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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perait lilY be subject to 'deed restrictions" which 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 owner has hired 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 lilY be
<br />cited for a .isdeJeallor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requireleDts illY 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, he is advised to have the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for which 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 wisbes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to peIlitting privil. 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 'Plorida's construction Lien Law - lIoIeowner's Protection
<br />Guidell prepared by the Plorida Departlent of Agriculture and Consuer Affairs. If the applicant is SOI8OJ1e other than the
<br />'owner', I certify that I have obtained a copy of the above described docuent and prmlise in good faith to deliver it to the
<br />"owner. prior to C~Cl!leDt.
<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 cOlpliance with all
<br />applicable laws regulating construction, laning, and land developent.
<br />
<br />Application is hereby Iilde to obtain a perait to do work and installation as indicated. I certify that no work or
<br />installation bas CDleDced prior to issuance of a perait and that all work will be perfOIll!d to I8et standards of all laws
<br />regulating construction, City codes, loning regulations, and land develO(lll!llt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gOYeIDlleDtal agencies lilY apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in COIpliance. Such agencies include but are not lilited to:
<br />t Departlent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and Bnvirouentally Sensitive Lands,
<br />Water/Wastewater !reatlent
<br />I Southwest Plorida Water ManaqeleDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />I Aray Corps of Enqineers - Seawalls, Docks, lavigable Waterways
<br />I Deparbent of Health i Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater !reablent, Septic lants
<br />I US EnviIODleDtal Protection Aqency - Asbestos abat8lleDt
<br />I also certify that, if fill .aterial is to be used in Plood ZOne 'A' or "A,etc.', it is understood that a drainage plan
<br />addressing a 'CCJIIleD8ating volute' will be sw.ittedwbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perait issuance.
<br />
<br />A peIlit issued sball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />6et aside any provisions of the technical codes, nor sball issuance of a peIlit prevent the Building Official frml thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every pmit issued shall beco.e invalid
<br />unless the work authorized by 6uch perait is COllllJlced within sillODths of issuance, or if work authoriled by the perait is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work is co.enced. One 90 day 81tension of tile, lilY be
<br />allowed for the perait with fee charge of $15.00. Ibe extension shall be requested in writing to the Building Official. An
<br />approved inspec on be logged during each sil IODth period, or the project will be considered abaDdoned.
<br />WARIIIlfG to PAIL 0 RECORD A IOIICE OP CfIlMDCEMDf MAY RESUL! II YOOR PAYIIG nICE FOR IIIPROVIIIDtS 10 YOUR
<br />PROPERlY. 0 UI PIIIBCIIG, COISOLI Ium YOOR LlMDER OR D A'l'fORDY BIFORB RBCORDIIG YOUR IIOfICE OP
<br />COOtER 2,500 II VALUE DO 101 lfEED to RECORD AND POSI A 'IOIICE OF aJIMEIfCEllEHf'.
<br />
<br />81
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<br />
<br />d~~~
<br />SIGlAIURB: COftRAC'lOR
<br />
<br />(Siq.qatur .
<br />Rf'tl.( if. {r,qITHE/2
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />...-:..~v";;;";"" RAY G. GAITHER
<br />.~,. ~T(,.
<br />hA~fCOMMISSION I CC 335104
<br />"?f,,:!.~~..,., EXPIRES OEC8. 1997
<br />
<br />
<br />SIAIE OF ~
<br />coom OF
<br />The foregoing instI'Ull8llt was acknowledged
<br />before me this vrn~ .2 f.o , 19 q'f- by
<br />
<br />U~vn,~ -
<br />
<br />who is pers9Bally Jm~r JhC? has
<br />produced j-i~ . ~
<br />as identification and who did/did not
<br />
<br />t~;~~W~
<br />
<br />~ature) ~ ' ,} I
<br />~o I Vl Ai ...v H ~ ~ e.1
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />S!A!E OP RIDA 1/ j,
<br />coum OP h'>dJ ?Jr=
<br />The foregoing inst ent was acknowledged
<br />before me this /37'?I'o/19.2.t. by
<br />
<br />/la.o !/c~f I/t)
<br />who is personaI:J,y known to me or who has
<br />produced r/PN~'" tlrv'ycrJ ?/~#4.r,,~
<br />as identification and who ~did not
<br />take an oa . L
<br />
<br />. .";:'\
<br />NOTARY PURLIC, s1'A'tti: OF FI.,ORUU.
<br />MY C(l''ilMiS:.;lON FXFH:ES: No.. 20, 199!l.,
<br />BONDED Tci':;; NOTAR- "l'{,UC Ulm<:RwRITf>qll:
<br />
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