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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe underslgnedtunderatands that this perlit lay be subject to "deed restrictions" which lay be lOre restrictlvl thaa City .
<br />regulations. The undersigned assUles responsibility for cOlpliance 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 lay be
<br />cited for a liadeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requiretents lay apply for the intended work, they are advised to contact the City of Zephyrhills Building Departlent, (813)
<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 />"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 the contractor wishes you to sign
<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 U'fILITY CONNECTION FEES (,!
<br />
<br />D. CONSTRUCTION LIEN L~W (ClrnPTER 713, FLORIDA STATUTES~ AS-AMENDED)
<br />I certify that I, the applicant, bave been provided with a copy of "Floridats Construction Lien Law - HOIeOIDer'. Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone 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~Jt ~ the
<br />"owner" prior to coaencelent.
<br />
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI'l'
<br />I certify that all the inforlation in this application is accurate and that all work will be done in co.pliance with all
<br />applicable laws regulating construction, loning, and land deve~oplent.
<br />I
<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 perfoIJ8d to Jeet 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 otber governaentBI agencies lay apply to the intended worl, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not 118ited to:
<br />t Departaent of Bnvironaental Regulation - Cypress Bayheads, Wetland Areas and Bnvironaentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Water Hanagetent District - Wells, Cypress B~yheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - SeawaIis, DOCks, Navigable Waterways .
<br />t DepartJent of Health & Rehabilitative Services, Bnvironaental Health Unit - Wells, Wastewater TreatJent, Septic tanks
<br />t US Bnvironaental 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 autbority to ,101ate, cancel alter, or
<br />Bet aside any provisions of the technical codes, nor shall is~u~nce of a perlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery peIlit issued shall heCOlB iDyalid
<br />unless the work authorized by such perlit is cOllenced within Sil IOnths of issuance, or if wort authoriled by the perJit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOMenced. One 90 day utension of tile, Ii' 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 IOnth period, or the project will be considered abandoned.
<br />WARMING TO OWNER: YOUR FAILURE TO RECORD A fIOTICR OF COHHKfICKHENT HAY RESULT IfI YOUR PAYING 1'I11C1 FOR IHPROVIIIIIIIS TO YOUR
<br />PROPERTY. Ill' YOU IIfTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFOU RECORDING YOUR IIOTICB OF
<br />COKKEICEHENT. JOBS UNDER $2,500 IN VALUR DO NOT NEED TO RECORD AND POST A "NOTICR OF COKKKNCKMKNT"..
<br />
<br />L/~~
<br />~m~~'7" -
<br />
<br />East Pasco Medical Center
<br />
<br />STATE OF FLOR~
<br />COUNTY OF \--'D-.::, CD
<br />The foregOing in~~rum.ft.nt was acknowledged
<br />before me this ~ - ":1 ,8 ~y
<br />
<br />
<br />Co., Inc.
<br />
<br />\C
<br />who .
<br />pro ce \'0\
<br />as identification and. who di~_~EV
<br />
<br />~th. \ ~
<br />(S' atur2:'~'\~~~,Z:
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />r who has
<br />
<br />STATE OF FLOR~
<br />COUNTY OF \O-.S C (:)
<br />The foregoing instrume~ was acknowledged
<br />before me this ^+ - '2.. , S~O?~ by
<br />
<br />~ o.s-\~~ '\ "\.j\~~~
<br />who is ona11y known to m who has
<br />produced ~ ~
<br />as identification and who di d n~
<br />
<br />~~~~.\\~\\~\~
<br />(S~ ture) .
<br />~v "'~ ~,\\~ '\' \\\ 2\() V\
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />'''~'''''' JUNE M. HERNDON
<br />f~:&' ~;o MY COMMISSION # CC 980237
<br />='" : E EXPIRES' February 1, 2005
<br />- .~. . cIIrwrlllrt
<br />I';;'.. ..-.:.i1!i Bonded Thru Notary PlMio Un
<br />II 'r"Rt,.t;\'
<br />
<br />~ ,'''''''', JUNE M. HERNDON
<br />~ltt~1i.":} M~~~~~~~~~~:;~, ~:~37
<br />I "~~~"..~ IIcUnd rile 'I
<br />; "Ij,,~f.,~\\"" Bonded Thru Notlry Pub eM rs
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