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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this pecait lilY be subject to Ideed restrictions I wbieb lilY be lOre restrictive tban City
<br />regulations. lbe undersigned ass_s responsibility for COIpliance with any applicable deed restrictiODS.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they uy be required to be licensed in accordance with
<br />state and local regulatiODS. If the contractor is not licensed as required by law, both the owner and contractor lilY be
<br />cited for a lisdeleanor violation under state law. If tbe owner or intended contractor are uncertain as to wbat licensing
<br />reguir8lents lilY apply for tbe intended wort, tbey are advised to contact tbe City of Zepbyrhills BuilcUng Departlent, (813)
<br />788-6611.
<br />
<br />FurtberlOre, if tbe owner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portiODS of the
<br />IContractor Sections I of this application for wbieb they will be responsible. If fOU, as the owner sign as the contractor,
<br />you are indicating that you, rather tban the contractor, are responsible for the wort. If tbe contractor wisbes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to perIltting privileges in the
<br />City of Zepbyrbills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILI'l'Y 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 - lIoIeoImer's Protection
<br />GuideR prepared by the Florida Departlent of Agriculture and ConsUl8I' Affairs. If tbe applicant is 8OIIl!OIl8 otber than the
<br />lownerl, I certify that I have obtained a copy of the above described docUlent and proaise in good faith to deliver it to the
<br />lownerl prior to co.enCl!l8llt.
<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 COIpliance with all
<br />applicable laws regulating construction, loning, and land develolElt.
<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 bas CDlenced prior to issuance of a pecait and that all work will be perfoued to leet stanclarda of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify tbat I understand tbat the regulations of otber goverDl8lltal agencies lilY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in COIpliance. Sueb agencies include but are not lutted to:
<br />* Departlent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDleDtally Sensitive Lands,
<br />Water/Wastewater 'Ireatlent
<br />* Soutbwest Florida Water Hanagl!l8llt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />* AllY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />* Departlent of Health' Rehabilitative Services, EnviIOllll8Dtal Health Unit - Wells, Wastewater !reatlent, Septic Iws
<br />* US BnviIODl8l1tal Protection Agency - Asbestos abatl!l8llt
<br />I also certify that, if fill laterial is to be used in Flood Zone IAI or IA,etc.l, it is understood that a drainage plan
<br />addressing a lCOIp8D8ating volUleI will be saitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance. .
<br />
<br />A perlit issued shall be construed to he a license to proceed with the IfOrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of tbe tecbnical codes, nor shall issuance of a perlit prevent the Building Official fIOl thereafter
<br />reguiring a correction of errors in plans, CODStruction, or violations of any code. Ivery perIlt issued aball heCClle invalid
<br />unless the work authoriled by such perlit is CODeIlced within sillOntbs of issuance, or if work authoriled by the pecait is
<br />suspended or abandoned for a period of 8il IODths after the tile the work is c~ced. One 90 day eJtension of tile, lily be
<br />allowed for the perlit witb fee ebarge of $15.00. Ibe eJtension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillODth period, or the project will be considered abandoned.
<br />WARlING 'fO MIR: YOOR FAILURE 'fO RECORD A IIOIICE OF CCIIIIUCIIIDf lilY RESULT Iff YOUR PAYlIG DICE FOR DIPROVIIIIIrS 'fO YOUR
<br />PROPERlY. IF YOU IIf'fBIID 'fO OBIAIH iIIWlCIIG,. COHSUL'f WIm YcD LBIIDIR OR U AnORIIY BI10RB RICORDIIG YOUR HOIICI OF
<br />ClIIHEHClMBII. JOBS UKDIR $2,500 II YALDI DO 101 IBID 10 RECORD AID POSI A llO!ICE OF ClIMIICIIIIIII.
<br />
<br />. ,..
<br />
<br />SIGllAIURE: (MID OR AGIII
<br />
<br />SIGIA'fURE: COIIRAC'fOR
<br />
<br />S'fA'fB OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'fA'fB 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 oct.th.
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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