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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'fbe undersigned understands that this perait JaY be subject to "deed restrictions" wbieb Jay be lOre restrictive than City
<br />regulations. the undersigned asSUle& responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OImer bas bired a contractor or contractors to undertake work, 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 lisdl!lH!anor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />reguirl!leDts lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building Deparblent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the OImer has bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for whieb they will be responsible. If fOu, as the OIIDer sign as the contractor,
<br />you are indicating that fOU, rather than the contractor, are responsible for the worl. If the contractor wisbes you to sign
<br />as contractor that JaY be an indication that he is not properly licensed and is not entitled to pe1'Jitting privileges in the
<br />City of Zephyrbills.
<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 Construction Lien Law - lICIIl!OIfJler's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsWler Affairs. If the applicant is SOlC!Ol1e other than the
<br />"OImerA, I certify that I have obtained a copy of the above described dOCUleDt and pIOlise in good faith to deliver it to the
<br />"owner" prior to COlleDCl!lleDt.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the infoIlatlon in this application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, laning, and land develo.-ent.
<br />
<br />Application is hereby lade to obtain a peIlit to do work and installation as indicated. I certify that no IfOrk or
<br />installation has CDleDced prior to issuance of a perait and that alllfOrk will he perfoIled to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govl!I1lleDtal agenCies JaY apply to the intencledlfOrk, and that it is
<br />If responsibility to identify what actions I lUSt take to be in COIpliance. Sueb agencies include but are not luited to:
<br />t Departlent of EnviIODlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/llastewater 'freatlent
<br />t Southwest Florida Water Hanagelellt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t AIIY COIPS of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Depart:lent of Health i Rehabilitative Services, EnvirOJlleDtal Health Unit - Wells, Wastewater 'freatlent, Septic 'fants
<br />t US EnvirOllleDtal Protection Agency - Asbestos abatl!lellt
<br />I also certify that, if fill laterial is to be used in Flood ZOne "A" or AA,etc.", it is understood that a drainage plan
<br />addressing a "COIpeD8ating VOlUle" will be sublitted Ihieb is prepared by a professional engineer registered in the State of
<br />Florida prior to petlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with the IfOrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of the tecbnical codes, nor shall issuance of a perlit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beaIIe invalid
<br />unless the work authoriled by sueb peIlit is COllllllCed within slllOnths of issuance, or if work authorized by the perait is
<br />suspended or abandoned for a period of slllODths after the tile the IfOrk Is C08eDcec1. One 90 day eltension of tile, JaY be
<br />allowed for the perlit with fee charge of $15.00. !be eltension sball be reguested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb six IODth period, or the proj'ect will be considered abandonec1.
<br />WARIIIKG 'fa omR: YOUR FAILURE 'fa RECORD A NO'fICE OF a>>IMBICBIIBM'f MAY RBSUL'f IN YOUR PAYING DICE FOR DIPROVIIIBII'fS 'fa YOUR
<br />PROPmY. IF YOU III'fDD 'fa OB'fAIIf FIlIAIfCING, COBSOL'f WI'fH YOUR LBlfDIR OR U AftORDY BEFORE RECORDIIfG YOUR NO'fICB OF
<br />COMMBIfCBMIM'f. JOBS UliDBR $2,500 IN VALUE 00 NO'f DEn 'fa RECORD UD POS'f A "NO'fICB OF C<IIMDCBMBIf'fA.
<br />
<br />SIGJfAfURE: (MfBR OR AGm
<br />
<br />e~Q-~ -~__
<br />SIGJfA'fURB: COJl!RAC'fOR
<br />
<br />S'fA'fE 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 />~~O~F~~~)( ~~
<br />The foregoing instrument was acknowledged
<br />before me this \\'\Cu-.,~ \ ~ , 19 q ~ by
<br />
<br />('r ~' ~I \
<br />'-LL(' ~, ~~f'
<br />who is ersonal y kn01lll to . or who has
<br />produced -~IA
<br />as~t,i,fication' ~4 Wh{J1id/did, not
<br />. :t1Ike o~tb. /)
<br />/-_. ? /' '\ ..,/ /L--"?
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~t1'y PUI(
<br />~~~~
<br />.Ii"
<br />" "
<br />. .
<br />
<br />...~ ~~
<br />"'''FOF fl.()'I'
<br />
<br />TARA N ALFORD
<br />My Commission CC263392
<br />Expires Mar 09. 1997
<br />Huckleberry Associates Ino
<br />800-422.1555
<br />
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