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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned' understands that this per.it .ay be subject Lo "deed restrictions" which lay be lOre restrictive ~City
<br />regulations. The undersigned assUles responsibility for co.pliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the ONner has hired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
<br />Btate and local regulations. If the contractor is not licensed as required by law, both the owner and contractor aay be
<br />cited for a liBdeaeanor violation under state law. If the owner or intended contractor are uncertain aB to what licensing
<br />reguireaents lay apply for the intended Nork, they are advised to contact the City. of Zephyrbills 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 the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for which they will be reBponsible. 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 wilhes you to lign
<br />aB contractor that lay be an indication that he is not properly licensed and is not entitled to peraitting 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 L~W (ClmPTER 713, FLORIDA STATUTES~ ASAMBNDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HOIeOWDer'l Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler AffairB. If the applicant i8 sOleone other than the
<br />"owner", I certify that I have obtained a copy of the above described docu.ent and prOlise in good faith to deliver~Jt tu the
<br />"owner" prior to couenceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<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 dev~~oplent.
<br />I
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<br />Application iB 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 perforled to aeet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I allO
<br />certify that I underBtand that the regulations of other goverOlent81 agencieB aay apply to tbe intended wort, and tbat it is
<br />IY responsibility to identify what actionB I lust take to be in cOlpliance. Such agencies include but are not 11lited to:
<br />· Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroOlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />· Southwest Florida Water Hanageaent District - Wells, Cypress B~yheads, Wetland Areas, Altering Watercourses
<br />· ArlY Corps of Engineers - Seawalis, Docks, Kavigable Waterways .
<br />· Deparllent of Health i Rehabilitative Services, Environaental Health Unit - Wells, Wastewater !reallent, Septic !anls
<br />· US EnviroOlental Protection Agency - Asbestos abateaent
<br />I also certify that, if fill .aterial is to be used in Flood Zone "A" or "A,etc.., it is understood that a drainage plan
<br />addreBsing a .co.pensating volUle" 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 the NOrk 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 f[OI thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery perait ilsued ahall beCOle invalid
<br />unless the worl authorized by such perlit is cOllenced within six IOnths of issuance, or if work autboriled by the peIlit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day eatension of tile, lay be
<br />allowed for the perlit with fee charge of $15.00. The extenBion Bhall be reguested 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 />WARKIKG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMHENCEHRNT HAY RESULT IN YOUR PAYING twICE FOR IHPROYBMBKTS TO YOUR
<br />PROPERTY. IPYOU IKTEKD TO OBTAIN FIKANCING, CONSULT WITH YOUR LENDER OR AN ATTORIBY BEFORB RBCORDIKG YOUR MorICH OF
<br />COKMENCEHENT. JOBS UNDER $2,500 IN VALUE DO NOT NEID TO RICORD AND POST A "NOTICE OF COMHBKCEHEKT".,
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<br />SIGKATURE: ONKER OR AGENT
<br />
<br />SIGNATURE: COKTRACTOR
<br />Poole Construction Co., Inc.
<br />
<br />East Pasco Medical Center
<br />
<br />STATK OF FLORIDA
<br />COURTY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY 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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