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<br />. .' - CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to "deed restrictions" which lay be lOre restrictive than City
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
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<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 lay be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<br />788-6611.
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<br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have tbe contractor(s) sign portions of the
<br />"Contractor 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 tbe contractor wishes you to sign
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to peClitting privileges in the
<br />City of Zephyrhills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. CONSTRUCTION LIEN LnW (ClmPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law _ HOIeOIDer's Protection
<br />Guide" prepared by tbe Florida Departlent of Agriculture and ConSUler Affairs. If the applicant is sOIeDne 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 couencl!Jlent.
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<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI'1'
<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, zoning, 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 />installation bas cOllenced prior to issuance of a perlit and that all work will be perforted to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDlental agencies lay apply to tbe intended wort, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not liJited to:
<br />A Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater rreallent
<br />A Southwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />A ArlY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />A Departlent of Health & Rehabilitative Services, RnvirODJental Health Unit - Wells, Wastewater Treablent, Septic Tanks
<br />A US EnviroDleDtal Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,ete.", it is understood that a drainage plan
<br />addressing a "cOlpensati~g volute" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit, issuance.
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<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 provisionscof tbe technical codes, nor shall is~u~nce of a per.it prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall becoie iDvalid
<br />unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day 81tension of tile, Ia! be
<br />allowed for the per.it with fee charge of $15.00, Tbe extension shall be requested in writing to the Building Official. An
<br />approved inspection .ustbe logged during each six I9ntb period, or tbe project will be considered abandoned.
<br />WARIIIG TO OIlIER: YOUR FAILURE TO RECORD A 10TICE OF COMMEICIIIKIIl' HAY RESULT II YOUR PAYIIG TlUCK FOR IHPROVIIIBIIl'S TO YOUR
<br />PROPERTY. IF YOU UTEID TO OBTAU FIIANCIIG, COISULT WITH YOUR LEIDER OR AI ATTORlEY BEFORH RECORDIIG YOUR IOIICK OF
<br />COKHEICEHENT. JOBS UNDER $2,500 II VALUE DO lOT NEED TO RECORD AID POST A "IOTICE OF COHHEICIIIKIIl'".
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<br />SIGIArURE: OWNER OR AGEIT
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<br />SIGIATURE: COITRACTOR
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<br />STArE OF FLORIDA
<br />COUI1Y OF
<br />The foregOing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />STATE OF FLORIDA
<br />COUITY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 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
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