|
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />~. NOTICE OF DEED RESTRICTIONS
<br />!be under.lgned under.Lands tbat Ibi. per.it .ay be .ubJect lo 'deed re.lriction.' .bieb ..y be ..re restrlctl.. tbao City
<br />regulations. rhe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CON1'RAC'!'On RESPONSIBILITIES
<br />If !be "'er bas blred a cootraclDr or cootractor. to underLale worl, lhe1..y be regolred to be licensed iu 'CCOCdauce .Iii
<br />.t.te and local regul.tl.... If Ibe contr.ctor I. not licen.ed a. required by I.., bolb lbe ..... and coolrlctor .., be
<br />cited fur a .i""'...r violation under .tate I... If tbe ...er or intended cootractur are unrerLaiu as to 8Iot licenslag
<br />regoir....t. ..y apply fur Ibe lolended norl, !bey are advised tu cunLact tbe City uf Zephyrhlll. Bulldlng Deparblent, (1131
<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 />'Contr.ctor Section.' of Ibi. 'pplic.llon fnr .bicb lhe1 .ill be respon.ible. If you, .. !be ..... sign .. lbe cootractor,
<br />you .re indic.tlng tbat you, r.tber tban Ibe coote.ctnr, are re.pon.lble for tbe unrl. If lbe coote.ctor .lsbes roo to si"
<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 U1'ILI'fY CONNECTION FEES ,."
<br />
<br />D. CONSTRUC'!'ION LIEN Lnw (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law _ HDIeOMDer'. Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant il lOIeone other than 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 cOllenCelent.
<br />
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI1'
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, Joning, and land developtent.
<br />,
<br />
<br />Application is hereby lade to obtain a perlit to do work and instailation as indicated. I certify that no worl or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perfolled to teet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of otber govelDlental agencies aay apply to the intended vort, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not litlted to:
<br />· Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater rreattent
<br />· Southwest Florida Water Hanagetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />· ArlY Corps of Engineers - Seawalls, Docks, Navigable Naterways
<br />· De arttent of Health' Rehabilitative Services EnviroDlental Health Unit - Wells, Wastewater Treattent, Septic lanls
<br />· US BnviroDlental Protection Agency - Asbestos abatetent
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" 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 perlit issued shall be construed to be a license to proceed with tbe work and not as authority 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 lrOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery pertit issued &hall beCOll invalid
<br />unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if vork authorized by the perJit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day eltension of tile, tal be
<br />allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six IOntb period, or the project will be considered abandoned.
<br />NARNING TO ONNER: YOUR FAILURE ro RECORD A NOTICE OF COHHBNCEHBNT HAY RESULT IN YOUR PAYING BICE FOR IHPROVIIIDrS TO YOUR
<br />PROPERTY. IF YOU INTBND ro OBTAIN FINANCING, CONSULI NUB YOUR LENDBR OR AN ATTORIEY BEFORE RECORDING YOUR NOTICE OF
<br />COHHENCRHENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COIOlBNCBIfBH1'".
<br />
<br />~crud~ ~ (). /L/L,o,,-,-
<br />GNATURE: OWNER OR AGENT
<br />
<br />. I
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />srATE OF FWRIDA
<br />COUlf1'Y OF ~I'ts c: Q
<br />The foregOing instrument was acknowledged
<br />before me this Q S ~ 0 Ff;~.. 2..G>P..> by
<br />
<br />STATE OF FWRIDA
<br />COUNTY' OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was aCknowledged
<br />, 19_ by
<br />
<br />who is personally known to me or who has
<br />produced t=i..4 Mr lit'. itA6ckJ'/o/-dJ--6/,()-o
<br />as identification and who did/did not
<br />
<br />~~n oa~~1~
<br />(Si9~ .
<br />'~"It~
<br />(Name Typed, pr~~~!.... zed)
<br />NOTARY PUBLIC ~~~..~.~\SS/04';~*6'\
<br />s '", ." ""..... ...,. . ...... .,
<br />~ . ~v ...I'-ER 1. ~ .,,' :::;.
<br />~ . ~ ~.~" " ~_ e. ~
<br />:::: :~ ("" .~~. =
<br />=*: ~.....g =*=
<br />=%: . .::
<br />~~~~#CC597681 ....:~~
<br />, . ~r. S ~
<br />~~"" ~bOllded\"~~~"~$'
<br />~~'J-4~'~"blic un6~..~_~...-$'
<br />'''' v~ ....... ~, :<<\....
<br />;fll,,, ZlC ST~~ """
<br />:1"'1/;/111\\1\\\\
<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 />
|