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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this pemt laY be subject to 'deed restrictions' wbich laY be lOre restrictive than City
<br />regulations. !be undersigned assUJes responsibility for ~1iance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe owner has hired a contractor or contractors to undertake work, tbey 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 lisdl!ll!allOr violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireIeDts laY apply for tbe intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner has bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbich they lill 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 he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zepbyrhills.
<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 lith a copy of 'Florida's Construction Lien Law - &.oImer's Protection
<br />Guide' prepared by the Florida DepartJent of Agriculture and ConsWIeI Affairs. If the applicant is 8OIl!OI18 other than the
<br />'owner", I certify that I bave obtained a copy of the above described dOCUleDt and pnmse in good faith to deliver it to the
<br />lIownern prior to COIIeJlCeleDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoflation in this application is accurate and that all wort will be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land develOpleDt.
<br />
<br />Application is hereby Jade to obtain a peIlit to do work and installation as indicated. I certify that no work or
<br />installation has ~ced prior to issuance of a perlit and that all work will be perfOIJed to .et standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develo(lEllt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDlleDtal agencies laY apply to the intenc1ed wort, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in co.pliance. Such agencies include but are not lilited to:
<br />t Departlent of BnviIOlllelltal Regulation - Cypress Baybeads, Wetland Areas and EnvirollleDtally Sensitive Lauds,
<br />Water/Vastewater !reatlent
<br />t Southwest Florida !later lIanageleDt District - Wells, Cypress Baybea4s, Wetland Areas, Altering Watercourses
<br />t AIIY COIPS of Engineers - Seawalls, Docks, Ravigable Waterways
<br />t Departlent of Health i Rehabilitative Services, EnvirODlelltal Health Unit - !lells, Wastewater rreatlent, Septic ranks
<br />t US EnvirODleDtal Protection Agency - Asbestos abateleDt
<br />I also certify that, if fill laterial is to be used in Flood ZOne IIA' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpeDSating volute' will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />.. l'
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<br />A perlit issued sball be construed to be a license to proceed with the wort and not as authority to violate, cancel alter, or
<br />set aside any provisions of tbe technical codes, nor sball issuance of a perlit prevent the Building OUicial fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every pem1t isaued sball beCCIIe invalid '
<br />unless the wort authorized by such peIlit is COIIeJlced within sillODths of issuance, or if wort authoriled by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work is co.enced. One 90 day utension of tile, lilY be
<br />allowed for the perlit with fee charge of $15.00. !be utension shall be requested in writing to tbe Building Official. An
<br />approved inspection lUSt be logged during each sil IODth period, or the project will be considered abandoned.
<br />WARlfIRG ro omR: YOUR PIILURE ro RECORD A RO!ICE OF CCIIMDCIIIIIfl' IlAY RESULf IR YOUR PAYlRG DICE FOR DIPROVIIIIIrS ro YOUR
<br />PROPBRrY. IF YOU IJIUID ro OBrlDf FllflIfCIRG, COJISULf WID YOUR LBIIDIR OR 11 AftORDY BI10RI RICORDIRG YOUR JIOflCE OF
<br />COODCEMm. JOBS UlDIR '2,500 IR VALUE 00 RO! mD ro RECORD AMD POSr A -DICE OF CCJIIIDCBIIDr'.
<br />
<br />
<br />i{j~,,~ ;jf1t2Xl/1
<br />SI ruRI: COIfJ'RACro
<br />
<br />~
<br />
<br />
<br />::rO~/LORID~O .
<br />
<br />The foregoing in~as a~OWledged
<br />before me this '" 19 by .
<br />,
<br />,
<br /><>r who has
<br />
<br />Sf ArB OF FLORI~
<br />COURY OP ~ SC 0
<br />The foregoing inst~t was aCImQ)l1edged
<br />before lie this dO y, I J...., 19~ by
<br />
<br />~ e' I\J <;-j-; tV IV e1t-
<br />who 1S perso~ll.Y known to me or who has
<br />produced \'J'o u.J N
<br />as id .ficatian and who did/did not
<br />tat iJth.""
<br />
<br />
<br />(Si~Ure) , P
<br />C5S1 e. F. A-s f</ e ~
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />DARCY REISMAN
<br />MY COMMISSION' cc 364671
<br />EXPIRES: May ,. 1998
<br />Bonded ThnI NolaIy PubIlc UnderWri18rs
<br />
<br />'i'
<br />
<br />BESSIE F. CASKEY
<br />S1Me of Florida
<br />My ConlIlI. EllD. Dee, 4, 1995
<br />Camm.' Cc 165513
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