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<br />CONDITIONS OF PEI~IT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lOre restrictive than City
<br />regulations. The undersigned assWles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CON'l'RAC'l'On 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 laY 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 />788-6611.
<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 />"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, raUler Ulan the contractor, are responsible for the wort. If the contractor wishes fOU 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 U'1'ILl'fY CONNECTION FEES ""
<br />
<br />D. CONSTRUC'l'ION LIEN L1\W (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 _ HOIeOWDer's Protection
<br />Guid~" prepared by the Florida Departlent of Agriculture and ConSWler Affairs. If tbe applicant is sOleone other tban 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 couenCl!Jlenl.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation 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.
<br />I
<br />
<br />Application is hereby lade to obtain a perlit to do wort and instailation as indicated. I certify that no wort or
<br />installation bas cOllenced prior to issuance of a perlit and that all wort will be perfolled to aeet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify tbat I understand that the regulations of otber goverDlental agencies laY apply to the 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 />· Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />. Water/Wastewater freallent
<br />· Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />· ArlY Corps of Engineers - Seawalls, Docks, Navigable Materways
<br />· De artlent of Health & Rehabilitative Services EnviroDlental Health Unit - Wells, Wastewater freatlent, Septic fanks
<br />· US EnviroDlental Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,ete.", it is understood that a drainage plan
<br />addressing a "co.pensating 'olUle" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it. issuance.
<br />
<br />. A perlit issued sball be construed to be a license to proceed with the work and not as autbority 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 frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code, Bvery petlit issued sball beCOle invalid
<br />unless the wort authorized by such perlit is cOllenced within six IOnths of issuance, or if wort authorized by the per.it is
<br />Suspended or abandoned for a period of six IOnths after the tile the work is couenCed, One 90 day 81tenaion of tile, lay 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 each six IOnth period, or the project will be considered abandoned.
<br />WARNING TO OIINER: YOUR FAILURE TO RECORD A NOTICE OF COHIfIlNCEHBNT HAY RESULT IN YOUR PAYING TIIICK FOR IHPROVIHlIfIS TO YOUR
<br />PROPERTY. IF YOU IlfTEND TO OBTAIN FINANCING, COlfSULT WITH YOUR LIlNDBR OR AN AnORNEY BBFORE RECORDIHG YOUR HI1lICK OF
<br />COHHlllfCIlHIlHT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COHKKNCKMEIIl'".
<br />
<br />SIGNATURE: OWNER OR AGIlNT
<br />
<br />. I
<br />
<br />SIGNATURE: COlfTRACTOR
<br />
<br />STAfll OF FLORIDA
<br />COUlflY OF
<br />The foregOing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATIl 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 />8S 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 />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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