<br />.( .~_..... ,-~,....."~..,,
<br />
<br />CONDITIONS OF PERMIT AF#IDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this penit aay be subject to 'deed restrictions" wbich aay be lOre restrictive than City
<br />regulations. !be undersigned il88UIIe& 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 JaY be required to be licensed in accordance with
<br />state and local regulation,s. If the contractor is Dot licensed as required by law, both the owner and mntractor aa, be
<br />cited for a lisdeleallOr violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelellts aay apply for the intended work, they are advised to CODtact the City of Zepbyrhills Building DepartleDt, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbich they will be responsible. If JOU, as the owner sign as the contractor,
<br />you are inclicating that JOU, rather than the contractor, are responsible for the wort. If the contractor .iabes JOU to sign
<br />as contractor that lilY be an indication that be is Dot properly licensed and Is not entitled to peraitting privileges in the
<br />City of Zepbyrbills.
<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 'Plorida's construction Lien Law - lkIIeoImer's Protection
<br />Guide' prepared by the Plorida DepartJent of Agriculture and ConsUIeI Affairs. If the applicant is SOIeODe other than the
<br />'owner', I certify that I bave obtained a copy of the above described dOCUleDt and prClUse in good faith to deliver it to the
<br />"owner' prior to co.enceleJlt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation 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 lade to obtain a peIlit to do wort and installation as indicated. I certify that no work or
<br />installation baa CDIeIlCed prior to issuance of a penit and that all work will be perfOIJed to leet standarlls of all 1_
<br />regulating construction, City codes, loning regulations, and land developlleDt regulations in the jurisdictiOll. I also
<br />certify that I understand that the regulations of other goverDlleDtal agenCies IilJ apply to the intended worl, and that it is
<br />If responsibility to identify wbat actions I lUst take to be in COIPliance. Such agencies include but are not lialted to:
<br />t Departlent of Environaental Regulation - Cypress Baybeads, Wetland Areas and Environaentally Sensitive Lands,
<br />lIater /liastewater freataent
<br />I Southwest Florida lIater Hanageaent District - lIells, Cypress Baybead8, lIetland Areas, Altering lIatercourses
<br />I Ally Corps of Engineers - Seawalls, Docks, Ravigable lIaterways
<br />I Departaent of Health i Rehabilitative Services, Environaental Health Unit - lIells, Wastewater freataent, septic lants
<br />I US Environaental Protection Agency - Asbestos abateaent
<br />I also certify that, if fill aaterial is to be used in Plood ZOne 'A' or "A,etc.", it is understood that a drainage plan
<br />addressing a 'coapensating volae" will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A ~it issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a petlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery pmit issued shall becme invalid
<br />unless the work authoriled by such perlit is ~ced lIithin sillODtbs of issuance, or if work autboriJed 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 eltensiOll of tile, IIilJ be
<br />allowed for the perait with fee charge of $15.00. !be stension shall be requested in writing to the Building Official. An
<br />approved inspection at be logged during each SDlOIlth period, or the project will be considered abanc1oned.
<br />IIAlUIING !O WID: YOUR PAILURE !O RECORD A ROIICE OF aIIIIDCBIIU! MAl RlSULI IN YOOR PAIIIG niCE FOR IIIPROVIIIDIS !O lOOK
<br />PROPEII'lY. IP YOU IIDID !O OBfIIN PIlIIICIIG, COIISUL! 111m YOOR LIIIDIR OR AI AnomY BIPORE RICORDDG YOURlOIlCE OP
<br />allMDCEHm. JOBS UJlDIR $2,500 III VALUE DO IOIIDD !O RECORD AID POSf A 'IOIICE OF aJIIDCBIIIII'f'.
<br />
<br />SIGIIA!URB: (JftIIR OR AGD'l
<br />
<br />SIGIIA!URI: COlI!BAC!OR
<br />
<br />SfAfE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SIAn OP FLORIDA
<br />room OF
<br />The foregoing instl'Ullellt was acknowledged
<br />before me this , 19_ by
<br />
<br />who is personally known to lie 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 oiJth.
<br />
<br />(Signature)
<br />
<br />(Na.e 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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