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<br />CONDITIONS OF PERHI~ AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perllt lilY be subject to 'dee4 res~i~tions' .hich lilY be lOre restrictive than City
<br />regulations. the undersigned asSUle& responsibility for lDpliance .lth any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the 0IIID8[ bas hired a contractor or contractors'to undertake 1IOrk, they lilY be required to be liceued in accordance tlith
<br />state and local regulations. If the contractor is not licensed as required by lilli, both the IJIfDer and contractor lilY be
<br />cited for a .isdeEaDOr violation under state lilll. If the owner or intended contractor are uncertain as to .bat licensing
<br />requireIeDu lilY apply for the intendec1 .rk, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
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<br />FurtheIlore, if the ower has hired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the '
<br />'Contractor Sections' of this application for eich they will be responsible. If JOU, as the OII1er sign as the contractor,
<br />you are indicatinq that you, rather than the contractor, are responsible for the 1IOrk. If the contractor .iahes you to sign
<br />as contractor that lilY be an inc1ication that be is not properly licensed and Is not entitled to peIlitting 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 lIith a copy of "lorida's construction Lien Law - lDeoImer's Protection
<br />Guide' prepared by the 'lorida DepartleDt of Agriculture and ConsUIeI Affairs. If the applicant is 8OI8OIlll other than the
<br />'OlfIlerl, I certify that 1 bave obtained a copy of the above described docUIent and prOlise in good faith to deliver it to the
<br />'OlfIler' prior to co.encell!l1t. .
<br />
<br />~. CONTRACTOR' S/OWNER I S AFFIDAVIT
<br />I certify that all the infOIliltion in this application is accurate and that all 1IOrk will be done in CCJlpliance with all
<br />applicable IDS regulating construction, lOlling, anclland developleDt.
<br />
<br />Application is hereby lade to obtain a peIlit to do 1IOrk and installation as indicated. I certify that 110 1IOrk or
<br />installation has ~cec1 prior to issuance of a perlit and that all1lOIk will be perf ODed to _t atandards of alllillla
<br />regulating construction, City codes, lOlling regulations, and land develO(llll!llt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gGYeIDleDtal agencies lilY apply to the intenl1ed work, and that it is
<br />IY responsibility to identify what actions I lUSt take to be in cmpliance. Such agencies include but are not lilited to:
<br />I Depart.ent of EnviIOlllelltal Regulation - Cypress Baybeada, Wetland Areas and Env1rolllelltally Sensitive Lands,
<br />, Water/Wastewater !reablent
<br />I Southwest 'lorida "ater Manage.ent District - "ells, Cypress Bayhea4a, "etland Areas, Altering Watercourses
<br />I AllY Corps of Engineers - Seawalls, Docks, lavigable "atenays
<br />I Departlent of Health i Rehabilitative Senices, EnvirODleJltal Health Unit - Wells, WastBllater '1reablent, Septic '1anka
<br />I US InvirODlleDtal Protection Agency - Asbestos abateaent
<br />I also certify that, if fUllilterial is to be used in Flood Zone lA' or 'A,etc.', it is understood that a drainage plan
<br />addressing a lcoapensating volue- will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to petlit issuance.
<br />
<br />A ~it issued shall be construed to be a license to proceed with the IOrk and not as authority to violate, cancel alter, or
<br />set 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. Ivery pemit issued shall belme invalid
<br />Wlless the IOrk authorlled by such perlit is co.enced ..ithin sillODtbs of issuance, or if IOrk autboriled by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the 1IOIk is co.encec1. One 90 day utension of tile, lilY be
<br />allOlfed for the peIlit with fee charge of $15.00. !be utension shall be requested in tlriUng to the Builc1ing Official. An
<br />approved inspection lUSt be logged durinq each sillODth period, or the project will be considered abandoned.
<br />WARJIIIfG 'fO owm: YOUR 'IIUJRB 'fO RECORD A 10UCK OF aJlHllCIIIIIf MAY RKSOLI II YOOI PAYIJIG nICK POll IMPROVIIID'fS 'fO YOUR
<br />PROPBR'IY. IF YOU II'fIlD 'fO OB'fAIII 'DIAICIHG, COISOL'I WID YOUR LllDBR OR 11 A!'fOIIIIIY BIPORB RBCOBDIJIG YOUR 10lICK 0'
<br />
<br />
<br />~Jj;l.~OOQ~umm~~r$UL-
<br />
<br />SIGJIA'IUBI. OR - SIGIIA'fURB: COI'fBAC'fOR
<br />
<br />S'lA'l1 OF 'LORIDAA
<br />COUI'fY OF 1}5"( t)
<br />The foregoing instrument was acknowledged
<br />before me this ~ -.;zt , 19!/..L. by
<br />
<br />SIA!B 0' n.oRIDA /)
<br />coom OF rltSc 0
<br />The foregoing instrument was acknowledged
<br />before me this b -Dl S- , 19.-!l..::L. by
<br />
<br />
<br />who is ersonally kn
<br />produce
<br />as identificat.
<br />take an oath.
<br />
<br />
<br />..r
<br />to lie or who has
<br />
<br />I
<br />who is ersonally known 0 me or who has
<br />produce
<br />as identification and who did/~
<br />
<br />take an 04th. ~ At. ftb4;::
<br />(Signature) /
<br />-r~1L~ Ii moA--TF's ::nz.
<br />(Name Typed, Printed or Stamped)
<br />NO'1'ARY PUBLIC
<br />
<br />_~ STA'5 at rLOfl,IDA
<br />tallIll ..-- PI ;JJLY 14, l_
<br />Ilt CIl:MIIII; V'~ _. _. .A
<br />... -
<br />
<br />/11
<br />(Signature)
<br />Jc:":a-;t l::l. ffJoAiF..s :r~.
<br />(Name Typed, Print or Stamped)
<br />NOTARY PUBt.IC ,.... rUJllIDA
<br />JIltl pmu.IC STA'l'B "'"
<br />~ c:cJM15SIOIIIXP. JULY 14, 19M
<br />II(JIatJ) '!HJI.U ..,.r. _. _.
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