|
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Th@ undersigned understands that this p@r.it .ay b@ subj@ct to 'd@@d r@strictions- Mhich .ay b@ .or@ r@strictiv@ than City
<br />r@gulations. Th@ undersigned assu.@s responsibility for co.plianc@ Mith any applicabl@ deed r@strictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OMn@r has hired a contractor or contractors to undertake Mork, they .ay b@ required to b@ lic@ns@d in accordanc@ with
<br />state and local regulations. If the contractor is not licens@d as required by laM, both the owner and contractor .ay b@
<br />cited for a .isd@.@anor violation under state laM. If the OMn@r or intended contractor are unc@rtain as to Ihat lic@nsing
<br />r@quir@.@nts .ay apply for the intended Mork, they are advis@d to contact the City of 2@phyrhills Building D@part.@nt, 18J31
<br />788-6611 .
<br />
<br />Furth@r.or@, if the OMn@r has hired a contractor or contractors, h@ is advised to have the contractorlll sign portions of the
<br />"Contractor S@ctions- of this application for Mhich they Mill b@ responsible. If you, as the OMner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are r@sponsibl@ for the Mork. If the contractor Mish@s you to sign
<br />as contractor that .ay b@ an indication that h@ is not prop@rly lic@ns@d and is not entitled to p@r.itting privileges in the
<br />City of 2ephyrhills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LA~ (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I c@rtify that I, the applicant, have been provided Mith a copy of "Florida's Construction Lien Law - "o.@owner's Prot@ction
<br />Guide- prepared by the Florida Depart.ent of Agricultur@ and Consu.@r Affairs. If the applicant is so.@one other than the
<br />"oMn@r", I c@rtify that I have obtained a copy of the above d@scrib@d docu.@nt and pro.is@ in good faith to deliver it to the
<br />-oMn@r" prior to co..@nc@.@nt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I c@rtify that all the infor.ation in this application is accurat@ and that all IDrk "ill b@ done in co.plianc@ .ith all
<br />applicabl@ la.s regulating construction, zoning, and land d@v@lop.@nt.
<br />
<br />Application is hereby .ad@ to obtain a p@r.it to do work and Installation as indicat@d. 1 c@rtify that no Mork or
<br />installation hal cO'l@nc@d prior to issuanc@ of a p@r.it and that all Mork will be p@rfor.ed to leet standards of all laM5
<br />regulating con5truction, City cod@s, zoning regulations, and land d@v@lop.@nt regulations in the jurisdiction. 1 al50
<br />c@rtify that I understand that the regulations of other govern.ental ag@nci@s .ay apply to the intended work, and that it is
<br />.y r@5ponsibility to identify what actions I .ust take to be In cotplianc@. Such ag@nci@5 include but are not li.ited to:
<br />I Depart.@nt of Environ.@ntal R@Qulation - Cypress Bayh@ads, M@tland Ar@as and Environ.@ntally Sensitive lands,
<br />Nat@r/Mastewat@r Trfat,@nt
<br />I Southwest Florida Nater "anaQ@.ent District - NeIls, Cypress Bayheads, Metland Areas, Altering NatercDurs@5
<br />4 Ar.y CorDS If Enain@@rs - SeaMalls, Docks, Navigable Naterways
<br />I D@part.ent of Health l Rehabilitative Services, Enviro",ental H@alth Unit - W@lls, Wastewater Tr@at.ent, S@ptic Tanks
<br />I US Envirln.ental Protectill Aaency - Asbestos abatelfnt
<br />I al50 certify that, if fill .aterial is to be used in Flood Zone "A" or "A,@tc.", it is understood that a drainage plan
<br />addressing a -co.pensating 'Dlu.e- will be sub.itted which is prepared by a professional engineer registered in the State of
<br />Florida prior to p@r.it issuanc@.
<br />
<br />A p@r.it issued shall b@ construed to be a licens@ to proceed with the lork and not as authority to violate, cancel alter, or
<br />s@t aside any provisions of the t@chnical cod@s, nor shall issuanc@ of a p@r.it prevent the Building Official frol thereafter
<br />requiring a correttiDn of errors in plans, construction, or violations of any cod@. Every per.it issued shall becole invalid
<br />unless the work authorized by such per.it is co..enced within six lonths of issuance, or if work authorized by the p@r.it is
<br />5usp@nd@d or abandoned for a period of six IOnths after the ti.e the Mork is to..enced. One 90 day extension of ti.e, .ay b@
<br />allow@d for the per.it lith f@@ charg@ of 115.00. Th@ extension shall b@ requested in Mriting to the Building Offitial. An
<br />approved inspection lust be logg@d during each six .onth periDd, or the projett Mill be consid@r@d abandoned.
<br />HARMING TO OUNERI YOUR FAILURE TD RECORD A NOTICE OF c~MCEftEMT KAY RESULT 1M YOUR PAYING TUICE FOR I"PROVE"ENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TD OBTAIN FINANCING, CONSUlT HITH YOUR LENDER DR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COftItEMCE~NT. JOBS UNDER 12,500 IN VAlUE DO NOT NEED TO RECORD AND POST A "NOTICE OF CotItlENCE~NT-.
<br />
<br />SI6NATURE: CONTRACTOR
<br />
<br />
<br />SlAT\' OF flORIDA ~ ~~ - --
<br />COUNTY OF /. /1L:&A
<br />The foregt,ing instrument was acknowledged
<br />b~fore me this, 19_____ by
<br />
<br />SIGNATURE: OWNER OR AGENT
<br />
<br />SIRIE OF FlllRI.A~ ~ ~,~.
<br />COUNTY OF. -
<br />The foregoing instr ent 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 oath.
<br />
<br /><Signature)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLI C
<br />
|