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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this penit lilY be subject to 'deed restrictions I wbich lilY be lOre restrictive than City
<br />regulations. !be undersigned assU11e8 responsibility for co.pliance with any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they lilY 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 0IIIleI and contractor lilY be
<br />cited for a lisdf!ll8aDor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireents JaY apply for the intenc1ed work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
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<br />FurtheIlOre, if the owner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
<br />IContractor Sectionsl 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 wishes you to sign
<br />as contractor that JaY be an indication that be is not properly licensed and is not entitled to perJitting privileges in the
<br />City of Zepbyrbills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of 'Plorida's construction Lien Law - BoIemmer's Protection
<br />Guidell prepared by the Florida Departlent of Agriculture and COnsUIeI Affairs. If the applicant is SOElle. other than the
<br />lowner', I certify that I have obtained a copy of the above described dOCUlent and pnmse in good faith to deliver it to the
<br />lIownerl prior to cOllenceent.
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<br />E. CONTRACTOR I S/OWHER I S AFFIDAVIT L-,
<br />I certify that all the infonation in this application is accurate and that all work will be done in cOJpliance with all A C[ )
<br />applicable laws regulating construction, loning, and land developlellt. ~lv~ ~ Vj vI A
<br />
<br />Application is hereby Jade to obtain a perlit to do work and insWlation as indicated. I certify that nO work of:k. ~ f:;~'
<br />installation bas CDlenced prior to issuance of a penit and that all work will be perfoIJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gOYeIDIIl!Iltal agencies lilY apply to the intended work, and that it is
<br />If responsibility to identify what actions I lUst take to be in co.pliance. Such agencies include but are not lillited to:
<br />t Departlent of InvirOlllelltal Regulation - Cypress Bayheads, Wetland Areas and Invirollll!lltally Sensitive Lands,
<br />Water /IIastewater !reatlent
<br />I Southwest Florida Water Hanagel8llt District - VeIls, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />I AIly Corps of Engineers - Seawalls, Docks, Havigable Watenays
<br />I Departlent of Health i Rehabilitative Services, InvirOJllental Health Unit - Wells, Wastewater !reatlent, Septic !anks
<br />I US InviIOlllental Protection Agency - Asbestos abatuent
<br />I also certify that, if fill laterial is to be used in Flood Zone 'A' or IIA,etc.l, it is understood that a drainage plan
<br />addressing a lCOIpen8ating VOIUle' will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to penit issuance.
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<br />A ~it issued shall be construed to be a license to proceed with 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 fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perJit issued shall beCOle invalid
<br />unless the wort authorized by such peait is COII8Ilced within sillODtbs of issuance, or if wort authorized by the penit is
<br />suspended or abandoned for a period of sil IODtbs after the tille the work is co.encec1. One 90 day eltension of tile, lilY be
<br />allowed for the peait with fee charge of $15.00. !be eltension shall 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 />VARIIIMG 'fa OIIHBR: YOUR FAILURE 'fa RECORD A NOt'ICE OF aJtMBICBHBlft' MAY RlBUL! IN YOUR PAYIHG filCE FOR IIIPROVBIImS !O YOUR
<br />PROP . IF YOU IJft'BHD 'fa DUlIN PINUCIMG, COHSUL! WID YOOR II OR 11 IftORRIY UPOD RICORDIJIG YOUR IIO'fICE OP
<br />. JflIIlIIlIJIIR 12,500 II muJl 00 IIIr IIIlD 10 lID j~~~
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<br />SIGJIA!URIl: COHIRAC'fOR
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<br />
<br />
<br />~~O~FFLORI~(b :O~FJ(?
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<br />The foregoing ins.!f;WDent was acknowledged The foregoing ins~~t was aCknowledged
<br />before me this ~, 1~ by before lie this , 19_ by
<br />
<br />
<br />w is persooally 1m0llD 0... or who ha~perlljlDil~~'" or who has
<br />oduced. 4
<br />as identification and who id/did not as identification and who did/d"d not
<br />take an oath. take an oath
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<br />
<br />
<br />
<br />(Sign
<br />~
<br />(Name. Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~~*,~'rit... JACK A. WHITE
<br />f*:"A'f*i MY COMMISSION' CC 194125
<br />~'. .';f~ EXPIRES' ......, 15 1996
<br />..:.*'.....;f:~~ . "t'" .
<br />"Rf.,fti.'" IlondecI Thru NolIry PuIIIIo lInd8Iwrtl8nI
<br />
<br />"'~~"""" JACK A. WHITE
<br />!~l:" l'Ii.t~ MY COMMISSION' CC 194125
<br />-.- ....
<br />~~" .~J EXPIRES: AplIl15. 11186
<br />"1.?f.iif:~\f..'~ Bonded Tlwu NolIIy PublIc UndeIWlllll
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