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<br />CONDITIONS OF PERMIT AFFIDAVIT ((~ -
<br />A. NOTICE OF DEED RESTRICTIONS
<br />rile undersigned understands that tIlis pel1lit JaY be subject to .deed restrictions. wbich Jay be lOre restrictive tIlan City
<br />regulations. Ihe undersigned asSUles respcmsibility for CCIIpliance witll any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tile OImer bas bired a contractor or contractors to undertake lIOrk, tbey JaY be required to be licensed in accordance witll
<br />state and local regulations. If tile contractor is not licensed as required by law, botll tile ower and contractor JaY be
<br />cited for a lisdf!ll!illlor violation under state In. If tile owner or intended contractor are uncertain as to wbat licensing
<br />requirelellts JaY apply for tile intended lIOrk, tIley are advised to contact tile City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtbeIlOre, if tile OImer bas bired a contractor or contractors, be is advised to bave tile contractor(s) sign portions of tile
<br />.Contractor Sections. of tIlis application for wbich tIley will be responsible. If JOU, as tile OIIDer sign as tile contractor,
<br />you are indicating that JOU, ratller tIlan tile contractor, are responsible for tile lIOrt. If tile contractor wishes you to sign
<br />as contractor tIlat JaY be an indication that be is not properly licensed and is not entitled to perlitting privileges in tile
<br />City of Zepbyrhills.
<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 witll a copy of .Florida's Construction Lien Law - lDeoImer's Protection
<br />Guide. prepared by tile Florida Departlent of Agriculture and COnsUller Affairs. If tile applicant is SOIIeOI1a other than the
<br />.00000erR, I certify that I bave obtained a copy of the above described docuJent and pIOlise in good faitll to deliver it to tile
<br />"01f1ler" prior to C~Cl!l8llt.
<br />
<br />E. CONTRACTOR' SlOWER'S AFFIDAVIT
<br />I certify that all tile inforaation in tIlis application is accurate and that all work will be done in COIPliance witll all
<br />applicable laws regulating construction, loning, and land developlleDt.
<br />
<br />Application is bereby lade to obtain a perlit to do lIOrk and installation as indicated. I certify that no work or
<br />installation bas CDleDced prior to issuence of a perlit and that allllOrk will be perfol1lecl to Jeet standards of all laws
<br />regulating construction, City codes, loning regulations, and land develo(lleDt regulations in the jurisdiction. I also
<br />certify tIlat I understand tIlat tile regulations of other gGYeI1IJeDtal agencies JaY apply to tile intended lIOrt, and that it is
<br />IY responsibility to identify wbat actions I lUSt take to be in COIpliance. Such agencies include but are not lilited to:
<br />I Departlent of EnviIODlelltal Regulation - Cypress Baybeads, Wetland Areas and EnvirODJeDtally Sensitive Lands,
<br />Water /Wastewater Ireatlent
<br />I Soutbwest Florida Water Managl!l8llt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />I ArIy Corps of Engineers - Seawalls, Docks, lIavigable Watenays
<br />I Departlent of Healtll & Rehabilitative Services, InvirODJeDtal Healtll Unit - Wells, Wastewater lreatJent, Septic lanks
<br />I US InviIODJeDtal Protection Agency - Asbestos abatelellt
<br />I also certify that, if fill Jaterial is to be used in Flood Zone .A. or .A,etc.', it is understood that a drainage plan
<br />addressing a .CllIpeDSating volUle. will be saitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />
<br />A perlit issued shall be construed to be a license to proceed witll the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of tile technical codes, nor sball issuance of a perlit prevent the 'Building Official frOl tIlereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCOle invalid
<br />unless tile lIOrk authoriled by such perlit is co.enced witllin sillODtbs of issuance, or if IIOrk authoriled by the perlit is
<br />suspended or abandoned for a period of sil IODths after tile tile the work is CDleDced. One 90 day utension of tile, Jay be
<br />allowed for tile perlit witll fee charge of $15.00. !he utension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODtIl period, or tile project will be considered abandoned.
<br />FAILURI to RlCORD A IIO!ICE OF aJIMBIICIIIDI MAY Rl8UL! III YOUR PAYIIG twiCE FOR DIPIIOVIIID!S !O YOUR
<br />OB'IAIII FIIIDCIIIG, COIISUL! WID YOOR LODER OR 111 AnomY BIFOBI RICORDIIG YOUR JfO!ICE OF
<br />00 III VALUE DO 1101 mD to RECORD AID JOSH · ICE OF ClJIIIIIfClMm-.
<br />
<br />
<br />81AD OF FLORIDA
<br />coum OF ~~..u
<br />The foregoing instrument was acknowledged
<br />before me this S.~ , 19 q \.\. by
<br />
<br />~\",)\ ~ \:.. C\...." '::,.s,~_
<br />who is personally known to me or who has
<br />produced t:\()~,6.'A \)(\l''''~ \~~~
<br />as identification and who did/did not
<br />
<br />tak\~~\ ~~(...}/Y.~
<br />
<br />(Signature)
<br />\- <::.\<.,;...,' .--s. C.\~~'::,
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />LEIGH :J. CLASS
<br />NOTARY PUBLIC, STATE OF FLORIDA
<br />~ commission expires Mar. 21. 199/
<br />. ~ommission NO. C C 2 7 0 3 ~ 1.
<br />
<br />srAD OF FLORIDA
<br />coom OF y<:.W;~~
<br />The foregoing instrument was acknowledged
<br />before me this S:""-- , 19-TI- by
<br />
<br />Q-v\.<:. (" \\\.\.J\'\ c",-,".
<br />who is personally known to me or who has
<br />produced \=-\G)(\JA WI \0,1"',,, ~
<br />as identification and who did/did Dot
<br />
<br />take ~ ~~.~ \ (Q.0J}- ~
<br />
<br />(Signa,~~~)~:, -S c \,..,\(o,'J
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />t:EIGH :J. CLASS
<br />NOTARY PUBLIC, STATE OFFLO,RI?^
<br />My commission exp:res 1\1.". ,,- 1, .,,) I
<br />. Com~;scjOI1 NQ. C C 2 7.0 :;) .8 .I.
<br />
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