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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />De undersigned understands that this penit IlaY be subject to 'deed restrictions' wbich IlaY be lOre restrictive tIIan City
<br />regulations. the undersigned assUIeB responsibility for COIpliance lith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner lias lIired a contractor or contractors~to undertake IOrk, tIIey laY be required to be liceD8ed in accordance lith
<br />state and local regulations. If tile contractor is not licensed as required by law, botll tile owner and contractor IlaY be
<br />cited for a lisdeJeallOr violation under state lal. If the owner or intended contractor are uncertain as to "bat licensing
<br />requirell!llu IlaY apply for tile intended IOrk, they are advised to CODtact the City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />Furtheraore, if the owner bas lIired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
<br />'Contractor SectiOll8' of this application for IlIicll they lill be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that fOU, rather than the contractor, are responsible for the work. If the contractor lliahes you to sign
<br />as contractor that IlaY be an Indication that he is not properly licensed and is not entitled to penitting 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, have been provided lith a copy of 'Florida's construction Lien Lal - IIaIeoIIner'S Protection
<br />Guide' prepared by the Florida DepartJent of Agriculture and CoI18UleI Affairs. If the applicant is 8CIIl!OIla other tIIan the
<br />'OIDeru, I certify that I have obtained a copy of the above described docuJent and pIOlise in good faith to deliver it to the
<br />uOII1er" prior to co.enCell!llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infonation in this application is accurate and that all work li11. be done in COIPliance lith all
<br />applicable lilll regulating construction, IOI1ing, and land developElt.
<br />
<br />Application is llereby lIilde to obtain a penit to do work and installation as indicated. I certify that no IOrk or
<br />installation baa CDlenced prior to i88uance of a penit and that all work lill be perfonecl to Jeet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govel1lleDtal agencies IlaY apply to the intenc1ed IIOIk, and that it is
<br />If responsibility to identify what actions I lUSt take to be in COIPliance. Such agencies include but are not lilited to:
<br />I Departlent of BnviI'Olllelltal Regulation - Cypress Baybeads, Wetland Areas and BnvirolllenWly Sensitive Lands,
<br />Water/Wastewater !reatElt
<br />I Southwest Florida Water JlanageleDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />I AIIY Corps of Engineers - Seawalls, Docks, lIavigable Watenays
<br />I Depar1:lent of Health i Rehabilitative Senites, BnviIODMlltal Health Unit - Wells, Wastewater Ireatlent, Septic !anks
<br />I US BnviIOlllll!lltal Protection Agency - Asbestos abatelellt
<br />I also certify that, if fillllaterial is to be used in Flood Zone 'A' or 'A, etc. " it is understood that a drainage plan
<br />addressing a 'COIpeD8iting vol_' lill be saitted which is prepared by a professional engineer registered In the State of
<br />Florida prior to penit issuance.
<br />
<br />A ~it 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 i88uance of a penit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every pemit issued shall becoIe Invalid
<br />unless the work authorized by such penit is co.enced lithin sillODths of i88uance, or if IOrk authorized by the penlt is
<br />suspended or abanc10ned for a period of siJ IODths after the tUe the IIOIk is ~ced. One 90 day atension of tUe, IlaY be
<br />allowed for the penit lith fee charge of $15.00. 'fbe atension shall be requested In lriting to the Building Official. An
<br />approved inspection lUSt be logged during each sil IODth period, or the project lill be considered abanc1oned.
<br />twUfIIIG 1'0 lMfIR: YOOR FAILURE 1'0 RECORD A IOI'ICE OF aJIIIPCIIIIII! lilY RESUL! III YOUR PAYIIfG !IIICE FOR. IIIPROVIIIII'lS 1'0 YOUR
<br />PROPDIY. IF YOU IJI'DIID 1'0 OBIAIII FIIIAIICIIIG, COHSUL! WIn YOUR LBIDIR OR 1II1ftOBDY BB10RI RICORDIIG YOUR DICE OF
<br />C(JUIIIfCBMBll!. JOBS urmlR $2,500 III VALUE DO 101' IIDD 1'0 RECORD 1IID POSI' A 'IOI'IC! OF ClIIIIIICBMIII'.
<br />
<br />/
<br />X
<br />SIGII!URI: (IIIIIR OR IGIlI!
<br />
<br />,A
<br />
<br />SIGIII!URI: COIII'BACfOR
<br />
<br />SUII OF FLORIDA
<br />coum OF Y
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SUR OF FLORIDA
<br />coom OF'/.
<br />The foregoing instl'UlleDt 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 o~tb.
<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 />(Nue Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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