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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this pe~it lay be subject to Ideed restrictions I Ihieb laY be lOre restrictive than City
<br />regulations. The undersigned assUles responsibility for cOlpliance lith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has bired a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
<br />state and local regulations. If tbe contractor is not licensed as required by lal, both the owner and contractor laY be
<br />cited for a lisdeaeanor violation under state lal. If tbe owner or intended contractor are uncertain as to wbat licensing
<br />reguirelents laY apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />188-6611.
<br />
<br />FurtberlOre, if the owner has bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />IContractor Sections' of this al.'plication for Ibicb they lill be responsible. If you, as the owner sign as the contractor,
<br />you are indicating tbat you, rather than tbe contractor, are responsible for the lork. If the contractor wisbes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to per.itting privileges in the
<br />City of Zepbyrbills. .
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 113, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided lith a copy of IFlorida's Construction Lien Law - HOIeOIDer's Protection
<br />Guidel prepared by tbe Florida Departlent of Agriculture and Conslller Affairs. If tbe applicant is SOJeODe otber than the
<br />lowner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to cOllellcelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all lork lill be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is bereby .ade to obtain a per.it to do lork and installation as indicated. I certify that no work or
<br />installation bas cOlleDced prior to issuance of a pe~it and that all work lill be perf oIled to teet standards of all lals
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDIeDtal agencies lay apply to the intended work, and that it is
<br />IY responsibility to identify Ihat actions I .ust take to be in co.pliance. Sueb agencies include but are not Ii.ited to:
<br />* Departlent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDleDtally Sensitive Lands,
<br />Water/Wastewater freatJent
<br />* Soutbwest Florida Water Hanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />* Ar.y Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health & Rebabilitative Services, EnvironJental Health Unit - Wells, Wastelater freatlent, Septic lanks
<br />* US EnviroDlental Protecti~n Agency - Asbestos abatClent
<br />I also certify tbat, if fill laterial is to be used in Flood Zone IA" or IA,etc.", it is understood that a drainage plan
<br />addressing a Acolpensating VOlUleA will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />~. ~~~
<br />SIGNATURE: OWIIER OR AGEIII
<br />
<br />A perlit issued sball be construed to be a license to proceed lith 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 perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery pe~it issued shall beCOle invalid
<br />unless the IOrk authorized by sueb perlit is co_nced within sillODths of issuance, or if work authorized by the per.it is
<br />suspended or abandoned for a period of sillOnths after the tile the work is co.enced. One 90 day extension of tile, lay be
<br />allowed for the pe~it with fee cbarge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eaeb sil IOntb period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICB OF COHMBNCBlllNI MAY RESULT IN YOUR PAYING TWICE FOR IHPIIOVBIIBJI1'S TO YOUR
<br />PROPIRTY. IF YOU IIITIND fa OBTAIN FINANCING, CONSULT WITH YOUR LINDIR OR AN AnORlEY BEFORE RECORDING YOUR NOTICE OF
<br />COHMBNCEHENT. JOBS UNDIR $2,500 IN VALUE 00 lOT NEBD TO RECORD AND POST A .NOfICI OF COHHENCEIlBIII".
<br />
<br />JDtJ
<br />
<br />
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF It/IA b~
<br />The foregoing in~rument was acknowledged
<br />before me this UI-1li/J-f- J , 19 -1!:L by
<br />
<br />\-7? ttJ dlrfLw. !1IJ-d'{)U)
<br />who is personally known to me or who -has
<br />pl'6duced
<br />as identification and who 8*d/did not
<br />take ,p oath. ~".
<br />~ 11-.. ~JL
<br />(Signature)
<br />
<br />(Nam[~;{~d~p*,=i~r Stamped)
<br />NOTARY PUBLIC
<br />Notary Public, State of Florida
<br />My Commission Expires Nov. 17, 1995
<br />
<br />Bondod Thru Troy Fain ..lrisurQn~e rne.
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF )~/ //SbrYltJU-t;
<br />The foregoin~ ia:; ent was acknowledged
<br />before me thIS wIr I , 19~ by
<br />
<br />< /};uJ l tA IA) r ~AJ1 SOJ/\......,
<br />who is personally known to me ~whohas
<br />produced
<br />as identification and who ~/did not
<br />take ~ oath.
<br />p ~. 11, rJ~H.b
<br />(Sign~Ure)
<br />nk II, (a.l4'rhe.//
<br />(Name Typed, Printe or Stamped)
<br />NOTARY PUBLIC
<br />
<br />Notary Public, State o{ fieri:!"
<br />
<br />My Commission Expires Nov, 11, 1995
<br />Bonded Thru Troy Fain . Insuran(~ Inc.
<br />
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