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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perlit lay be subject to 'deed restrictions' Ibieb lay be lOre restrictive than City
<br />regulations. !be undersigned assU1e8 responsibility for COIpliance litb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe OIlIer bas bired a contractor or contractors to undertake IOrk, tbey JaY be required to be licensed in accordance litb
<br />state and local regulations. If tbe contractor is not licensed as required by lal, botb the 0IJler and contractor laY be
<br />cited for a lisdeleanor violation under state lal. If tbe owner or intended contractor are uncertain as to wbat licensing
<br />requirelents laY apply for tbe intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />Furtberlore, if the OIlIer bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />'Contractor Sections' of tbis application for Ibieb tbey will be responsible. If you, as tbe owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If tbe contractor wishes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to peIlitting 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, tbe applicant, bave been provided with a copy of 'Florida's Construction Lien Lal - lGeolmer's Protection
<br />Guide" prepared by tbe Florida Departlent of Agriculture and ConsUIN!I Affairs. If the applicant is 8OIM!OI1e other than the
<br />'OIlIer', I certify tbat I have obtained a copy of the above described dOCUleDt and prolise in good faitb to deliver it to tbe
<br />"owner' prior to COlleDCelellt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all tbe infoIliltion in this application is accurate and that all work lill be done in COIpliance lith all
<br />applicable Ian regulating construction, loning, and land developent.
<br />
<br />Application is hereby lade to obtain a peIlit to do IfOrk and installation as indicated. I certify that no IOrt or
<br />installation has ~ced prior to issuance of a perlit and that all work lill be perfoIled to lleet standards of all lals
<br />regulating construction, City codes, loning regulations, and land developent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of otber govl!I1lllelltal agencies lilY apply to the intended wort, and that it is
<br />If responsibility to identify lbat actions I lUst take to be in COIpliance. Sueb agencies include but are not lilited to:
<br />I Departlent of Invirol1llelltal Regulation - Cypress Baybeads, lIetland Areas and Envirolllelltally Sensitive Lands,
<br />lIater IlIaste.ater !reatlent
<br />I Soutblest Florida lIater Managl!leDt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />I AIIY Corps of Engineers - Sealalls, Docb, Havigable lIatenays
<br />I Depart:lent of Health & Rehabilitative Senices, EnvirODleDtal Health Unit - lIells, lIaste.ater !reatlent, Septic 'Iants
<br />I US InviroJlll!lltal Protection Agency - Asbestos abatl!lent
<br />I also certify that, if fill Iilterial is to be used in Flood Zone 'A' or 'i,etc.', it is understood that a drainage plan
<br />addressing a 'COIPeD8ating 901_' will be saitted wbieb 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 be a license to proceed lith the IOrk 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 fIm! thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOle invalid
<br />unless tbe wort authoriled by sueb peIlit is COIIllJlced litbin sillODtbs of issuance, or if IOrk authorized by the perlit is
<br />suspended or abandoned for a period of sillODtbs after the tile the 10ft is ~ced. One 90 day eltension of tile, lilY be
<br />allOled for the perlit lith fee ebarge of $15.00. 'Ibe eltension shall be requested in lriting to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillODtb period, or the project lill be considered abandoned.
<br />IfARHIMG !O (MfER: YOUR FAILURE !O RECORD A larICE OF aIIIIIICIIIIIf' MAY RESUL! 1M YOUR PiYIMG niCE FOR DIPROVEIIEI'IS !O YOUR
<br />PROPER'lY. IF YOU IJIDID !O OB'IAIJf FlIfAlfCIHG, COMSUL'I 1I1'IH YOUR LDDIR OR 11 A'I'fOBDY BlFORE RICORDIJfG YOUR MO'IICE OF
<br />_. JIIIS 1lIDIR$2,500 ~ IIIID to IIIIlllIlIIIIO poar I 'IOIICIl OF _'.
<br />
<br />
<br />~lJ/. ~~0
<br />: OR ;JGD' R
<br />
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<br />
<br />S!UI OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S!A'IE 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 oath.
<br />
<br />(Signature)
<br />
<br />(Name. Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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