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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to 'deed restrictions' whieb 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 ~er 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 />ci ted for a lisdelH!anor violation under state law. If the owner 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 Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner has bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of tbe
<br />"Contractor Sections' of this application for wbicb they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, ratber tban the contractor, are responsible for the work. If the contractor wishes 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, bave been provided with a copy of 'Plorida's Construction Lien Law - lIoIeoImer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleODe other than the
<br />lowner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to cOll8Dcelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cQIPliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas cOlleDced prior to issuance of a perlit and tbat all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developl8llt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDIeDtal agencies laY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in cOlpliance. Sueb agencies include but are not lutted to:
<br />* DepartJent of EnviroDlental Regulation - Cypress BBybeads, Vetland Areas and EnviroDleDtally Sensitive Lands,
<br />Vater/Vastewater Treatlent
<br />* Southwest Florida Vater Managelent District - Wells, Cypress Baybeads, Vetland Areas, Altering Vatercourses
<br />* ArlY Corps of Engineers - Seawalls, Docks, R~vigable Waterways
<br />* Departlent of Health i Rebabilitative Services, EnvirODlental Health Unit - Veils, Vastewater !reatlent, Septic lanks
<br />* US BnvirODleDtal Protection Agency - Asbestos abatelH!nt
<br />I also certify that, if fill laterial is to be used in Flood Zone "A' or "A,etc.', it is understood that a drainage plan
<br />addressing a 'cQlpeDsating volUle" will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit 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 tecbnical 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. Every perlit issued shall beCOle invalid
<br />unless the work authoriled by sueb perlit is cOllllnced within sillOnths of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of sillOnths after the tile the work is c.-enced. One 90 dar I!Itension of tiJle, laY be
<br />allowed for the peIlit with fee ebarge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eaeb sil IOnth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR PAILURE TO RECORD A NOTICE OF C(lfMBNCEllBNT MAY RESULI IN YOUR PAYIRG nICE FOR IMPROVEIIDl'S TO YOUR
<br />PROPERTY. IF YOU INTBND 10 OBTAIN PIHARCING, CONSULT WITH YOUR LEER OR All AnORllY BEFORE RBCORDIRG YOUR )(()'fICE OF
<br />COMMERCBMBNT. JOBS UNDER $2,500 IN VALUE DO NOT NBED 10 RECORD AIID POST A "NOTICB OP C(JIMDCEMBN'f".
<br />
<br />SIGHATURB: CONTRACTOR
<br />
<br />SIGNATURE: OIOfBR OR AGBNT
<br />
<br />STATB OF FLORIDA
<br />COURTY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STAn: OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19_____ by
<br />
<br />who is personally known to me or who bas
<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 oath.
<br />
<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 />
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