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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />.A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned undentands that tbis pemt JaY be subject to "deed restrictions" wbich JaY be lOre restrictive than City
<br />regulations. !be undersigned assUle& responsibility for capliance witb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, tbey JaY be reguired to be licensed in accordance witb
<br />state and local regulations, If tbe contractor is not licensed as reguired by law, botb tbe owner and contractor JaY be
<br />cited for a lisdl!lll!allor violation under state law, If tbe owner or intended contractor are uncertain as to wbat licensing
<br />requirl!lents JaY apply for tbe intended work, they are advised to contact tbe City of Zepbyrhills Building DepartJent, (813)
<br />788-6611,
<br />
<br />FurtheIlOre, if the owner bas hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections" of tbis application for whieb tbey will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, ratber than the contractor, are responsible for the work. If tbe contractor wishes you to sign
<br />as contractor tbat Jay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrbills.
<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, tbe applicant, have been provided witb a copy of "Florida's Construction Lien Law - lbIeolmer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs, If tbe applicant is 8OIM!OI1e other than the
<br />"owner", I certify that I have obtained a copy of tbe above described docUIent and pl'Olise in good faitb to deliver it to the
<br />"owner" prior to C~Cl!IeDt,
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlition in tbis application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land develDpleDt.
<br />
<br />Application is hereby Jade to obtain a perlit to do work and installation as indicated, I certify tbat no work or
<br />installation has CDlenced prior to issuance of a perlit and that all work will be perf OIled to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land develDplent regulations in the jurisdiction. I also
<br />certify that I understand that tbe regulations of otber goverJllleDtal agencies IaJ apply to the intended work, and that it is
<br />If responsibility to identify what actions I lUst take to be in capliance, Such agencies include but are not luited to:
<br />t DepartJent of BnviIOl1l8lltal Regulation - Cypress Bayheads, IIetland Areas and BnvirolllH!lltally Sensitive Lands,
<br />IIater /Wastewater !reatlent
<br />t Soutbwest Florida IIater Hanagl!leDt District - IIells, Cypress Baybeads, Wetland Areas, Altering IIatercourses
<br />t AIIY Corps of Eng'ineers - Seawalls, .Docb, Ravigable IIaterways
<br />t Departlent of Healtb i Rehabilitative Services, EnvirODlental Healtb Unit - IIells, IIastewater !reatlent, Septic !ants
<br />t US EnviIOl1lental Protection Agency - Asbestos abatl!lent
<br />I also certify that, if fill laterial is to be used in Flood ZOoe "A" or "A,etc,l, it is understood that a drainage plan
<br />addressing a "COIpl!IlSating volUll!" will be sublitted which is prepared by a professional engineer registered in tbe State of
<br />Florida prior to peIlit issuance,
<br />
<br />A perlit issued shall be construed to be a license to proceed witb tbe work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perait prevent the Building Official fl'Ol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall becDe invalid
<br />unless tbe work authoriled by such perlit is ~ced within slllOntbs of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of slllODtbs after the tile tbe work is C31eDced, One 90 day utension of tile, Jay be
<br />allOlfed for the perlit witb fee charge of $15,00, !he utension shall be requested in writing to the Building Official, An
<br />approved inspection lUSt be logged during each sillODtb period, or the project will be considered abandoned.
<br />IIA11JfllfG !O (JfIER: YOUR FAILURE !O RECORD A RorICE OF COIIDCEIIIlft' MAY RESUL! IR YOUR PAYIlfG !VICE FOR DIPROVEIIDl'S !O YOUR
<br />PROPERfY, IF YOO IIImD !O 0BI1Ilf 'IWCllfG, COlfSOL! 111m YOUR LEIIDER OR 11 AftORDY BEFORE RICORDIIG YOUR DICE OF
<br />a>>oo:lfCEMER!, JOBS OlDER $2,500 Ilf VALUE 00 Ror IIDD !O RECORD lID POS! A "RorICE OF aJIIIDCEIIDrl.
<br />
<br />SIGlAfURI: OOIER OR AGEJI!
<br />
<br />SIGlAfURI: comIACTOR
<br />
<br />S!A!E OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SfAn: OF FLORIDA
<br />coum OF
<br />The foregoing instrument 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 />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />,(Signature)
<br />
<br />. (Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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