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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands tbat tbis perlit lay be subject to "deed restrictions" wbich laY be lOre restrictive than City
<br />regulations. !be undersigned asSUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired 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 mmer and contractor lilY be
<br />cited for a lisdl!leanor violation under state law. If the olfIler or intended contractor are uncertain as to wbat licensing
<br />requirelents laY apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtberlOre, if the owner bas hired a contractor or contractors, he is advised to have the contractor(s) sign portions of tbe
<br />"Contractor Sections" of this application for wbicb they will be responsible. If you, as the mmer sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
<br />as contractor that laY be an indication that he is not properly licensed and is not entitled to per.itUng 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 with a copy of 'Florida's Construction Lien Law - lDeowner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUIeC Affairs. If the applicant is sOlBODe other than the
<br />"mmer", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to coaenCeleDt.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforlation in tbis application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developleBt.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. 1 certify that no work or
<br />installation bas COIIenced prior to issuance of a perlit and tbat all work will be perforJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developtent regulations in the jurisdiction. 1 also
<br />certify that 1 understand that the regulations of other goveroJental agenCies laY apply to the intended wort, and that it is
<br />IY responsibility to identify what actions 1 lust take to be in coapliance. Such agencies include but are not lilited to:
<br />t Departlent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />Water/Wastewater TreatleDt
<br />t Southwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater !reableDt, Septic ranks
<br />t US BnvirODleDtal Protection Agency - Asbestos abateIeDt
<br />I also certify that, if fill lateria1 is to be used in Flood Zone "A' or "A,etc.', it is understood that a drainage plan
<br />addressing a 'cOlpensating volllle" will be sublitted wbicb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A per.it issued sball 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 tbe 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. Bvery perllt Issued shall beCOle Invalid
<br />unless the work authorized by sucb perlit is cOllenced within sil IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sil IOntha after the tile the work Is cOBeDced. One 90 day l!Itenslon of tile, laY be
<br />allowed for tbe perlit with fee cbarge of $15.00. The extension sball be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each sil IOnth period, or the project will be considered abandoned.
<br />WARHING TO OWNBR: YOUR FAILURE TO RBCORD A NOTICE OF C<IIMBNClIlEtI1' MAY RESUL! IN YOUR PAYING !lICE FOR IMPROVBHEIft'S TO YOUR
<br />PROPERTY. IF YOU IJI'J'END TO OBTAlH FIMAKCING, CONSOLT WITH YOOR LENDBR OR All AnORREY BBFORE RECORDING YOOR NOTICE OF
<br />COHHBNCBHBJI'J'. JOBS UNDBR '2,500 IN VALOB DO NOT NBBD TO RECORD AIID POST A IINOTICE OF C(JOlBHCBHBHlII.
<br />
<br />SIGNATURB: COJl'J'RACTOR
<br />
<br />SIGNAtURE: OVIIBR OR AGBJI'J'
<br />
<br />STATB OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19_ by
<br />
<br />STATB OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument 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 oQ.th.
<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 />(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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