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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />rhe uodersigu.d und.r.tands tb.t tbi. peroit oay be ',bj.ct to 'deed r..trlction." wbleb oay be ..r. ...trlcti.. lbao City
<br />regul.tion.. 110 und.rsig..d "'WI.. r..pon.lblllty lor coopll..c. with ..y 'pplicabl. deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />II the ....r b.. bired · contr.ctor or contr.ctor. to ,ndert.l. NOrt. they oay be rsgoired to b. licensed In accordance with
<br />.tat. aod local regul.tion.. If the contr.ctor i. not lic....d .. reg,ir.d by I... both the ..... and oootractor lOr be
<br />cited for · .I.d......r vlol.tion und.r .t.t. I... II tbe ONn.r or Intended contractor .r. ....rt.1n .. to IIot lic...IDg
<br />regulr....t. oay ,pply for th. InLend.d NOrl. Lb.y .r. advl..d Lo contacL tb. City of Z.pbyrhill. Building Departoo,t. (813)
<br />788-6611.
<br />
<br />F,rtb.r..... if tb. ....r bas bired · cootr'cLor or contr.ctor.. b. i. advi.ed to hav. the contr.ctor(.) .igu portloos of th.
<br />'Cootractor S.ctions' of thi. .ppllc.tion for .bich lb.y .ill be r"pon.ibl.. If YOU. as the "'er .igo as the contractor.
<br />yon are indicating tb.t roo. r.tb.r tb.. the contr.ctor. are r"pon.ibl. for th. NOrl. If the oontr.ctor .Isbes roo to .Igu
<br />as cootr.ctor lb.t lOy be .. Indic.tlon that b. i. not properly llcen.ed and I. not entitled to P<rIittiog pri.llegeo 10 the
<br />City of Zephyrhills.
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<br />C. TRANSPORTA'l'ION IMPACT FEES AND U'l'ILl'rY CONNECTION FEES
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<br />D. CONSTRUCTION LIEN LnW (CnAPTER 713, FLORIDA STATUTES, AS llHENDED)
<br />I certify th.t I. lb. .pplicant. 10.. beeo provided .ith . copy of 'Florid.'. Coo.traction Lien Lao _ HOIeowoer'. Protectioo
<br />G,ld.' pr.pared by the FlorId. Deparlleut of Agric,lt,r. awl Coos...r Aff.lro. If tb. 'ppll...t i. ....... other tloo lbe
<br />.....r., I certify that I hav. obt.ioed · copy of tbe .bov. d..crlbed docuoent .nd Prosi.. I. good f.ith to deliver It to lbe
<br />"owner" prior to cOalencelent.
<br />
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVl'l'
<br />I certify that .11 tbe'lnfollOti.. io thi. .pplication i. 'ccur.te .od that .11 NOrt .111 be done In COIpIi.... .ith .11
<br />applicable laws regUlating construction, loning, and land developlent.
<br />I
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<br />Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no wort or
<br />io.tall.ti.. bas COIIenoed prior to I..uanc. of . per.it ..d that .11 NOrt viii be perforooi to ...t 'laodardo of .11 100.
<br />reg,l.ting Co.,tructlon. City codes. .oniog reg'l.ti.... .Dd land dev.I",,".t regul.ti... io the jwrlodlctl... I ai..
<br />..rtlfy lhat I 'Dd.r.tund lb.t th. r.,'I.tion. of ntber ....'"""L.I .gencl.. &Of s,ply to the inleoied ...t. aod lIot It i.
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />· Doparlleot of Envlr.....t.1 Regul.ti.. - ClPr... Boyhood.. Wetland Ar... .nd Ro'ironoentally Seasltive LaoIs,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Natercourses
<br />t Arl' Corps of Bngineers - Seawalls, Docks, Navigable Naterways
<br />· De arlleut of Heallb , Rehabillt.ti,. S.r'lc.. Ro,lfODIeot.1 Health Doit - >>ell., lO.tevat.r rrealleot, Septic faoIo
<br />t US EnviroDlental Protection Agency - Asbestos abatelent
<br />I .100 certify that. If fill oat.ri.1 i. to b. ,.ed in Flood .... 'A' or "A..tc.'. it I. understood lhat . dratoage plao
<br />addre..l.g · "COBpenBatiog ..I.... viii be ..Ioitled wbicb I. pr.pared by . p,of...I...1 ..gl.... regi.tered io 1Io Slale of
<br />Florida prior to perlit. issuance.
<br />
<br />. A peroit iBB.ed .hall be coo.trued to be . lic.... to proceed with tb. NOrl and not .. anlboritr to ,lol.te. .....1 a1tor. or
<br />..t ..id. .ny provi.ions of tb. t,cholc.1 cod". no, shall i.,.!"co .f . per.it pr.ve.t th. 8uildlng Official froo Ii....fter
<br />requlrimr · correctl.. of error. 10 pi.... coo.tructl... or ,iol.tl... of "y cod.. Every ,","it is..oI obaIl becooo iDvaIld
<br />unlOB' the NOrl anlbori'ed by 'uch per.it i. COIIDDced witbin .in IDOtbs of i........ or if wort a'lborl.ed by lie porait I.
<br />OO'pond.d or abandoned for · period of .In IDOlbs .ft.r tb. ti.. the NOrl I. ......coa. 00. !O:day OBt"'lon of tloe. .., be
<br />allowed for th. p.rolt with fee cb.rg. of $15.00. rbe ..t...i.. sh.11 be regu"led io .'Itiog to !be 8oI1diog Official. An
<br />approved inspection .ust be logged during each Sil IOnth period, or the project will be considered abandoned.
<br />_lUG TO OIIi11lB: YOOB FAILBBIl TO BIlCOBD A IIOI'ICI OF ClIlIIBJCBum HAr BIlSULr II _ PArlJlG mClI'Oll __ TO fOOII
<br />PROPERTY. IF YOU Ilf1'BND TO OBTAIN FINANCING, CONSULT NITH YOUR LENDER OR AN ATTORBEJ BBFOR! RBCORDIIIG YOUR IfOTICB OF
<br />COHHENCEHBNT. JOBS UNDER $2r500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICB OF COHH.KNClHBIf1'''.
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<br />SIGNATURE: ONNER OR AGENT
<br />
<br />-----SIGNATURE: CONTRACTOR
<br />
<br />. I
<br />
<br />STATE OF FLORIDA
<br />Coolf1'Y OF
<br />The foregOing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATB 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 JrJ10wn to me or who has
<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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