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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this penit Iilr be subject to 'deed restricUOII8' whieb Iilr be lOre restrictive than Citr
<br />reguJatiOll8. !be undersigned iI88UI88 responsibility for cmpliance with any applicable deed restrictiOll8.
<br />
<br />B. UNLICENSED'CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertake work, they Iilr be reguired to be licensed in accorcJance with
<br />state and local regulaUOIII. If the contractor is not licensed as required by lill, both the owner and contractor lilY be
<br />cited for a lisdl!lll!aDOr violation under state lilI. If the owner or intended contractor are uncertain as to what licensing
<br />rl!CJllirell8llta lilY apply for the intencIecJ IOrk, they are advised to contact the City of Zepbyrbl11s Bullding Departlent, (813)
<br />788-6611.
<br />
<br />PurtherlOre, if the OlDer bas hired a contractor or contractors, he is advised to have the contractor(s) sign portiona of the
<br />IContractor SectiOll8' of this applicatioo for whieb ther will be responsible. If JOU, as the 0IIIler lign as the contractor,
<br />you are iDc1icatinq that JOU, rather than the. contractor, are responsible for the IOrk. If the contractor ,ilbes JOU to sign
<br />as contractor that lilY be an iDc1ication that he is not properly licensed and is not entitled to perJitting 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 AMBNDED)
<br />I certify that I, the applicant, have been provided with a copy of 'Florida's CODstruction Lien Law - Bc-.ner's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUIII Affairs. If the applicant is ... other than the
<br />'OIDer', I certify that I have obtained a copy of the above described c10cuIent and p~ise in good faith to deliver it to the
<br />lownerl prior to co.enCl!l8llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certifr that all the iDforJation in this application is accurate and that all work will be done in ClJlpliance with all
<br />applicable laws regulating construction, loning, and land develo....t.
<br />
<br />Application Is herebr tade to obtain a perIIit to do work and installation as indicated. I certify that DO IOrk or
<br />installation has ~cec1 prior to iuuance of a perJit and that alllOrk will be perfOIll!C1 to _t ltandards of alII_
<br />regulating construction, Citr codes, loning regulations, anc11anc1 developEDt regulatiOlll In the juris4ictiOll. I also
<br />certify that I understaDc1 that the regulations of other goverDl8l1tal agencies lilY apply to the intenc1ecJ work, and that It is
<br />If responsibility to identify what actions I lUSt tab to be in COIIpliance. Sueb agencies include but are not lillted to:
<br />I Departlent of InvirOlllellW Regulation - Cypress Baybeads, lIetlanc1lreas anc1lnviroDleDtally Sensitive Lands,
<br />lIater/lfastewater !reatleDt
<br />I Southwest Florida lIater ManaQel8Dt District - lIells, Cypress Bayheads, lIetlanc1lreas, Alterinq lIatercoUrses
<br />I Al'IJ Corps of Engineers - Seawalls, Docks, lavigable lIatmays
<br />I DepartleDt of Health i Rehabilitative Services, InvirOlll8Dtal Health Unit - lIells, lIastewater 'freatleDt, Septic !anks
<br />I US InvirouenW Protection Agency - I8heat08 abatell8llt
<br />I also certify that, if fllllilterial is to be used in Flood lone 'A' or lA, etc. I, it is understood that a clraiDage plan
<br />addressing a 'cmpenaating volue' will be sw.itted whieb is prepared by a professiODal 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 work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a pemt prevent the Building Offidal f~ thereafter
<br />rl!CJlliring a correction of mors in plans, construction, or violationa of any code. Ivery perJit iuued shall becoIe invalid
<br />unless the work authoriled by sueb penit is ~ced within sillODths of issuance, or if work authoriled by the penit is
<br />suspended or abandoned for a period of sillODths after the tile the work is co.encecl. One 90 day ateuilll of tile, lilY be
<br />allOled for the perllt with fee charge of $15.00. !be atension shall be requested in writinq to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sil IODth period, or the project will be considered abaDdooec1.
<br />IIARNIIG !O (JfDR: YOOR FAlLURI 'fO RECORD A IO'IICE OF alllBlCllllllllAY RBSUL! II YOOR PITIIG niCE FOR lJIPROVIIIDIS 'fO YOOI
<br />PROPBm. IF YOU lJUID 'fO OBIJII FIUlCIIG, CORSUL! III'IH YOOR LBIIDIR OR D AnomY BlFORI RICOIDIIG YOUIIO'IICE OF
<br />aJlMDCBIIDI. JOBS UIDII1$2,SOO II VILUI DO IO! IIID 'fO RECORD AID POS! A 'JIO!ICI OF COIIIIJICIIID!'.
<br />
<br />'" ,0, ~ l
<br />~~ OJ.'{ ~
<br />SIGRlfURI: OOIR OR IGII! SIGRI!UHIl: COI1BAC'fOR
<br />
<br />SfA!1 OF FLORIDA
<br />COUI!Y OF PASCO
<br />The foregoing instrument was acknowledged
<br />before me this Julv 13 , 19~ by
<br />
<br />Sf AD OF FLORIDA
<br />COOllY OF
<br />The foregoing instru.ent was acknowledged
<br />before .lie this , 19__ by
<br />
<br />Daniel W. Burgess, Sr.
<br />who is personally known to .e DlXldImtI88
<br />IImdBud .
<br />~~un un. and who "/did. not
<br />t an oath. '3 /~ .
<br />!J. tLtif. _ /, .LJ!. a /'vd
<br />ignature) ,
<br />Charlotte B. Ballard
<br />(Billie. Typed, Printed or StilllDAd~ 'd
<br />ROTARY PUBLIC Notary Public, SfaftJoT on a
<br />lIct Commission Expires F.b. 7. 1995
<br />..... 1iNlde4111N lrQl fllill- ~_Iac. ....;
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an O$th.
<br />
<br />(Signature)
<br />
<br />(Nue Typed, Printed or Stuped)
<br />NOTARY PUBLIC
<br />
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