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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />fbe undersigned understands that tbis perlit JaY be subject to 'deed restrictions' whieblaY be lOre restrictive than City
<br />regulaticms. lhe undersigned asSUles responsibility for COIpliance witb any applicable deed restrictiOll8.
<br />
<br />B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe owner bas hired a contractor or contractors to undertate IOrk, tbey laY be required to be licensed in accordance ,itb
<br />state and local regulations. If tbe contractor is not licensed as required by law, botb tbe OlDer and contractor laY be
<br />cited for a lisdl!leallor violation under state law. If tbe owner or intended contractor are uncertain as to wbat licensing
<br />reguirellelJts laY apply for tbe intended IOrk, they are advised to contact tbe City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner has bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />"Contractor SectiOll8~ of tbis applicaticm for whieb they will be respoosible. If fOU, as the OlDer sign as the contractor,
<br />you are indicatinq that you, rather than tbe contractor, are responsible for the work. If the contractor wishes you to sign
<br />as contractor that laY be an indication tbat he is not properly licensed and is not entitled to perti~ting privileges in tbe
<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, tbe applicant, have been provided witb a copy of "Plorida's Construction Lien Law - lIoIeoImer's Protection
<br />Guide" prepared by the Florida Departtent of Agriculture and COnsUler Affairs. If tbe applicant is 80180I18 other than the
<br />"owner", I certify that I have obtained a copy of the above described docUlent and prOlisl in good faitb to deliver it to the
<br />"owner" prior to co.enCl!l8llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infonation in this application is accurate and that all work will be done in COIpliance with all
<br />applicable IllS regulating construction, loning, and land developl8llt.
<br />
<br />Application is hereby lade to obtain a perlit to do IOrt and installation as indicated. I certify that DO IOrk or
<br />installation has CDleDced prior to issuance of a pertit andtbat alllOrk will be perforJed to teet standards of all Ills
<br />regulating construction, City codes, loning regulations, and land developaent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gov8IDlental agencies laY apply to the intended work, and that it is
<br />-r responsibility to identify wbat actions I lUst take to be in COIpliance. Sueb agencies include but are not liaited to:
<br />* Departtent of Bnvirollll8lltal Regulation - Cypress Bayheads, Wetland Areas and Bnvirolll8lltally Sensitive Lands,
<br />Water /Wastewater freatlent
<br />I Soutbwest Florida Water Hanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />* ArlY Corps of Bngineers - Seawalls, Docks, Havigable Waterways
<br />I DepartJent of Hea1tb i Rehabilitative Services, BnvirODlental Health Unit - Wells, Wastewater Ireatlent, Septic lants
<br />I US Bnvirontental Protection Agency - Asbestos abateaent
<br />I also certify that, if fill laterial is to be used in Flood lone 'A" or "I,etc.", it is understood that a drainage plan
<br />addressing a "COIpeDSating volute" will be subtitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />I pertit issued shall be construed to be a license to proceed with the IOrk and DOt as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official fa thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery pertit issued shall belDe invalid
<br />unless the IOrk authoriled by sueb perlit is co.enced within sillOllths of issuance, or if work authoriled by the pertit is
<br />suspended or abandoned for a period of sillODtbs after the Ute the work is ~ced. One 90 day 81tension of tite, tay be
<br />allowed for the pertit with fee ebarge of $15.00. !he 81tension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillOllth period, or the project will be considered abandoned.
<br />WARlfIMG ro OWR: YOUR FAILURB ro RECORD I HOliCK OF COIIIUCBIIBIfI MAY RESULI 1M YOUR PIYIHG fliCK FOR DIPROVBIIBIrS ro YOUR
<br />PROPBJI'fY. IP YOU IImD ro OBIAII PIWCI.G, CONSULI IUfH YOOft LBIDBR OR AI ArroRDY BBPORE RICORDIHG YOOR JIOIICK OP
<br />C<IOIIIfCBHBHr. JOBS UHDBR '2,500 IH VALUE DO NOI mD ro RECORD AND POSf A 'HOIICH OP aJIIlKHCBIIBJfr".
<br />
<br />
<br />()'~1>>1 ~ _~
<br />SIGHAIURB: COI1'IIACIOR
<br />
<br />~ t>(.,'; ~
<br />SIGDa: OIDR OR AGm
<br />
<br />SIATB, OF FLO~DA
<br />COIJIfIY OP Ct.5 C ()
<br />The foregoing instrument was acknowledged
<br />before me this Se.p-\-, ~) , 19!i!L by
<br />
<br />who is personally known to me or who has
<br />produced j\ I.-
<br />as identification and who .diet/did not
<br />take an oath.
<br />
<br />
<br />STAfE OF FLORI>>I
<br />CDUm OP VaSco
<br />The foregoing instrument was aC~ledged
<br />before me this SePT, ,). S , 19 q by
<br />
<br />n . {()J'V'1 Ht:{ [' I)P~
<br />who is personally known to me or wile hee
<br />produeed
<br />iUL identification aDd who did/did not
<br />t~~lJth. lQ >
<br />r' ~'{
<br />(Signatu,re . .,
<br />\10. (er,e L. -St1ClI/")~II)~
<br />(Name Typed, Printed or St~l
<br />NOTARY PUBLIC " ,'.,"'''' ~<""'''''''''''''''''~f,,<''~,~''''''<W''''''''''''''''''''''''''''''''''''''''''''''l
<br />~,.", ~"8 Valerie L. Shampine (
<br />· ~~ Notary Public, Sta~ (
<br />,,~Wl.1 Cotnmissiaa No. CC 340129 (
<br />.. ?()f"-~MyCommissioDRxpires01l16198 (
<br />Iondod TIuough Fla. Notary Service " Baedia& Co. :
<br />. ,((((((((((({(((((((((((((({((((t/{(({(({(((((. t
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