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<br />
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'file undersigned understands tlJat tbis penit IIilY be subject to 'deed restrictions' wbich lIily be lOre restrictive tban City
<br />regulations. !be undersigned asSUle& responsibility for cmpliance witb any applicable deed restrictions.
<br />
<br />."" ..' :-t
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe orner bas bired a contractor or contractors ' to undertake rork, they IIilY be required to be licensed in accordance wi tb
<br />state and local regulations. If tbe contractor is not licensed as required by law, botb the OlDer and contractor IIilY be
<br />cited for a lisdeJeaDOr violation under state law. If tbe orner or intended contractor are uncertain as to wbat licensing
<br />requirellents lIily apply for tbe intended rork, tbey are advised to coatact tbe City of ZepbyrhUls Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtberJOre, if the orner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of tbe
<br />'Contractor Sections' of tbis application for wbich tbey will be responsible. If you, as tbe orner sign as tbe contractor,
<br />you are indicating tlJat you, ratber tban the contractor, are responsible for tbe rork. If tbe contractor "iabes you to sign
<br />as contractor tbat EY be an indication tlJat be is not properly licensed and is not entitled to perJitting privileges in tbe
<br />City of Zepbyrhills.
<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 tbat I, tbe applicant, bave been provided witb a copy of 'Florida's Construction Lien Law - lbIeolmer's Protection
<br />Guide' prepared by tbe Florida Departlent of Agriculture and Consl1ler Affairs. If tbe applicant is lICII!ODe otber tban the
<br />'orner', I certify tbat I bave obtained a copy of the above described docUIent and proUse in good faitb to deliver it to the
<br />'orner' prior to co.enCl!lellt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify tlJat all tbe infoI'lation in tbis application is accurate and tlJat allrork will-be done in COIpliance witb all
<br />applicable lava regulating construction, loning, and land develOplent.
<br />
<br />Application is hereby lade to obtain a penit to do work and installation as indicated. I certify tlJat no rork or
<br />installation has cmleDced prior to issuence of a penit and tlJat allrork will be perfOIlled to Ieet standards of alllars
<br />regulating construction, City codes, loning regulations, and land developlent regulations in tbe jurisdiction. I also
<br />certify tbat I understand tbat the regulations of other gOYeIllleDtal agencies IIilY apply to the intended work, and tbat it is
<br />If responsibility to identify wbat actions I lUSt take to be in COIpliance. Such agencies include but are not luited to:
<br />I Deparf:lent of BnvirODleDtal Regulation - Cypress Baybeads, Wetland Areas and !nviroDleDta1ly Sensitive Lands,
<br />Water/Wastewater !reaf:lent
<br />I Soutbwest Florida Water JlanagllleDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />I AI'If Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />I DepartJent of Healtb i Rehabilitative Services, InvirODleDtal Hea1tb Unit - Wells, Wastewater !reaf:lent, Septic tanks
<br />I US InviIODllental Protection Agency - Asbestos abatllleDt
<br />I also certify tlJat, if filllaterial is to be used in Flood ZOoe lA' or 'A, etc. " it is understood tlJat a drainage plan
<br />addressing a 'COIpeJ18ating volUle' will be sublitted 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 witb the rork and not as autbority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a penit prevent the Building Official fa thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery P8I1it issued aball hecme invalid
<br />unless tbe IIOrt autboriled by such penit is COIIlIIlced witbin sil IODtbe of issuance, or if wort autboriled by the perJit is
<br />suspended or abandoned for a period of sil IODtbs after the tile tbe work is co.enced. One 90 day 81tension of tile, .y be
<br />allowed for tbe penit witb fee charge of $15.00. 'file 81tenslon shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be ltlgged during each snlOlltb period, or the project will be considered abandoned.
<br />IIA1U1ING !O I*RBR: YOUR FAILURE TO RECORD A NOI'ICB OF COIIIBICIIlIH MlY RESUL! IN YOUR PAYIXG DICE FOR IJIPBOVIIID!S TO YOUR
<br />PROPmY. IF YOU IImD !O OB'IJDf FIWCIIG, COISUL! wlm YOUR LIIIDIB OR AI AftORDY BBFOBI BICOIDDIG YOUR DICI OF
<br />-. JlIIS IlIDIR $2,500 U VILIlIl DIlIOlIBlllIO IIIIllIID lID z~.
<br />
<br />
<br />/!.~~
<br />. SIGJIA'llJRB: SI : COIDAC'fOR
<br />Lynn Scott Nidy, President
<br />
<br />srA!! OF FLORIDA
<br />coum OF
<br />The foregOing instrument was acknowledged
<br />before me this , 19_ by
<br />
<br />St'AR OF FLORIDA
<br />coum OF Seminole
<br />The foregOing instrument was aCknowledged
<br />before me this 5th of Jun~ 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 />Lynn S. Nidy
<br />who is personally known to me <<UX-.Xllaax
<br />,~xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
<br />"XI4M~ittU4i~:lMXand who ait/did not
<br />take an oath. _ _ /J D. i1 A
<br />'--r'"'Y\~l ~ ~~
<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
<br />
<br />",lolly PUs(
<br />.~ti-t'
<br />* *
<br />
<br />"'~~ o"'~""
<br />~f f\.
<br />
<br />MONICA L DILLON
<br />My Commission CC380593
<br />Expires Jun. 08,1998
<br />Bonded by HAl
<br />800-422-1555
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