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<br />LUNlJl'1' 1 UN::> U1' PERMIT AFFIDAVIT
<br />A.. ~_ OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perJit aay be subject to 'deed restrictions" wbich lay be lOre restrictive tban City
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicab~~ deed restrictions.
<br />
<br />B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertake work, tbey 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 lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirements lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />Furthermore, if the owner bas bired a contractor or contractors, he is advised to hav.e tbe contractor(s) sign portions of the
<br />uContractor Sectionsll of this application for which 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 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 perlitting 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 uYlorida's Construction Lien Law - Hoaeowner's Protection
<br />Guidell p,epared by the Florida DepartJent of Agriculture and ConsUlar Affairs. If the applicant is sOleone other than the
<br />Uowner", I certify that I have obtained a copy of the above described docUlent and prolise in good faith to deliver it to the
<br />"owner" prior to couenceJent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the infor.ation in this application is accurate and that all work will be done in compliance with all
<br />. applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby lade to obtain a per.it to do work and installation as indicated. I certify that no work or
<br />installation has COIIenced prior to issuance of a perlit and that all work will be perforJed to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governaental agencies lay apply to the intended work, and that it is
<br />.y responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not Ii.ited to:
<br />* Department of Environmental Regulation - Cypress Baybeads, Wetland Areas and EnvironJentally Sensitive Lands,
<br />Water/Wastewater TreatJent
<br />* Southwest Florida Water Manageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* DepartJent of Health & Rehabilitative Services, KnvirODJental Health Unit - Wells, Wastewater TreatJent, Septic Tanxs
<br />* US Environaental Protection Agency - Asbestos abateaent
<br />I also certify that, if flll laterial is to be used in Flood Zone "AU or "A, etc. ", it is understood that a drainage plan
<br />addressing a "cOlpensating volUle" will be sublitted which 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 witb the Morx and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a pertit prevent the Building Official frOt thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall be cOle invalid
<br />unless the Mork authorized by such peflit is cOlleDced Mithin six IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sillOnths after the tiAe the Mork is couenced. One 90 day eJtension of tae, Jay be
<br />allowed for the perlit with fee charge of $15.00, The extension sball be requested in Mriting to the Building Official. An
<br />approved inspection lust be logged during each sil IOnth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKHENCKKENT HAY RESULT IN YOUR PAYING TWICE FOR IMPROVKKENTS TO YOUR
<br />PROPERTY. IF YOU IKTKND TO OBTAIN FINANCING, COHSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />COM~~~>~1)2'500 IN VALU! DO NOT HiED TD~UfCDMME;CiHANT"
<br />
<br />~L \1:= .. - \,. \ /
<br />
<br />SIGIlATURE: OWNER OR ~ SIGNATURE: CONTRACtOlt-_____
<br />
<br />STATE OF FLORIDA
<br />COUlI'1'Y OF
<br />The foregoing instrument was acknowledged
<br />before me this ,19 by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19 by
<br />
<br />whc.. ,,8 personarknown to me or who has
<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 />(Nam~ 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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