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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The und~rsign;d unders~nds Ithat~hj~-per.i'~.ay~-~ubject to "deed restrictions' which .ay be lore restrictive than City
<br />regulations, The undersigned assu.es responsibility for (o~pliance with any applicable deed restrictions,
<br />
<br />B. !-,NLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a cDntractor or contract~~-~~~~dert~ke ;ork, th~1I-;ay-'b;~quired 't~iicensed in accordance with
<br />state and local regulations, If the contractor is not licensed as required by Ia", both the owner and contractor .ay be
<br />cited for a .isde.eanor violation under state law, If the owner Dr intended contractor are uncertain as to "hat licensing
<br />require.ents lay apply for the intended work, they are advised to contact the City of lephyrhills Building Depart.ent, (BI3)
<br />7BB-6611,
<br />
<br />Further.ore, if the OHner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />'Contractor Sections" of this application for Hhich they Mill be responsible, If you, as the OHner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work, If the contractor wishes you to sign
<br />as contractor that .ay be an indication that he is not properly licensed and is not entitled to per.itting privileges in the
<br />City of lephyrhilIs,
<br />
<br />C, TRANSPORTATION H1PACT FEE~J-)I'm UTIl,...ITY j:ONNECTION_ FEE.!2.
<br />
<br />I), CONSTRUCTION I".JEN .!:-AI1 (CHAPTER 713. FLORIDf) STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction lien Law - Ho.eoHner's Protection
<br />Guide' prepared by the Florida Depart.ent of Agriculture and Consu.er Affairs, If the applicant is so.eone other than the
<br />"owner", I certify that I have obtained a copy of the above described docu.ent and pro.ise in good faith to deliver it to the
<br />.0Mner' prior to co..ence.ent,
<br />
<br />E, t:ONTRACTOR' S/Ol-JNER' S AFFI,DAY-!.I
<br />I certify that all the infor.ation in this application is accurate and that all Hork will be done in co.pliance with all
<br />applicable laws regulating construction, loning, and land develop.ent,
<br />
<br />Application is hereby .ade to obtain a per.it to do Hork and installation as indicated, I certify that no work or
<br />installation has co..enced prior to issuance of a per.it and that all work "ill be perfor.ed to .eet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction, I also
<br />certify that I understand that the regulations of other govern,ental agencies .ay apply to the intended work, and that it is
<br />,y responsibility to identify what actions I ,ust take to be in co.pliance, Such agencies include but are not Ii,ited to:
<br />I Depart.ent of Environ.ental ReQulation - Cypress Bayheads, WetJand Areas and Environ.entally Sensitive lands,
<br />Nater/Wastewater Treat,ent
<br />, Southwest Florida Nater nanaqe.ent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />, Ar.y Corps of EnQineers - Seawalls, Docls, Navigable Waterways
<br />I Depart.ent of HeaJth L Rehabilitative Services, Envir~n.ental Health Unit - NeIls, Wastewater Treat.ent, Septic Tanks
<br />, US Environ.ental Protection AQency - Asbestos abate.pnl
<br />I also certify that, if filJ .aterial is to be used in Flood Zonp "A" or "A,etc,', it is understood that a drainage plan
<br />addressing a "co.pensating volu.e" MilJ be sub.itted which is prepared by a professional engineer registered in the State of
<br />Florida prior to pertit issuance,
<br />
<br />A perlit issued shall be construed to be a Jicense to proceed with the Mork and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a per.it prevent the Building Official fro. thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code, Every per.it issued shall beco.e invalid
<br />unless the Norl authorized by such per.it is co..enced Hithin six .onths of issuance, or if Hork authorized by the per.it is
<br />suspended or abandoned for a period of six .onths after the ti.e the work is co..enced, One 90 day extension of tile, .ay be
<br />allowed for the per.it with fee charge of '15,00, The extension shall be requested in writing to the Building Official, An
<br />approved inspection .ust be logged during each six lonth period, Dr the project will be considered abandoned,
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NoTJCE OF COMnENCEMENT nAY RESULT IN YOUR PAYIN6 TWICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY, IF YOU INTEND TO OBTAIN FJNANCIN6, CONSULT NITH YOUR lENDER OR AN ATTORNEY BEFORE RECORDIN6 YOUR NOTICE OF
<br />conMENCEMENT, JOBS UNDER $2,500 IN YALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT",
<br />
<br />SIGNATURE: ONNER OR A6ENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was ackno",ledged
<br />, 19 _ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />befc'l-e mI:' th i s
<br />
<br />..,as ackno",ledged
<br />, 19_ by
<br />
<br />who is personally known to me or who has
<br />pl-oduced
<br />as identification and who did/did not
<br />take an oath,
<br />
<br />who is personally known to me or who has
<br />pl-oduced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed Dr Stamped)
<br />tlOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />t-lQTARY PUBLIC
<br />
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