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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 "deed restrictions" whicb lay be lOre restrictive tban City
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired 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 lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirelents lay apply for tbe intended work, they are advised to contact tbe City of Zephyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />IContractor Sections I 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 be is not properly licensed and is not entitled to perlitting privileges in the
<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 that I, the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOWner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
<br />"owner", 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 couencelent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of a perlit and tbat all work will be perforled 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 governJental agencies laY apply to tbe intended work, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />* DepartJent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />* Southwest Florida Water Kanagelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* Departlent of Health & Rehabilitative Services, EnviroDlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />* US EnviroDlental Protection Agency - Asbestos abatelent
<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 .colpensating volUle" will be sublitted whicb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with tbe 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 perlit issued shall becOIe invalid
<br />unless the work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is cOIIenced. One 90 day extension of tile, laY be
<br />allowed for the perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six IOntb period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COKMENCBHENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN FINANCllfG, COlfSULT WITH YOUR LBlfDBR OR AN ATTOR8BY BEFORB RBCORDllfG YOUR NOTICE OF
<br />COHKHlfCEHENT. JOBS UNDER $2,500 IN VALUE DO NOT lfEED TO RECORD AND POST A "NOTICE OF COHMBNClMBNTH.
<br />
<br />~).JJell1c.- h ~
<br />
<br />SIGNATURE: OWIfER OR AGENT SIGNATURE: COlfTRACTOR r
<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 oath.
<br />
<br />STATB OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />before me this ~, 19~ by
<br />
<br />~s.~llo.- ~-T~M.L~
<br />who is personally known t~~me or who has
<br />produced ~e"f~^CL' / * fvVWWI1.
<br />as identifi ion and W 0 did/did not
<br />take an oijth.
<br />
<br />Pt ,.J fcQL;t5
<br />
<br />(Signature)
<br />
<br />
<br />--
<br />
<br />(Signature)
<br />
<br />I , # a-l1 /} Cl.. '6
<br />or Stamped)
<br />L
<br />NANCY T HANNA!
<br />NOI'AIY PUBLlC STA'Ti OF
<br />OOMMJSSION NO. a:278138
<br />MY~ EXP. APll1819'J'1
<br />1o_:L"'_"'~--"""'''''
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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