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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'be undersigned understands that this perait JaY be subject to Ideed resyictionsl wbich Jay be lOre restrictive than City
<br />regulations. !he undersigned assUles responsibility for COIpliance with 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, they JaY be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be
<br />cited for a lisdl!leanor violation under state law. If the OIIIl8r or intended contractor are uncertain as to wbat licensing
<br />requireJeJ1ts laY apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />Furtberaore, if the owner bas hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />IContractor Sectionsl of this application for which they will be responsible. If JOU, as the owner sign as the contractor,
<br />you are indicating that JOU, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign
<br />as contractor that laY be an indication that he is not properly licensed and is not entitled to peraitting privileges in the
<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, the applicant, bave been provided with a copy of IFlorida's Construction Lien Law - lkIIeoImer's Protection
<br />Guidel prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is SOJeODe other than the
<br />lownerl, I certify that I bave obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the
<br />"ownerl prior to COIIenCl!IeDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developent.
<br />
<br />Application is hereby lade to obtain a perait to do work and installation as indicated. I certify that no work or
<br />installation bas cmleDced prior to issuance of a Perlit and that all work will be perfoIJed to Met standards of all laws
<br />regulating construction, City codes, loning regulations, and land developJll!Jlt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverJllelltal agencies laY apply to the intended wort, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in COIpliance. Such agencies include but are not liJited to:
<br />* DepartJent of BnvirOlllelltal Regulation - Cypress Baybeads, lIetland Areas and Bnvirolllentally Sensitive Lands,
<br />lIater/Vastewater 'l'reablent
<br />t Southwest Florida Nater Managelellt District - lIells, Cypress Baybeads, lIetland Areas, Altering lIatercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, lavigable lIaterways
<br />* DepartJent of Health & Rehabilitative Services, BnvirODleDtal Health unit - lIells, lfastewater 'l'reatlent, Septic !ws
<br />t US EnviIODll!lltal ProtectiOn Agency - Asbestos abateJeJ1t
<br />I also certify that, if fill laterial is to be used in Flood Zone IAI or lA, etc. I, it is understood that a drainage plan
<br />addressing a lCOIp8DSating VOIUleI will be subJlitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to petlit issuance.
<br />
<br />A perait issued sball be construed to be a license to proceed with the wort and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a petlit prevent the Building Official fIOl thereafter
<br />requiring a correction of erIOrs in plans, construction, or violations of any code. Every perait issued sball beCOll! invalid
<br />unless the work authoriled by such perait is COIIeDced within sillODtbs of issuance, or if work authoriled by the petlit is
<br />suspended or abandoned for a period of sil IOnths after the tile the work is COII8Dced. One 90 day utension of tile, laY be
<br />allowed for the petlit with fee charge of $15.00. !he extension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned.
<br />IfARlfIIIG fO 0IfIfER: YOUR FIILURE to RECORD I IO'I'ICE OF aJIIDCEIIBIf! MAY RESUL! 111 YOUR PIYIIG !lICE FOR lMPROVIIImS to YOUR
<br />PROPER'lY. IF YOU Irrmm '1'0 OB'l'AII FIWCIIG, CONSUL'I' III'l'B YOUR LDDIR OR 11 lnORDY BEFORE RICORDIIG YOUR IIO'l'ICI OF
<br />~I . J 2,500 IN VALUI DO 10'1' lIED to RECORD AID POSt A 'IIO'l'ICE OF C(JDfDCBIID'l".
<br />
<br />cV: W. K/
<br />
<br />&~~~~ vuR~~ -t~ SIGIfA'l'URI: comAC!OR
<br />goO \o.Q.\ -\- L, W ~\ i' "\ e...
<br />S'I'A'I'E OF FLORIDA (\
<br />COOII'l'Y OF t-n- s,c 0
<br />The foregoing instrument was acknowledged
<br />before me this (')C) \ 9. , 19q~ by
<br />
<br />(~)'yJ D.... Lu h\' t- e... ~ ~8~ + L, CU VI ,+ ~
<br />who is personally known to me or who has
<br />produced F\ 0.... b f L, \ CE: V\ S ~
<br />as identification and who eid1did not
<br />taJr.ErAA oath. ("'\
<br />~~~~
<br />(Signature) ",~';(..v:'ft.t;;. RHONDA DUNCAN
<br />:';;).' "'f,;~ ~ COMMISSION * CC384519 EXPIRES
<br />(Name Typed, p-.: ."',: o~
<br />NOTARY PUBLIC ',.1F.....'
<br />
<br />S'I'A'I'E OF FLORIDA
<br />COURY 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 />(Signature)
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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