|
<br />CONJJJ'l'IONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED HESTRICTIONS
<br />the undersigned underBtands that this per.ft--~-be subject to "deed restrictions" which .ay be .ure restrictive than City
<br />regulations. the undersigned assUles responsibility for co.pliance wiLh any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTOnS AND CON'l'RAC'l'On RESPONSIBILI'l'IES
<br />If the owner has hired a contractor or contractors to undertake worl, they .ay be required to be licensed in accordance with
<br />state and local regulations. If the contraclor is not licensed as required by lalf, both the owner and contractor lay be
<br />cited for a .isde.eanor violation under state law. If lhe owner or intended contractor are uncertain as to what licensing
<br />require.ents .ay apply for lhe intended work, they are advised to contact the City of Zephyrbills Building Deparblent, (813)
<br />788-6611.
<br />
<br />Further.ore, 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 w/lich they Ifill be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rat/ler than the contractor, are responsible for the work. If the contractor wishes you to 8ign
<br />as contractor that .ay be an indication that he is not properly licensed and Is not entitled to per.itting privileges in tbe
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />t' ~I
<br />
<br />D. CONS1'RUC'l'ION LIEN L1\W (CHAPTER 713, FLORIDA STA'l'UTES, AS AMENDED)
<br />I certjiy-tha~-ihe applicant, have been provided with a copy of "Florida's Construction Lien Law - Hu.eowner's Protection
<br />Guide" prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs. If the applicant is so.eone other than the
<br />"owner", I certify that I have obtained a copy of the above described docu.ent and pro.ise in good faith to deliver it to the
<br />"owner" prior to co..ence.ent.
<br />
<br />E. CONTRACTOR'SLQWNER'S AFFIDAVIT
<br />I certify that all the infor.ation in this application is accurate and that all worl will be done in co.pliance witb all
<br />applicable laws regulating construction, loning, and land develop.ent.
<br />I
<br />
<br />Application is hereby lade to obtain a per.it to do Ifort and instailation as indicated. I certify that no worl or
<br />installation has cOllenced prior to issuance of a per.it and that all work Ifill be perforaed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land develop.ent regulations in the jurisdiction. I alBo
<br />certify that I understand that the regulations of other gove~ental agencieB .ay apply to tbe intended work, and that it iB
<br />.y responsibility to identify what actions I lust take to be in co.pliance. Such agencies include but are not lilited to:
<br />· Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />Water/Wastewater Treablent
<br />t Southwest Florida Water Hanage.ent District - WeIIB, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t Ar., Corps of Bngineers - SeawallB, Docls, Navigable Waterways
<br />· Deparblent of Health' Rehabilitative Services, BnviroDlental Healtb Unit - Wells, Wastewater Treataent, Septic ranis
<br />· US InviroDlental Protection Agency - Asbestos abate.ent
<br />I alBO certify that, if fIll .aterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "co.pensating volule" will be sub.itted which is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it issuance.
<br />
<br />A per.it issued shall be construed to be a license to proceed Ifith the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or vloiations of any code. Bver, perlit issued sball beCOle invalid
<br />unless the wort authOrized by such per.it is co..enced within sil IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned (or a period of six IOnths after the ti.e the work is coa.enced, One 90 day eatension of tile, aa, be
<br />allolfed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection .ust be logged during each six IOnth period, or the project will be considered abandoned.
<br />WARNING TO ONNBR: YOUR FAILURR TO RECORD A NOTICR OF COHHENCBHBNT KAY RBSULT IN YOUR PAYING TWICB FOR IHPROVRHBNrS TO YOUR
<br />PROPERTY. IF YOU INTBND TO OnTAIN FINANCING, CONSULT WITH YOUR LBNDBR OR AN ATTORNBY BIFORR RBCORDING YOUR NorICH OF
<br />COKHRNCBHRNT. JOBS UNDRR $2,500 IN VALUR DO NOT NRRD TO RRCORD AND POST A "NOTICR OF COKHBNCKMBNT".
<br />
<br />/
<br />
<br />
<br />-SiCKiru?~ ~
<br />
<br />SIGNATURE: OWNER OR ACRNT
<br />
<br />, I
<br />
<br />STAtR OF FLORIDA
<br />COUNn OF
<br />The foregOing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19 by
<br />
<br />STATR OF FLORIDA ill, 11 0 <:
<br />COUNTY OF ~ V-..A~ tovow I----
<br />The foregoing injjt~UJIent was ac wledged
<br />hefon! me this ~-'O , 19 iJy
<br />
<br />k.)~. JQ~\;l
<br />who i~personally known to~e or who has
<br />produced --
<br />as id,e ntification ~d who di~/dld not
<br />
<br />take _ ath. ,r-C:)I~!/h' -{~-
<br />
<br />(Si ture)
<br />r~ O~
<br />(Name Typed, Printed or ~~.
<br />NOTARY PUBLIC #~ ....... l/L'l"~
<br />~r~ '.:~\SSIO'" "."'/ ~.
<br />~ ~ . ~. ',J:L ..~~';r
<br />.::F-'<:l".'r:o<:j ~17 '-r~'~"
<br />;::~..~ n~ '<170 ~'.~:::.
<br />: :~ ~ ,. (j') ~ ::
<br />=*: ..... :*=
<br />~~ ~ ~ #ce 639826 "" j i$ g.
<br />~ :::;.\ e. 0 ^ ~-. ~ '-~
<br />~ ~ .. ~ uOlJded \\i.\""_...i,~.. <::).'::-
<br />~ ''7- .'1' Pllbl. UnOt\ '.' iN ~~'
<br />~ A'. Ie .' <.." ~
<br />~ 't/lll ......~ ()' ~,....
<br />"I/: "Ie S1r\\ '- ~,,,
<br />~II'",,, '11\'\\""
<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 />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
|