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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. N9TICE OF DEED RESTRICTIONS
<br />f6. """..igned und.r.l.nd. 16.1 1IO. p.OIil an, 6e .ubJ,cI In 'deed re'lriclinne' 06i<6 an, be "re rentricti.. !loa Cil,
<br />regulations. rhe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />if the ..... 6.. hired · conlr'clor nr enolr.cl.r. 10 und.rtale NOrl, 16., an, 6e roguired 10 be li....ed in accordao.. oi16
<br />.1.1. .nd loc.1 regul.li.... If the contr.cl.r io n.1 licen.ed .. reguired IT I.., 1016 1Io ..... and conlr3etor IOf be
<br />clled f.r · .ied....oor ,i.l.li.. und.r .l.l. 1.0. if th. ....r .r Inlended conlraclor are uncerlai. .. 10 .101 licenoiog
<br />reguir....I. an, .ppl, f.r th. Inl.nded NOrl, th., .r. .d'ised Ie c.ntacI the Cil, .f Zephyrlill. Boildlog Departo,nl, (813)
<br />788-66Il.
<br />
<br />FUrI6.r..r., if 16. owner has 6ired · c.nlr,clor .r conlr.clor., 6. i. ad'i.ed 10 ha,. 16. conlr.clor(., .i9O portl... of lhe
<br />'Coolracl.r S.cli...' .f thi. .ppiication f.r ohic6 lb., oiii be r"pon.i61.. If you, .. 16. ..... .ign .. 1Io contractor,
<br />yuu Ire indicaling thaI you, ratloer than 16. contraclor, .re renflO/lli61. f.r llIe worl. If 16. contraclor oi""'" you 10 .igo
<br />.. contracl.r 16.1 any lie .n indic'li.. 16.l be i. n.1 pr.perly li....ed .nd i. n.l enlilled 10 Peroiltiog pri'll"," I. lio
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND U'l'ILITY CONNECTION FEES ""
<br />
<br />D. CONSTRUCTION LIEN LAW COrnPTER 713, FLORIDA STATUTES, AS AH~EDJ
<br />f c.rtlfy thaI f, the .pplicanl, ha,. Ioeo provided oith . copy .f 'Florid.,. eoo.truclion Lien Lao _ Booeoooer'. Protecti..
<br />Guid.' prepared 6, 16. FI.rlda Oep.rloe.l .f "ricullur. .nd C......r Aff.ir.. If 16. 'ppiicanl i. ....... .tIer 16an lhe
<br />.....r., i c.rlify thaI i 10,. .61.in.d . copy .f the abo,. d..crilod docuoenl and Proof.. i. good f.i16 10 deliver il 10 lhe
<br />"owner" prior to co..ence.ent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I c.rlif, thaI .11 lIo Inf.ranti.. in 16i. .pplic'linn i. 'ccur.l. and thol .ii oorl olii be done i. ODIpllance 0116 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 worl or
<br />i..I.II.llnn 10. COIOOnCed pri.r l. i...ance .f . per.il .nd thol .11 NOrl oill be perforood to ...1 .!Iodards of all laos
<br />regUlating construction, City codes, loning regUlations, and land developlent regulations in the jurisdiction. I also
<br />c.rlify 16'1 I und.r.l.nd thaI the regol.li... .f ellor go"""nL.1 .gencl.. ..y .ppl, I. 110 inlended "'.. ROd that il i.
<br />IY responSibility to identify what actions I lust tale to be in cOlpliance. Such agencies include but are not lilited to:
<br />· Oelorlleol .f En'iroooental Regul.li.n - Cypr... Bsybeads, NOlland Area. and Bo'ironoe.tall, Sensill.. Laads,
<br />. Water/Wastewater Treatlent
<br />I Southwest Florida Water Hanage.ent District - Wells, Cypress Barheads, Wetland Areas, Altering Watercourses
<br />I ArlY Corps of Engineers - Seawalls, Docls, Navigable waterways
<br />· De artlent of Health & Rehabilitative Services EnviroDlental Health Unit - Wells, Wastewater Treatlent, Septic ranks
<br />· US EnviroDlental Protection Agency - Asbestos abate.ent
<br />I .110 certlf, that, if fiii ..teri.1 i. 10 6. ueed i. Fieed .... 'A' .r 'A..Lc.'. il ie understood tIot . dr.ioago pian
<br />addreooi.g · ',"""",,ti.g vol.... oill 6e ..lIitled 06icb i. pr,p'red 6, . pr.f...i...i engineer r.gi.tered in tIo Stale .f
<br />Florida prior to perlit. issuance.
<br />
<br />. A per.il i".ed 8IoIi 10 construed 10 10 · lic.... to proceed 'ilb tIo worl nod nnl .. autborlty to ,101.1.. cancel .Iter. or
<br />"I ..Ide 'or prOfi.i... .f tIo l.cIolt.1 cod", onr 8Ioil il!"!Oc. .f . porolt pr....1 tIo Iollding Official fr.. tIorsafler
<br />r.quirlng · correcti.. of .rrur. in pi.... construclion. or ,ioi'li... of .ny cod.. 8Yery PItIlt llODed 81011 ...... Iata1ld
<br />.01... t6. worl autbori,~ IT 'uc6 por.il I. COIIeOced oilbin .i, 100111 of i......., .r if IOrl aotlorl'ed by tIo PItIlt I.
<br />.uopended .r abandoned for · period nf .i, 100110 .fler tIo tl.. tIo worl i. COIIOnCod. One gO day ..leo8l.. of tIoo, '"' 10
<br />.ii...d fnr tIo pocoil oilb foe c6.rg. .f $15.00. r6. ..1...lon Bioil 10 reqo..led in 'riling to tIo Bol1d1og Official. 10
<br />approved inspection lUst 'be logged during each six I9nth period, or the project will be considered abandoned.
<br />IIAIRIIG ro OIiIIER: YOOR FAILURE ro RIlCOIlD A IIOrICll OF ~ IlAY IlISULT II TOOl PI'fJJG MCI IllR iIIP8llVRIIUrs ro 100II
<br />PROPERTY. IF YOII IH1'END ro OBrAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ArrORItEY BEFORE RECORDING YOIIR NOTICI OF
<br />COHHINCIHINT. JOBS UNDER $2,500 IN VALUI 00 NOT NEID TO RECORD AND POST A -NOTICE OF COMMHNCRIIRH1'-.
<br />
<br />SIGNATURE: OIfHBR OR AGIHT
<br />
<br />. I
<br />
<br />SIGNArURE: CONTRACTOR
<br />
<br />srATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STArl OF FLORIDA
<br />COUNTY OF
<br />The foregOing in~trument
<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 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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