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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perlit lily be subject to "deed restrictions" wbieb lily be lOre restrictive than City
<br />regulations. !be undersigned assUIeB responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIRIer haa bired a contractor or contractors to undertake wort, they JaY 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 JaY be
<br />cited for a .isdeJeanOr violation under state law. If the OIRIer or intended contractor are uncertain as to wbat licensing
<br />requirelellts lilY apply for the intended wort, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />J
<br />Furtherlore, if the OIRIer bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for wbieb they will be responsible. If you, as the OlDer sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor wisbes you to sign
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to perlitting 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 - HCIII!OIfJler's Protection
<br />Guide" prepared by the Plorida Departlent of Agriculture and ConsUJer Affairs. If the applicant i8 SOIeOne other than the
<br />"owner", I certify that I bave obtained a copy of the above described docuIent and prOJise in good faith to deliver it to the
<br />"owner. prior to COlleDCeJellt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIJation in this application is accurate and that all wort will be done in COIpliance with all
<br />applicable laws regulating construction, lOlling, and land develo~t.
<br />
<br />Application is hereby lade to obtain a perlit to do wort and installation as indicated. I certify that no wort or
<br />installation bas CDlenced prior to issuance of a perlit and that all wort will be perfol'led to _t standards of all laws
<br />regulating construction, City codes, loning regulations, and land developll!llt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agencies laY apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lUSt tate to be in COJpliance. Sueb agencies include but are not li.ited to:
<br />I Departlent of EnvirOJ1lelltal Regulation - Cypress 81Yheads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />Water/llastewater Treatlent
<br />t Southwest Plorida Water Managel8llt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, lIavigable Watenays
<br />t Departlent of Health & Rehabilitative Services, EnvironJeJltal Health Unit - Wells, Wastewater Treatlent, Septic rants
<br />t US BnviroDlental Protection Agency - Asbestos abateJent
<br />I also certify that, if fill Jaterial is to be used in Plood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "co.pensating volllle" will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Plorida prior to perlit issuance.
<br />
<br />A peIJit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in~plans, construction, or violations of any code. Bvery perlit issued ahall becoIe invalid
<br />unless the work authoriled by sueb perlit is COIIeIlCed within sil IODths of issuance, or if wort authorized by the Perlit is
<br />suspended or abandoned for a period of sillODtbs after the tile the wort is COIIeIlced. One 90 day utension of tile, lilY be
<br />allowed for the perlit with fee ebarge of $15.00. !be utension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sil IODth period, or the project will be considered abandoned.
<br />WARlIIIIG TO OIlIER: YOUR PAILURE TO RECORD A OICH OP C(JlMllCIIIIlIT MAY RESULT III YOUR PAYIIIG filCH FOR DIPROVIIID!S TO YOUR
<br />PROPEm. IP YOU IIlDlID TO OBfAIJI FIIIBCIIIG, COlISULT wlm YOUR LIJIDBR OR lJI AnoRIIY BBFORE RBCORDIIIG YOUR IIOtICH OP
<br />alDlBlICItIBlIf. JOBS UlDER '2,500 III VALUE DO IIOt NBBD TO RECORD lJID POST A "NOtICE OF aJOIBlICBMDf-.
<br />
<br />SIGlIAfURI: 0IftfBR OR AGm'
<br />
<br />SIGIIA'IUIIB: CON!RACfOR
<br />
<br />SfATB OP FLORIDA
<br />coum OP
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STArE OP FLORIDA
<br />COUlIIY OP
<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 o~th.
<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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