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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to 'deed restrictions' wbich lay be lOre restrictive than City
<br />regulations. Tbe undersigned assUIBS responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired 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 OlDer and contractor laY be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611. \
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />11 Con tractor Sectionsll of this a~plicat1on for whicb they will be responsible. If you, as the OlDer sign as the contractor,
<br />you are indicating that JOU, ratber than the contractor, are responsible for the work. If the contractor lIishes you to sign
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to permtting 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, the applicant, bave been provided with a copy of IIFlorida's Construction Lien Law - 8oIeoImer's Protection
<br />Guidell prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is 8OI8ODe other than the
<br />lIownerll, I certify that I bave obtained a copy of tbe above described docUleDt and prOlise in good faith to deliver it to the
<br />lIovner. prior to COll8DCel8Dt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas COIIenced prior to issuance of a perlit and that all work will be perfoIJed to l8et standards of all lalls
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDleDtal agencies IaJ apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in COIpliance. Such agencies include but are not lilited to:
<br />I Departlent of EnvirODleDtal Regulation - Cypress Bsybeads, Wetland Areas and EnviroDleDtally Sensitive Lands,
<br />lIater/llastewater Treatlent '
<br />I Southwest Florida lIater HanageJellt District - lIells, Cypress Bayheads, lIetland Areas, Altering lIatercourses
<br />. ArlY Corps of Engineers - Seawalls, Docks, lavigable lIatenays
<br />. Departlent of Health , Rehabilitative Services, EnvirODleDtal Health Unit - lIells, lIastewater Treatlent, Septic Tanks
<br />. US EnvirODleDtal Protection Agency - Asbestos abat8lent
<br />I also certify that, if fill laterial is to be used in Flood Zone "All or IIA,etc.II, it is understood that a drainage plan
<br />addressing a IIcOlpensating volOl8' will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued sball be construed to he a license to proceed with tbe work and not as authority to violate, cancel alter, or
<br />Bet aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every peIilit issued shall beCOl8 invalid
<br />unless tbe work authoriled by such perlit is cOllenced within slllODlhs of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of sillOntbs after the tile the IIOrt is cu.enced. One 90 day atension of tile, lay be
<br />allOlled for the perlit with fee charge of $15.00. !be extension shall be requested in llriting to the Building Official. An
<br />approved inspection lUst be logged during each slllOnth period, or the profect lIill be considered abandoned.
<br />WARIING TO OWIlR: YOUR FAILURE TO RICORD A' 10Tia OF OJIMIICIIIBM1' lilY RESUL! II YOUR PAYIIG niCK FOR IMPROVIIIBIl'S TO YOUR
<br />PROPERTY. IF YOU IITEND TO OBUIN FIIIAKCING, CONSULT III'IH YOUR ORDER OR AI AnORlEY BEFORE RICORDIIIG YOUR KOTICI OF
<br />COMMKNCEIIEHT. JOBS URDER $2,500 II VALUE DO NOT IEED fO RECORD AID POSt A 'NOTICE OF COHHDCBMBIIIII.
<br />
<br />
<br />~L Jj~ ~,
<br />SIGNATURE: ~ O~ AGBNT ' CONTRACtOR
<br />
<br />
<br />STATI OF FLORIDA
<br />COOlfJ' OF ~~
<br />The forego ng instrument was acknowledged
<br />before me this //f;t7 ~' 19~ by'
<br />
<br />STAll OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this #~ ???~ ' 19 9~ by
<br />
<br />
<br />who is personally known to me or who has
<br />produced \\\\lIlIIIIl',,,,,/
<br />>\\' ~ ~
<br />as identificat!t~. d.... ~id/did not
<br />take an C?ath{~ ~
<br />~~,., .-
<br />(S1gnature~ 1 ~.,.'... ~ j it
<br />-;PI A- v A),q ytiift'7K~ftt6D ~ L.
<br />(Name ~yped, p. ,~1i:Ql' \ amped)
<br />NOTARY PUBLIC Illl(((((IJ,I1I\\\\\\\
<br />
<br />Notary Public. State ot' j:.t-j,~ti~
<br />DIANNA L. TRZNAUl:L M '~o. on r-
<br />MyComm. Exp. Nov. 11,199!J ,/~ II ~) 770
<br />Comm. No. CC 159184
<br />
<br />Notary Public. State 01 fiotida
<br />DIANNA L. TIlZNAD~L.;,/J ,;./.
<br />My Comm. Exp. Nov. 11. 19la 7/ tl7r/ I (.N<f
<br />Comm. N.o, CC 159L84
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<br />)Q9S-
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