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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />file undersigned understands that this pel'lit laY be subject to 'deed restrictions' wbich laY be lOre restrictive than City
<br />regulations. !he undersigned assu.es responsibility for co.pliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they illY 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 lisdelll!anor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requiruents lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbich 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 "isbes you to sign
<br />as contractor that laY be an indication that be is not properly licensed and is not entitled to pertitting privileges in the
<br />City of Zepbyrbills.
<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, bave been provided with a copy of 'Florida's Construction Lien Law - ROIl!OIIIIer's Protection
<br />Guide' prepared by the Florida DepartJent of Agriculture and ConsUlleI' Affairs. If the applicant is SOIeOIle other than the
<br />'owerD, I certify that I bave obtained a copy of the above described dOCUlellt and pIOlise in good faith to deliver it to the
<br />"owner' prior to COllellCl!lll!llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land develo.-ent.
<br />
<br />Application is bereby lade to obtain a pel'lit to do wort and installation as indicated. I certify that no work or
<br />installation bas ~ced prior to iSsuance of a pertit and that all work will be perforted to .et standards of all laws
<br />regulating construction, City codes, loning regulations, and land developtent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governtental agencies laY apply to the intended wort, and that it is
<br />If responsibility to identify wbat actions I lUst take to be in eotpliance. Such agencies include but are not lilited to:
<br />t DepartJent of BnvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and Bnvirolllelltally Sensitive Lands,
<br />Water/Wastewater 'freatJent
<br />t Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t lIlY Corps of Bngineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health & Rebabilitative Services, BnviIODleDtal Health Unit - Wells, Wastewater 'freatlent, Septic 'fants
<br />t US BnvirODleJltal Protection Agency - Asbestos abatl!lent
<br />I also certify that, if fill taterial is to be used in Flood ZOne 'A' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpeDSating wIllie' will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to pel'lit issuance.
<br />
<br />A pertit issued sball be construed to be a license to proceed with the wort and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a pel'lit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery pmit issued sball beCOle invalid
<br />unless the work authoriled by such pel'lit is COIIeIlced within sillODtbs of issuance, or if wort authoriled by the pel'lit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work is co.enced. One 90 day extension of tile, laY be
<br />allowed for the perlit with fee charge of $15.00. 'fbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each sillODth period, or the project will be considered abandoned.
<br />wmUG 'f0 <*NBR: YOUR FAILURE 'f0 RlCORD A NO'flCE OF COIMUCBIIIM'f MAY RlSUL'f IN YOUR PAYING 'fIIICE FOR DIPROVIIID'fS 'f0 YOUR
<br />PROPIR'fY. IF YOU INmD 'fO OB'fIIN FIIIDCING, COXSUL'f wlm YOUR LINDO OR AN A'f'fOIIm' BBFORB RECORDING YOUR DICE OF
<br />COMHBMCBHBM'f. JOBS UllDO '2,500 IN VALUE DO NO! NDD 'f0 RECORD AND POS'f A "NO'fICE OF COMHBMCBHBM'fI.
<br />
<br />SIGMAfURI: OOIR OR IGm
<br />
<br />SIGlAfURI: COJmlAC'fOR
<br />
<br />S'fA'f1 OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'fA'f1 OF FLORIDA
<br />coum 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 />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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