin.er registered io tie Stale of
<br />Florida prior to perlit. issuance,
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<br />. · perait i..oed shali be ,",.trued to be · lic.nse to proc.ed witb th. ..rl and not as autlority to 'iolale, caooel alter, or
<br />set ..id. an, pro,i.i... of the t.chnic'l code.. our shall is,,,"", of . perait prevent the Bui1dlog Official froa tIoresfter
<br />requiring a OUCrection of error. io pians. construction, or ,iolalions of au, cod.. S,,., perajt iss.ed sbalJ beouoe loIa1id
<br />,nie,s the worl a.tlori.ed by .uch perait i. c......ed within .il auntbs of i......., Dr if worl SUtloriled by the perajt Is
<br />.olpeOded or ahaodouea for · period of .il auntbs .fter the t1ae the worl i. ......ced. Due 90 day ..t...... of lIsa. .., be
<br />.ll..ed for th. perait with fee charge of li5.00. ,he ..ten,ion .h.il be reguestea io writing to the 80Ildiug Official. So
<br />approved inspection lust be logged during each six IOntb period, or tbe project will be considered abandoned.
<br />IOIRl1i1G ro OIIIIBII: JOIlR 'AILORll ro RECORD A IIDTICE OF CllIlIIEICIiIIBJ 1Ill, RIlSDL' II YOOR PinG lIiCE F1lR IilPRllYIIIms ro IOOIl
<br />PROPERTY. IF YOU INTEND TO OBTAIN FIHANCING, CONSULT WITH YOUR LliNDER OR AN ATTORIEY BEFORB RBCORDIHG YOUR NorICI OF
<br />COHHENCEHENT. JOBS UNDER $2,500 IN VALUE DO NOT NBBD TO RECORD AND POST A IfN E OF COHHi "
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<br />
<br />STATE OF F~
<br />COUNTY OF ~
<br />The foregOing inptrurnent
<br />before e this UOtJ,). ~
<br />
<br />
<br />, I
<br />
<br />
<br />was acknowledged
<br />, 19U by
<br />- A-, /tie it "()M ~,
<br />ally knn~ to MQ ~ho has
<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 />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 />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
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