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<br />CONDITIONS OF PERMIT AFFIDAVIT 1
<br />A. NOTJCE OF DEED RESTRICTIONS ,
<br />fbe undersigned understands that tbis perait JaY be subject to Ideed restrictions" wbieb lily be lOre restrictive than City
<br />regulations. !be undersigned assUIeB responsibility for cmpliance with any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OlDer bas bired a contractor or contractors to undertake work, they 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 lilY be
<br />cited for a lisd_anor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireJeJlts laY apply for the intended work, tbey are advised to contact the City of Zepbyrhills Building DepartJent, (813)
<br />788-6611.
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<br />FurtheIlOre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />IContractor Sections I of tbis application for wbieb tbey will be responsible. If you, as tbe OlDer sign as tbe contractor,
<br />you are indicating that you, rather than tbe contractor, are responsible for the work. 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 pemitting 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 tbat I, tbe applicant, bave been provided with a copy of IFlorida's COnstruction Lien Law - HoIeoImer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and COnsUIeI Affairs. If tbe applicant is SOIIf!OJ1e other than the
<br />lowner", I certify that I bave obtained a copy of the above described dOCUllellt and prolise in good faith to deliver it to the
<br />"ownerl prior to COllenCeJeJlt.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all tbe infomation in tbis application is accurate and tbat all work wiU be done in COIpliance witb all
<br />applicable laws regulating construction, loning, and land developllent.
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<br />Application is hereby lade to obtain a perait to do work and installation as indicated. I certify that no work or
<br />installation bas CDJeJlced prior to issuance of a perJit and that all work will be perfomed to .et standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlent regulations in tbe jurisdiction. I also
<br />certify tbat I understand tbat tbe regulations of other govl!IDllel1tal agencies lilY apply to the intended IIOrt, and that it is
<br />If responsibility to identify wbat actions I lust take to be in COIpliance. Sueb agencies include but are not liJited to:
<br />t Departlent of EnvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and EnvirollleJ1ta1ly Sensitive Lands,
<br />Water /IIastewater freatJent
<br />t Southwest Florida Water HanaqeJellt District - Wells, Cypress Baybea4s, Wetland Areas, Altering Watercourses
<br />t Amy Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health & Rehabilitative Services, EnviroDleJ1tal Health Unit - lIells, Wastewater freatlent, Septic 'Ianks
<br />t US Envil'ODlelltal Protection Agency - Asbestos abatl!lent
<br />I also certify that, if fill laterial is to be used in Flood Zone 'AI or lA, etc. ", it is understood that a drainage plan
<br />addressing a lco.pensating vol_I will be suhJitted whieb is prepared by a professional engineer registered in tbe State of
<br />Florida prior to perait issuance.
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<br />A ~it issued shall be construed to be a license to proceed witb tbe wort and not as authority to violate, cancel alter, or
<br />set aside any provisions of tbe technical codes, nor shall issuance of a perait prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becoIe invalid
<br />unless tbe IOrt authoriled by sueb perait is COIIeIlced within sillOntbs of issuance, or if work authoriled by tbe pelIit is
<br />suspended or abandoned for a period of sillODtbs after tbe tile tbe wort is COIIeIlced. One 90 day utension of tile, lilY be
<br />allowed for tbe pelIit with fee charge of $15.00. fbe utension sball be requested in writing to tbe Building Official. An
<br />approved inspection lUSt be logged during eaeb sillODtb period, or the project lIill be considered abandoned.
<br />IIAIUlING fO OWNER: YOUR FAILURE '10 RECORD A NafICE OF aJlMDCIIIm MAY RlSUL'I IN YOUR PAYIRC 'lliICE FOR DIPROVIIID!S fO YOUR
<br />PROPEm. IF YOU mmm fO OBfIIN FIHAHCIRG, CONSUL! wlm YOUR LlllDIR OR AN AftORIEY BBFORI RICORDING YOUR RaflCE OF
<br />COOIENCEMEHf. JOBS ORDER '2,500 IN VALUE DO Naf HDD fO RECORD AND POSf A IINO'I'ICE OF aJlMEHCEMEn'l.
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<br />SIGIA'IURI: (IIJIBR OR AGm
<br />
<br />SIGlAfURI: COHJRAC'1'OR
<br />
<br />SfAfl OF FLORIDA
<br />coom OF
<br />The foregOing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SrAfl 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
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