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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />:. The undersigned understands that this pelllit lay be subject to Bdeed restrictions" which lily be lOre restrictive than City
<br />regulations. fhe undersigned assllles responsibility for co.pliance with any applicable'deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR 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 lilY be
<br />cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departaent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner has hired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />llContractor 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, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
<br />as contractor that.IilY be an indication that he is not properly licensed and is not entitled to peIlitting privileges in the
<br />City of Zephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provideiiwith a copy of BFlorida's Construction Lien Law - BOIeOWDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is sOJeOne other than the
<br />Nowner", I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the
<br />"ownerN prior to cOllenCeJent.
<br />
<br />E. CONTRACTOR'SIOWNER'S AFFIDAVIT
<br />I certify that all tbe inforaation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developleDt.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas COlleDced prior to issuance of a pelllit and that all work will be perfoIled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverJlleDtal agencies lily apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lust tate to be in COIpliance. Such agencies include but are not loited to:
<br />t Departlent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater freatlent
<br />t Southwest Florida Water HanageJeDt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, lIavigable Waterways
<br />t DepartJent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater TreatJent, Septic tants
<br />t US EnvirODJental Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood Zone "AB or "A,etc.", it is understood that a drainage plan
<br />addressing a .cOlpensating volUle" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A peIlit issued shall be construed to be a license to proceed with 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 violations of any code. Every pelllit issued shall beCOle invalid
<br />unless the work authorized by such perlit is COIIeIlced within six IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six IODths after the tile the work is C08e1lced. One 90 day extension of tille, lilY be
<br />allowed for the pelllit with fee charge of $15.00. fhe 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 />WARlfIIIG TO OIfIfER: YOUR FAILURE TO RECORD A IIOTlCE OF COJlMEIfCEJlElff HAY RESUL'f III YOUR PAYIIIG "'ICE FOR IHPROVEIIm'S TO YOUR
<br />PROPER'lY. IF YOU IlffElfD 'f0 OB'fAIII FIIWlCIIIG, COIISUL'f WI'lB YOUR LlJlDER OR Alf A'l'IOHBBY BEFORE RECORDIIIG YOUR IIOTICI OF
<br />COMHEHCEHElff. JOBS UNDER $2,500 III VALUE DO HOT IlEED 'f0 RECORD AND POS'f A "HOTICE OF COMHEHCEHElff".
<br />
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<br />
<br />SIGRA1URE: OIfIfER OR AGElff SIGRA'fURE: COH'lRAC'fOR
<br />
<br />STATE OF FLORIDA
<br />COUHfY OF ~ \ "- WI'<-!
<br />The foregoing instrument was acknowledged
<br />before me this f)~ ~, 19 ~~ by
<br />
<br />R-\.. Q..~".. V 0 68.-
<br />who ts-1>er~onally-nown to me or who has
<br />prodUced. ~
<br />as identification and who cUMOid not ~
<br />take an. oath. ~
<br />
<br />(Signature) \~
<br />~ \." l~(Vv.r--^---
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUB
<br />
<br />STArE OF FLORIDA f)
<br />coum OF t\ ~M
<br />The foregOing instrument was acknowledged
<br />before me this ~ E;Q.., ~ , 19 ~ by
<br />
<br />~ f\vc:; 0\ Q...f\'c:.."
<br />who is ~~al hown to me or who has
<br />produced ~
<br />as identification and who didJ id not: )
<br />take an oath. ~
<br />
<br />(Signature)
<br />
<br />(Name Typed,
<br />NOTARY PU
<br />
<br />
<br />?.y p(; OFFICIAL NOTARY SEAL
<br />0"1>- ,.!~ KEVIN KRUSE
<br />~ \)~. 'M ({ () COMMISSION. NUMBER
<br />1l: t . ,~, * . t:;
<br />if' 1~', m,,~ <:: CCo4B891
<br />~:~:_, '~:;;,<~,~;1-u ~~',) ~,,~\: ('
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