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<br />Oct 24 00 02:08p
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<br />Cit~ of Zeph~rhills
<br />
<br />18131788-3293
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<br />p.2
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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A, NO'rIeJ:: lW VI:;J::D Iu,:S2'IUC'l'loNl:i
<br />'l'he undc.r:::Jigncd undcrsti.lnd::j thi.lt thl:J pcrmi l IIIUY be 3\Jhjp.ct to "deed L'e:s'tl:icc.ion.sJl whicll
<br />may be mor'e rest rl cr.i ve than (;1 ty regulations, The undersigned aSSUmes responsibility for
<br />compliance Hi\'.h "ny dppli"<lbl" d..ed resLricLions,
<br />B, UNLICENSED CONTRACTORS AND CONTRACfOR RI;:SPONSlBI LI'!'IlCS
<br />II Lhe owner has hired a contractor or coneractors to undertake work, they may b", required
<br />to be liCensed ill "c'cord"l1ce with sLaLe and local regulations. If the contl-dctor i ,; not
<br />licensed as required by .Law, both the owner and cont:I'Qct('r mllY bc. cited [or a misdemeanor
<br />violation under' std'te la.w. It the cwn..::r 'n" ilttelJded Ct>tlL.ti:U;LllL' aL.e uncertain as to l,..Jhnt
<br />llo.;"n..lny H'yuln'llI"uL.. llIdY apply [or' L:le InL"'nded work, they are advised to cont""t: the
<br />City of Zmphyrhllls Building Oepartment, 813-788-6611,
<br />Furthermore, if the owner has hired Ii cont1.actor 0,1' "onttad:n!'"" he i>> adviseu to haVe Lh..
<br />contract.or (a) sign portiona of the "Contractor Sectionsl.l ot this applicd.liorl ff.)[ wld<.:h t.hey
<br />wl,ll h<1 responsibln, If you, as the owner signs as the contn.cto,r, you are indicating that
<br />you, l'ather that. the contractor, are r,;,spr!llsible fOl the Work. It t.he contntelor l.ishe05
<br />you to sign as contracto!: that, may be an illdication tholt he is not I'!:operly licens..d and is
<br />rIot. enti tIed Lo pe!:llutLlng pr'lvilege,; In the Ci t}' of Zephyrhills,
<br />C, TRANSPORTATION IMPACT FEES A~lD LJTTT.TTY CONNI':CTTON ~'P.F;S
<br />[I, CONSTRUCTUION LIEN LAI~ (CHAPTER 713, FLORIDA STATllTF.S, AS AMr.NDF.nl
<br />I certi tythat. T, the app] j cant, have ,1l'>en provided wi th a copy of "~'lorida' 0$ Con"Lructlon
<br />ll"'Il Law - Honu,'owner'" Pr'ol,.".:Llon Guide" pr'epared by the Florida (,..partmene of Ag!:i,cuJ ture
<br />and Conswner Affairs, If the applicant is someone other that the "owne.''', l' ceri ty that: T
<br />have obtaIned a copy of LillO above described document and promise .in good taith to deJ.lver.
<br />it. to the "o\.>1ner" prior to Coommcnccrnent._
<br />F" CONTRACTOR' S/O~mF,R' S AFf'TDAVrT
<br />T curti fy thdt dn th", infol.ln..t.iol1 ill this dl'l'1.icd\.j,on 1,; aCCUL'aLe and lhal, 011 work w.ill
<br />be ciolle 1n compliance wiLh all appli.cable laws: regulating const.ruction, zouin9, itnd l;:1:nd
<br />deveiopment:,
<br />Application is hereby made to obtain a permit to do work and instal]ation ~5 il1dic,1tecL T
<br />certify that no work or ins Lalla Lion h"s cOll~enced prior to issuance ot a permi~ and that
<br />all "ork will be performed to meet standards of all laws regulating construction, C:ity
<br />codes, zonin<;r regIl11lt.Jonil, MId Jilnd deve10pmcnt reglllations ill the ,\'It'lsdlcLion, I also
<br />certify that I IInderst.and t.hat the regulations of other governmental agencies lIIay apply to
<br />ehe intended work, anei that il is my responslbilil}' to idenlify "hat actions I must take to
<br />b~ in cOlllpli~nGt~. ~)uch ~9~nc,i es i ncl ude but ~H'e not limil:ed to: "'Departmen-r. of
<br />F.nv.i ronmental. Regulation-Cypress Bayheads, Wetland ALeas and F,nvi r.onment,l'l I.y Scnsi ti v.,
<br />Lands, ~Iater/Waste"ater 'I'r",aLmenl
<br />li'S~")uLhwesl: l:'lol':ida \vaL~r ManaguULt:lnl Dit;l.I'ic.:L-\-h:,ll.s, CYPJ.-e~.!i Hayhellds, i~etland Al.:~as,
<br />Altering WateLcollrses
<br />*ArIflY Curl's of I'"<]i ''''''1 s-Sea,." II s, DOC;KS, N"vtgauIe 11dtel:w"ys
<br />'Depa"t:mellt of Health & Rehabilitative Services. Environmental Health Unit'.I~eJls,
<br />Waste\.atel '!'r"'dtlllent, Sept.i c Tilnks
<br />J.U.S. EnVironmental ProtecLlou Ag~I1(,~Y-Aob~:::;.Lo.::J l"ll;ul.\o:.ltll...~I1L
<br />I ,.lso ,",':rt.ity th<:lt, it tl1llllaterial is to be used in Flood Zone "1\" or "1\.etc.", it is
<br />underslood Lhat. " dx"ir..'g'" pl.", addressing a "compensating volume" w.i.11 be submitted wlljch
<br />L:.l f'n:PQ1<.:d by Q prot...::;"ional enqineel: regist.ered in t.he Stat.e of Florida prio!: to permit.
<br />
<br />issuance..
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<br />A p.'l'lni t 1 "slled shall be construed to be a license to proceed with the work and nol as
<br />allthority to violat~, c.an!.,:",), t1.1Lp.r, nr ~P.t: H~irl~ arty provir-dnn~ of t".hp. t.~I~hn.i(~al cndp...;,;,
<br />nor shaLl issuance of a pernlit prevent the Buildiug O[flelal [rolll Lher'eafLer requIring"
<br />correction ot errors rn plans, construc'tion, or violat.ions of any COde. ~~vcry permit.
<br />isslled slld,ll become invalid unless the "ork 'Hlt.hol'i:.~ed by ::;uch peulUl. is conuneuced I.ilhin
<br />six months of issuance, or 1 t <<ork authorized bi' the permit is suspended or abandoned for a
<br />pe.liod of si.."'t mont.hs afte.t: l.he l.im~ l.llt:' W()Jk j ~ 1..:(')IlUII~LJ(_:~U. 0111:' 90 Uo.1.y e.....lt:::lI~.lull uf L.iUlt:'
<br />may be allowed for the permi t. wi t,h tee cbarge of $15,00, The extension shall be requested
<br />in <<riting to the BUildlu'.l OFf,j(;.idl, An appr.oved inspection lIIust be logged during each six
<br />month period, or t.he pJ:ojcct. "i 11 be cOln:lidClcd ...bandonud,
<br />WAllNING 'I'O O~INER: YOUR FAILURE TO R1::CORD A NOne!:: QJ,' COMMENCEMENT MAY HC:SUL'l' lN YOUR
<br />PAYING TWIC!:; ~'OR lMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN nNANCING, CONSULT
<br />~HTH YOUR LI;:IWER OR ./l.N ATTORNEY BEFORE' RECORr>lN(.; YOIIR NOTTCR ()To' r"lMMnlCp.MRNT, ,TOTlS IINDP.R
<br />$"~, 500 IN VALUE: DO NO'!' N<:ED '1'0 RECORD AND POST "NOTICE OF C CEME T",
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<br />STATE O~' ~'~llA
<br />COtJN'I'Y Or' A-1\.l~P-
<br />The toregoing inslrwn"'lll WHS dCKlIowl"'''ged
<br />Be~rc Ill" rhis'23tJ day of Q:..(d1elL- , J)l:lpcw
<br />by ~)( L Irl~
<br />Iname of perSOll acknowledged)
<br />~ho is perBonal..!.y kuc.)wl1 to me:!, OJ'
<br />
<br />'l'A'!'!:; Oli' ~'LORIllA
<br />COtJN'I'Y or- Oi2AN(,,~
<br />The foregoing instrument was aek!JOwledged
<br />Before me this ("~ilY ot ;l,? .~ . 1_25/0
<br />by ~~$G~LP. '0; l~{)UAtoQ ,
<br />-......J ,name of person acknol-lledg..d)
<br />llItho is personally known to lIle, or:
<br />
<br />PHl1..US RllPA1IJCIC
<br />Notay Public - siatii'Cif r i n
<br />My Commission EIcpHs Aug 2. 3:IQI
<br />CamlIssIon # CC763869
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<br />
<br />
<br />of identific~tion)
<br />Cake aU oilth,
<br />
<br />o who has
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<br />- , n t,akilllJ dcknowl.edgement
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<br />NumB typed, printed 0
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<br />PHYlLIS RlZPATRICIC
<br />s'~,~;~ Public;; -!~Ie rA fbIda
<br />My Commission &phis Aug 2. 2OQ2
<br />Commissial , CC163869
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