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<br />CONDITIONS OF PERMIT AFFIDAVI~
<br />A., NO'.l'ICE OF DEED HE "UCTIONS
<br />!be undersigned understands that thi.. ~rlit laY be subject to -deed restrictions II IUJch JaY be lOre restrictive than City
<br />regulations. !be undersigned asSUIeB responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />8. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIIIler bas bired a contractor or contractors to undertake wort, 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 lisdueanor violation under state law. If the OIfIler or intended contractor are uncertain as to what licensing
<br />requirelents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />. 788-6611.
<br />
<br />FurtheIlOre, if the owner has bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />IContractor Sections- 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 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, have been provided with a copy of -Florida's Construction Lien Law - lIOIeoImer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is SOIeODe other than the
<br />lIowner", 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 COllellCelent.
<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, zoning, and land develoJlll!llt.
<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 bas CDlenced prior to issuance of a perlit and that all wort will be perfoIJed to Jeet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIDJental agencies laY apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lUSt take to be in COIpliance. Such agencies include but are not lilited to:
<br />t Departlent of BnvirOllll!lltal Regulation - Cypress Baybeads, Wetland Areas and Bnvirolllentally Sensitive Lands,
<br />Water IWastewater !reatlent
<br />t Southwest Florida Water Managuent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health i Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater !reatlent, Septic !anks
<br />t US BnvirOllleDtal Protection Agency - Asbestos abatuent
<br />I also certify that, if fil1 laterial is to be used in Fl00d Zone "A- or .A,etc.-, it is understood that a drainage plan
<br />addressing a lCOIpeIlSating volUJe- will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />Aperlit 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 sball issuance of a perlit prevent the Building Official frOl thereafter
<br />relJUiring a correction of errors in plans, construction, or violations of any code. Every perlit issued sball beCOle invalid
<br />unfess the work authorized by such perlit is COIIIlIlCed within six IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a perioc1 of sillOnths after the tile the wort is co.enced. One 90 day l!ltension of tile, lilY be
<br />allowed for the perlit with fee charge of $15.00. !be l!ltension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned.
<br />WmUG !O OWNER: YOUR FAILURE !O RECORD A NOI'ICE OF cmtMDCBIlIIft' MAY BESUL! IN YOUR PAYING 'NICE FOR IMPROVBIIBIft'S !O YOUR
<br />PROPBRft. IF YOU IJI!BIiD !O OBt'AIN FIXAKCIJlG, COIfSUL! W!!H YOUR LBIIDBR OR III Anoam BEFORE RBCORDIMG YOUR MOI'ICE OF
<br />COMMBHCIMBN1'. JOBS URDER $2,500 1M VALUE DO MOl' IfBBD fO RECORD IIfD POS! A -NOI'ICE OF C<JlMBJlCBMBJI!II.
<br />
<br />(\T)~ ,/ ~
<br />~_Am.-Q"4Q._~ :#-4 ...~
<br />
<br />
<br />;q."t:71/C.'.r'-I fr.x~~e-/ L,h1S/r,/?II()';' /a--",,/v, h
<br />
<br />SlAfE OF FLORIDA
<br />coum OF \?D-':L-G
<br />The foregoing instrument was acknowledged
<br />before me this -z...-z.. .<,~ , 19 0,1) by
<br />
<br />~~'\ft\. .~. V JL~~~~l)'0
<br />who is personal~ known to me or, who has
<br />produced ~\.o\,;~ t1- '.~..'\\J.2Ci ~ ~
<br />as identification and who did/did not
<br />take ~ oath.
<br />~ ~~ ~~~
<br />(Si~ature)
<br />\.,--~ ~Y' " <::..\~ ~
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />SIAn: OF FLORI,QI.
<br />coum OF ~--- ~c.D
<br />The foregoing instrument was ackn)pwledged
<br />before me this .'Z--t-('~ , 19~ by
<br />
<br />~"'(\ <\). ~~o...~\\'C~~
<br />who is personally known to me.or who has
<br />produced ~"-el.~tl-A \)c'N."~ \...u~
<br />as identification and who did/did not
<br />
<br />take~h\ ~
<br />
<br />(Signature)
<br />'\ .e...'~~ ~ Cx.~s.\'"
<br />(Name Typea, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />j: ErG ;.~ ~_~' .,~ r }\ s S
<br />~;;(~~r;m;!:~i~:;~:XPiiP' L..J':~~)lR~~~
<br />Cornn-i;ss,i011 Nv. (.; \.- / 1..) ~-, 1
<br />
<br />LEIGH J. CLASS
<br />NOTARY PUBLIC, STATE OF FLORIDA
<br />My commission expires Mar. 21, 1 ~ "
<br />Commission No. C C 2 7 0 3 8 1
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