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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understaDds that this penlt lilY be subject to Rdeed restrictiODlR .bieb lilY be lOre restrictive than City
<br />regulatiODl. !be undersigned as8UIeB responsibility for COIPliance .ith any applicable deed restrictioos.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OlDer bas hired a contractor or contractors to undertake IOrt, they lay be required to be licensed in accordance .ith
<br />. state and local regulatioos. If the contractor is not licensed as required by lu, both the lJIIDeI and contractor IilJ be
<br />cited for a lisd8le8llOr violation under state lall. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelellts lilY apply for the intended IOrt, they are advised to contact the City of Zepbyrhills Building De1firtIent, (813)
<br />788-6611.'
<br />
<br />FurtherlOre, if the OIner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />RContractor SectioosR of this application for wieb they .ill be responsible. If you, as the OlDer sign as the contractor,
<br />you are indicating that' you, rather than the contractor, are responsible for the IIOrt. 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 perlittiDg privileges in the
<br />City of Zepbyrbills. '
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />1 certify that 1, the applicant, have been provided .ith a copy of RPlorida's COnstruction Lien Law - lkIIeoImer's Protection
<br />GuideR prepared by the Florida Departlent of Agriculture and COnsUIeI Affairs. If the applicant is 8OII!OIl8 other than the
<br />ROIDerR, I certify that I bave obtained a copy of the above described clocuIent and prOlise in good faith to deliver it to the
<br />RovnerR prior to ~Cl!l8Ilt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infonation in this application is accurate and that allllOrk will be done in COIPliance with all
<br />applicable lU8 regulating construction, loning, and land developent.
<br />
<br />Application is hereby Jade to obtain a pmit to do wort and insWlation as indicated. I certify that no IIOrt or
<br />installation baa ~ced prior to issuance of a perlit and that alllOrt will be perfOIJec1 to Jeet staDl1ards of all Ius
<br />regulating construction, City codes, loning rtguIations, anc11and clevelopJellt regulations in the jurisdiction. I also
<br />certify th~t I understand that the regulations of other goveIJll8Jltal agencies lilY apply to the"intenc1ec1l1OIk~ and that it is
<br />If responsibility to identify .bat actions 1 lust take ,to be, in COIPliance. Sueb agencies include but are not lilited to:
<br />t Departlent of Bnvirolll8lltal Regulation - Cypress BaybeacJs, Wetland Areas and EnvirODleDWly Sensitive Lands,
<br />'Watu/Wastl!1later '!reatlent
<br />t Southwest Florida Water Hanagl!l8Ilt District -Wells, ~ypress Baylleads, Wetland Areas, Altering Watercourses
<br />t Arl' Corps of Engineers - Sea.alls, Docks, lavigable Waterways
<br />t Departlent cif Health & Rehabilitative Services, EnvirDJIIeDW Health Unit - Wells, Wastewater '1reatJent, Septic 'lanD
<br />t US InviroJilental Protection Agency - 'lsbestOlabat8lleDt " .
<br />I also certify that, if f111lilterialis to beWled.in Flood Zone BAR'or BI,etc.R, it is understood that a drainage plan
<br />addressing a RCCJlPeDBilting vo1_R .ill be sublitted .bieb is prepared by a professional engineer registered in the State of
<br />Florida prior to penit issuance. . , . .
<br />
<br />I perIIit issued shall be cOnstrued to bea license to proceed with the Work and not as authority to violate, cancel alter, or
<br />set aside any provisioos of the \8cbnical,cod~, nor shall issuance of a pmit prevent the Building' 9ffici~. fa, ~8ltfter
<br />requiring a correction of errors in plans, construction, or violations of any code. ' Ivery pmit'i8sQed shall ~ invalid
<br />unless the WIt 'authorized by such ~tis, COMeIlcec1 .i~ln, sU'lOIltbs of issuance, or if IIOrt aut;boriled bl, the pmit is
<br />suspended or abandoned ,for a period of sUlODtbs after the tile the IIOrk is ~ced. One 90, uyutension of tile, .y be
<br />allowed for the perIIit with fee ebarge of '15.00. !be atension shall be recpested in uitiDgto.~ BuUlling Official. An
<br />approved inspection 'lUSt' be logged during eaeb' sil IODth. period~ or the 'project will be considered abandOIled. '
<br />IWUHIfG to ODD: YOUR PAILURB 'fO RBCORD A 1f0000ICE OF COIII8RCIIIIII MAY RESUL! II YOUR PAYIIG ICE FOR IIIPROVIIIIIl!S to YOUR
<br />PROPBR'fY. IF YOU mIlD to onm PllAIICIlG, COISUL!WllII' YOUR .LIJIDIR OR AI AnoRIBY B.IPORI IIG YOUIIIO'IICE OP
<br />C<IUIIICBHBIlI.JOBSUlDER '2,500 IH VlLUI 110 IOIHBID rORECORD lID POSt A 'ROIICK OF C(JtHII ".
<br />
<br />SIGlAtuRI: OIIIIBR OR IGIIl1'
<br />
<br />
<br />S'!I'!I OF FLORIDA
<br />coum OF
<br />The foregoing. instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SIAR OF FLORIDA r-)
<br />ccum OF '.'v'\j\..Q..\l..u. "S
<br />Tbe foregoing' lnstrument w,as acknowledged
<br />before me this \ ..~ , 19 eV5 by
<br />
<br />. ' ~(\ .'~~:"~LAc-
<br />who. is personally known to me or,.bo bas
<br />produced .
<br />as identification and .bo did/did not
<br />take ,an oct.tb.
<br />
<br />who is personally known to me or who bas
<br />produced
<br />as identification and .bo did/did not
<br />take an oatb.
<br />
<br />(Signature)
<br />(Name. Typed, Printed. or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />)
<br />
<br />i~~~f~_, MELISSA TREMBLAY
<br />kJ ,./!;;.~ E;~ MY COMMISSION # CC428509 EXPIRES
<br />~~"~:$i December 28, 1998
<br />"''Jf..9f.~'t>'' BONDED THRU TROY FAIN INSURANCE, INC.
<br />
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