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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS .
<br />Ibe undersigned understands that this perait iii' be subject to 'deed restrictions' wbieb iii, be lOre restrictive than Cit,
<br />regulations. tbe undersigned asSUle& responsibility for COIpliance with any applicable deed restrictiOll8.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIII1er bas bired a contractor or contractors to undertake work, they .y be required to.be llceD8ed in accordance with
<br />state and local reguJatiOll8. If the contractor is not liC8D8ed as required by law, both the lJIIDer and contractor iii' be
<br />cited for a lisdl!ll!aDor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />reguirl!lellu JIilY apply for the intended work, they are advised to contact the City of ZepbyrhUls Bullc1ing Departlent, (813)
<br />788-6611. .
<br />
<br />FurtheIlOre, if the owner has hired a contractor or contractors, be is advised to have the contractor(s) sign portiOll8 of the
<br />'Contractor Sections' of this applicatioo for whieb they wi11 be responsible. If you, as the OlDer Sign as the contractor,
<br />JOU are indicating that you, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to penittlng privileges in the
<br />Cit, of Zepbyrhills. . .
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of 'Florida's COII8truction Lien Law - &o.eoImer's Protection
<br />Guide' prepared by the Florida Departleot of Agriculture and ConsUIeI Affairs. If the applicant is 8OIl!ODI other than the
<br />'owner', I certify that I have obtained a copy of the above described docUIent and prolise in good faith to deliver it to the
<br />'owner' prior to co.enC8I8IJt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />,I certify that all the infoIliltion in this application is accurate and that all work will be done in COIpliance with all
<br />applicable 111II regulating construction, loning, and land develoPleDt.
<br />
<br />Application is hereby lade to obtain a perlit to do wort and insWlation as indicated. I certify that no wort or
<br />insWlation baa c:mIeDCed prior to issuance of a perait and that all wort will be perfonec1 to _t ltaDl1ards of all Ian
<br />regulating construction, City codes, loning regulations, and land devel~t regulations in the judsdictiCll. I also
<br />certify that I understand that the regulations of other gDVeIIII8J1tal agencies lilY apply to the intendedllOli, and that it is
<br />., responsibility to identify what actions I lUSt tate to be in COIpliance. Sueb agencies include but are not lilited to:
<br />I J)epartlent of InvirODlBDtal Regulation - Cypress Baybeac1s, lIetlanclAreas and InvirOlllBlltally Sensitive Lands,
<br />Water/Wastewater lreatlent
<br />I Soutlnrest Plorida lIater HanageHllt District - lIells, Cypress Bayheads, lIetland Areas, Altering llatercour_
<br />I ArIy Corps of Engineers - Seawalls, Docb, Navigable Waterways
<br />I DePBrtlent of Health , Rehabilitative Senices, InviIOnl8llW Health Unit - IfeUs, llastewater Ireatlent, Septic lants
<br />I US Envil'OlJl8l1W Protection Agency - Asbestos abatl!llBllt
<br />I also certify that, if fill aaterial is to be used in Plood Zone 'A' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpen&8ting volUle' will be suitted whieb is prepared by a professional engineer registered in the State of
<br />Plorida prior to perlit issuance.
<br />
<br />A perlit issued sball be construed to be a license to proceed with the work and not as autbority to violate, cancel alter, or
<br />set aside an, provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official f~ thereafter
<br />reguiring a correction of errors in plans, construction, or violations of any code. Ivery penit issued shall becme invalid
<br />unless the wort autborbed by sueb perlit is co.enced rithin sillOlltbs of issuance, or if rort autborbed by the perait is
<br />suspended or abandoned for a period of 11IIOIltbs after the tile the wort il ~ced. One 90 day atension of tiM, lilY be
<br />allowed for the perlit with fee ebarge of '15.00. !be atension shall be reguestec1 in writing to the BuilcUng Official. In
<br />approved inspection lUSt be logged during eaeb sil IOIlth period, or the project rill be considered abandoned.
<br />IIARMIIG to (lOR: YOUR PAlLURE to RICOHO A NOtICl OF C<IIIDCIIIIIf lilY RISUL! II YOUR PIYIIG DICI FOR DIPROVIIIIIrS to YOOI
<br />PROPmY. IP YOU II'lBIID to OBIAII PIJlAlCIIG, COISUL! IfIIB YOUR LIIDIR OR II AftORIIY BIPORB RICORDIIG YOOI JOIICI OP
<br />C<IIHDCIIDI. JOBS UJlDIR"2, 500 IN VALUE DO IO'f DID to RBCORD AID POSI A -NOtICl OP C(lllDCIIIIII'.
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<br />SIGJIlIURB: COIIIRACIOR
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<br />srArl OP PLORI~
<br />coum OF ~6 0
<br />The foregoing in~t was ackp9"ledged
<br />before me this , 19 qy by
<br />
<br />~Q ~(I -
<br />who is on to me or who has
<br />produc
<br />as identification and who did~
<br />
<br />t..... ~~~-I(~d'"
<br />(S1gnat ~' Sc.A~ J Lo-
<br />rnlI M (!JLI
<br />(Name TYP ,Printed or Sta.ped)
<br />NOTARY PUBLIC
<br />
<br />SIAII OP PLORI~
<br />COODY OP c..u
<br />The forego1ng i~st was a~~ledged
<br />before me this t- , 1~ by
<br />
<br />~UlCQ... . j/'2s
<br />who i~allY ~ to lIS or who has
<br />produce
<br />as identification and who ~
<br />
<br />take ~~>>~d,/,
<br />(Signat e) #J I c::::'A' P. If
<br />1\.. / m '.J..:JdA",n ec "-
<br />(Nillle Typed, Printed or Stuped)
<br />NOTARY PUBLIC
<br />
<br />
<br />.,. .'f
<br />
<br />
<br />.'iU'fARY PUllUC, S'rATE tlJlo' Jl<'LORWA.
<br />MY COMMISSlDlN EXi'illEI3: JUllie 1, 1995.
<br />BOlWED TBIW NOTARY 1>UB.LIC I1i'WKKWJUTlu.
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