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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perlit laY be subject to Ideed restrictions" wbich laY be lOre restrictive than City
<br />regulations. !be undersigned assUles responsibility for COIpliance 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 owner and contractor laY be
<br />cited for a lisdeJleaJ\or violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!leDts laY apply for the intended work, tbey are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />. 788-6611.
<br />
<br />FurtheIlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections 1 of this application for wbich they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor wisbes you to sign
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to perlitting 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, have been provided with a copy of IFlorida's Construction Lien Law - HOIeOIfDer's Protection
<br />Guidel prepared by the Florida Departlent of Agriculture and ConsUJeI Affairs. If the applicant is sOleOIle other than the
<br />lowner", I certify that I bave obtained a copy of the above described docUJent and pro.ise in good faith to deliver it to the
<br />Downerl prior to COlleDCeJIeDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developlleDt.
<br />
<br />Application is hereby lade to obtain a perlit to do wort and installation as indicated. I certify that no work or
<br />installation has cOlleDced prior to issuance of a perlit and that all wort will be perf oIled to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIDleDtal agencies laY apply to the intended work, and that it is
<br />If responsibility to identify what actions I lUst take to be in COIpliance. Such agencies include but are not 11lited to:
<br />* Depart:lent of EnvirOllleDtal Regulation - Cypress Baybeads, Wetland Areas and Envirollll!J\tally Sensitive Lands,
<br />Water /Wastewater 'freat:lent
<br />t Southwest Florida Water HanageJIeDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health & Rebabilitative Services, EnvirOllleDtal Health Unit - Wells, Wastewater 'freatlent, Septic Yanks
<br />t US InvirODlental Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood Zone "AI or "A,etc.l, it is understood that a drainage plan
<br />addressing a ICDlpeD8ating volUJeI will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A peIlit 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 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 perlit issued shall beCOle invalid
<br />unless the work authoriled by such perlit is ~ced within sillOntbs 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 C08eDcecl. One 90 day l!Itension of tile, laY be
<br />allowed for the perlit with fee charge of $15.00. 'fbe l!Itension sball be requested in writing to tbe Building Official. An
<br />approved inspection nst be logged during each sillOnth period, or the project will be considered abandoned.
<br />WARMING 'l'O omR: YOUR FAILURE 1'0 RECORD A IO!ICE OF CCIIMERCEIlm HAY RESULI' IN YOUR PAYING fiICE FOR IHPROVBMmS 1'0 YOUR
<br />PROPER'lY. IF 'YOU III!BID 'f0 OBllIH FIHAIICING, COIISUL! WIn YOOK LIIIDIR OR lI1 AnoRHIY BEFORE RECORDIIG YOUR IO!ICE OF
<br />COHMEICBHm. JOBS OlDER $2,500 IN VALUE DO NO! REED '1'0 RlCORD AID POS'f A INO!ICE OF COHMIIfCBHlll'D.
<br />
<br />\
<br />~ofJu/~~
<br />
<br />SIGlA!URE: COIll'RACl'OR ~
<br />
<br />~ca./~O('y~
<br />SIGlA'IURIl: OOBR OR !Gift
<br />
<br />
<br />SI'An: OF FLORIDA
<br />coum OF Hernando
<br />The foregoing instrument was acknowledged
<br />before me this July 27 , 19~ by
<br />
<br />Edward L. Larisey
<br />who is personally known to me IJjC~
<br />~M
<br />ask~t~;~ca,tion an, d, who did"'/,did not
<br />
<br />e~<~.~a 0, t4'1tfC7)
<br />(S1gnature) l
<br />Patricia F. Felger
<br />(Name Typed, Printed or St~ed)
<br />NOTARY PUBLIC ~ f I'JJ '! B I
<br />NOTARY PUBLIC, STATE OF FLORIDA..
<br />MY coMMISSION EXPIRES: Dee. 26, 199'. "
<br />, IONDED T81tU NOTAIlY PUBLIC UNDDWJU'l'E~
<br />
<br />S'l'A!E OF FLORIDA
<br />COUll'Y OF Hernando
<br />The foregoing instrument was acknowledged
<br />before me this July 27 , 19~ by
<br />
<br />Edward L. Larisey
<br />who is personally known to me ~x.hQdura:
<br />I~Hf*
<br />as 'd tification and who did/did not
<br />a oath.., I) 11! /J -: ~
<br />L(). tL,' .J" <,~
<br />( gnature) ~
<br />Patricia F. Felqer
<br />(Name Typed, Printed or ~tamped)
<br />NOTARY PUBLIC (!,,{!/ J /) / </8/
<br />l'<..H,..a i'li..LiC, Sl'A'l'h OF ""LOKIDA.
<br />MY COMMISSION EXPIRES: Dee. 16, 199'.
<br />laNDED TllRU NOTARY PUBLIC llNDUWBlTERS.
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