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<br />If::'" "., . '~l 11 j',- 1 J' . ,.)1, 1[1;' j I', li;- d,.,:-'H I H H ~L,:,
<br />--- .. _t)-.:::.::.-- :"q_l_ . _' _ . "_- _ _
<br />
<br />i EL 111.1: Ie:: L 3::::::::: 32'3=:
<br />
<br />l:tiJ.J4 Fr.l2
<br />
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />..\. l!QTICE OF DSED RESTRICTIONS
<br />!be un .reigned under.tandi tbat tbla petitt lay be SUbject to 'deed restrictions" wbicb '111 be tore restrictive tban City
<br />regulations. Ib, under.igned a81U1es responsibility for cOIpl.lanee wltb any applicable deed restriction..
<br />
<br />D. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner h.. bired-o contractor or contractors to undertake work, they IIY be required to be licensed in accordance with
<br />.tate and local regullUonl. If tbe contractor is not licenaee! liS required by lew, both the OlDer and contractor lay be
<br />cited for I .iI48l8anor ,iolation under state law. If the owner or intended contractor lre uncertain 8S to wbat licen8inq
<br />requlr8lentl lay apply for the intended worl, they are advised to contact the City of Zepbyrbilll Building Departlent, (813)
<br />788-6611.
<br />
<br />Furtb8llOr., it the owner bas hired a contractor or contractors, he 18 advised to have the contractor(s) .ign portions of the
<br />'Contractor Sections' of tbil application for whicb ther will be responsible. It you, as the orner lign as the contractor,
<br />you are indicating that you, rather than the contractor, ate responsible for the wort. If the contractor wishes you to sign
<br />as cootractor tbat .ay be an Indication that he is not properly licensed and is not entitled to per.itting privileges in tbe
<br />City of Zepbyrhills.
<br />
<br />c. TRANSPORTATION IMPACT FEES AND UTILITY CO~NECTIO~ FEES
<br />
<br />D. CONSTRUCTION LIgN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, tbe applicant, bave be!n provided with a copy of .Florida's Construction Lien Law _ HDI8OMD8r'. Protection
<br />Guide' prepared by th. 'lorida DepartJent of Agriculture and ConsUler Affairs. If the applicant i8 lo.eone other tban the
<br />-owner-, I certif, that 1 have obtaine~ a copy of the above described docUlent and prOl!se in good faith to deliver it to the
<br />-owner' prior to COIIIDcllent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certif, that 111 the Infoflltion In tbil Ipplication il accurate and that all work wIll be done in COIpliancl with all
<br />eppllcable llWI regulating conttructlon, loning, and land developlent,
<br />
<br />Application 11 hereby IIde to obtain a peuit to do work and installation liS indicated. I certify that no work or
<br />in8tall'tlon ba8 COIIeDced prior to issuance of a per.it and that all work will be perfOrled to leet 8tandard. of alJ law8
<br />r@gulating conltruction, City code., lonlng regulations, and land deyelop.ent regulations in the jurisdiction. I al10
<br />certif, tbat J und.rltand that the regulations of otber go,erntentBI agencies .ey appl, to the intended worl, and tbat it is
<br />'Y relponlibUit, to idlfttify what actions I lust take to be in co.pliance. Sucb agencie. include but ere not U.ited to:
<br />t Departlent of Invironlental Requl.tion - Cypress Barheads, Wetland Areas and EnvironJentally 8ensitiys Land.,
<br />Water/Wastewater IreatJent
<br />· SOUtblest Florid. Water Hanagel~t District - Mells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t All' COrDI of Blain..rl . Sea.alll, Docks, NaYigable weterways
<br />t DapartllDt of Sealtb , Behabtlitltl,. Services, lnyjrDnlental Health Unit - Wells, Wastewater freatlent, Septic fanks
<br />t US In,iroDllfttal Protection Avancy - IlbestoB abatllent
<br />I also certif, that, it fill laterial 18 to be used in Flood Zone "AW or "A,ete.", it is understood tbat I drainage plan
<br />addres.ing I 'CQIPIDIltJng volute" will be lublitted which is prepared by a professioDal engineer registered In the State of
<br />Florida prior to peraft issuance.
<br />
<br />\ I :',^ "~1.0rt-,>
<br />~(MfIR OR AGlIfT
<br />
<br />A petitt il8Ued eball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />let alide an, prowl.ioal of the technical codes, nor shall i8suance of a pettit prevent the Building Official frOl therellfter
<br />requiring. correction of Irrors in plana, construction, or violations of any code. B,er, perJit i81Ued Iball becOI8 in,alid
<br />unleSl the IfOr) authorhed br 8uch pel'Jlit fa couenced witbin dl IICntbs of bauance, or if work authoriled by tile pertit f.
<br />8uspended Dr lbandcmed for I plrlod of III IOntha after the UIe the work 18 cQUenced. one 90 day uten8ion of U., lay be
<br />allowed for tbe perllt with tee charge of $15.00. rbe tlten8ion sball be requested In writing to the Building Official. An
<br />appro,ed InlpectiOD IUlt be loggea during eacb six IOntb period, or the project will be considered abandoned.
<br />WARNING YO 0ItDI: YOfJrl FAlLURE 10 RBCORD A NOTICE OF COMHBMCiH!H! MAY RESULt IN YOUR PAYING !IIlCS FOR IHPROVEMEIl1'8 10 YOUR
<br />PROPIRn. IP YOU IlIbD to OBTIIJI FINANCING, COJlSULf WITH YOUR LBJlDIR OR AN ArrOMEY B&FQRB RBCORIlIHG YOUJIlIOTICfl OF
<br />COHKENCIMRMt. JOBS UlDIl f2, 500 IN VALUE DO HOI NBED fO RECORD AND POST A wNOTICK OF COMKBNCEHENT".
<br />
<br />
<br />- \.~,(y,.la~
<br />-----.-- SiG rURI: C !KAeTOR
<br />
<br />SIA'I OF FLORIDA " I' I
<br />coom OF if /I \
<br />The foregoing 1nstrUm~t was 8~knowledged
<br />before 118 this ;23/12i:. , 19..!:1j by .-te6 >
<br />
<br />(/Jp S ~Je Ld~J\ _'_
<br />who i8 Per.onany known to me or who has
<br />produced
<br />.e identif1~n and who did/did not
<br />take an oat~,~cvt; 4.1 ~ ___
<br />(Signature)
<br />
<br />(Hame Typed, Printed or Stamped)
<br />NOTARY PU8L~
<br />~"~,, , ~*, .,,',' ",::', ',"',., , , ., ", !IflI.185
<br />."1...., , ~",,,.
<br />; . - - - ; ~- .
<br />. ~.
<br />. ..... ,.1115
<br />
<br />~~ O~/LORIOA .~( I J S' ,
<br />The foregoing instrument1waa actnowledge~~t'
<br />beforQ me this ~ ,~a ~ _, 19--9:;- by r ..0.
<br />
<br />who is p.rf.6..~:i;M!;;:fj ~ ~hO haa
<br />
<br />produced
<br />as identific~_t. and \tho ~did/d1~ot
<br />take an OQtbi' I
<br />{ ~ a'
<br />(Signature)
<br />
<br />(Name Typed, Printed or-Stamped)
<br />NOTARY puaLIC
<br />. ji"'l..,,,." !, R,AC, HEL L RU,SSO
<br />.~ " .Ml'Commie.~CC~1..
<br />: '1C : Expjres Jul. 2et ~. ~ '.
<br />'" lOt &mded by HH
<br />~It Of f\.Q".aOO"'22'1~
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