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<br />CONrITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perait lay be subject to Ideed restrictions" which lay be lOre restrictive than City
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe owner bas bired a contractor or contractors to undertake work, they lay 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 lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirements lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections I of this application for wbich they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, 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 be 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, the applicant, bave been provided with a copy of IFlorida's Construction Lien Law - HOIeOKDer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
<br />.owner", I certify that I have obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the
<br />"owner" prior to coaenceaent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developaent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perforaed to leet standards of all laws
<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 goveIDIental agencies laY apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />t Departlent of Environaental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater TreatJent
<br />t Southwest Florida Water Manageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater TreatJent, Septic Tanks
<br />t US EnvirODlental Protection Agency - Asbestos abateaent
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a .cOlpensating volUle" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with 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 peIlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall beCOle invalid
<br />unless the Nork authorized by such perlit is cOllenced within six IOnths of issuance; or if work authorized by the perlit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOllenced. One 90 day extension of tile, laY be
<br />allowed for the perait with fee charge of $15.00. Tbe extension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO ,~ECO~ A, NOTICE OF COKHE~CEHENT KAY RESULT IN YOUR PAYING nllCE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU IH'l'EHD TO OBTAIN FIHAHCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COHIIEIICEIIIl T. J S 1lIIDBIl '50011000 Il/l lEBO TO RICOIIIl ~ M~
<br />
<br />
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />
<br />STATE OF FLORIDA /'I
<br />COUNTY OF rCiLXl---C--O
<br />The foregoing instrument was acknowledged
<br />before me this 0 c..r 2. 7 ' 191L by
<br />
<br />tL/~~7-' -<Y. /..3a--c~
<br />who is personally known to me or who has
<br />'produced- ---''-----
<br />as identification and who did/did not
<br />
<br />take an O~hLl~~ L J L/U~
<br />(gg,nature) " _ _
<br />- I/E (..3/5 11 ~~?tE ~~ I,\?~~ 7-.s
<br />(Name. Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~~:rO~FFLORIDA f1/:.--\1_C~O
<br />The foregoing instrument was acknowledged
<br />before me this air oP7 , 19~ by
<br />
<br />-Zc/~.e.~ f) ,(-3 Of-C_.l:_~
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />~a~e.ClIl_oatl1_~ d~-~.~.~r-LU!j:;
<br />
<br />(Signature) _
<br />~ E /7 /')"J I+,St( C. .,5'? /j7 E E ;-.s-
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />Nataty ~l;hi.i, ;.,'..'
<br />My cOlnnu'::j ';" 'j;i J
<br />"k ,,'
<br />C. C 1T /5 C, ;) 7,y
<br />
<br />
<br />~t';~:'~1t:.mC:~$i
<br />
<br />&Iy t:Omm. fil.~;h,;':,;; Oct 29 f ~5
<br />^k', ' "
<br />ff c(' /5'--..2~'I
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