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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understanc1s that this peIllit JaY be subject to 'deed restrictions' Ihich JaY be .re restrictive than City
<br />regulations. !be undersigned asSUle& responsibility for cmpliance lith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIIH!r bas hired a contractor or contractors to undertake wort, they lay be required to be licensed in accordance lith
<br />. state and local regulations. If the contractor is not licensed as regu.iIed by lal, both the 0IfD8[ and contractor.y be
<br />cited for a lisdel8allOr violation under state law. If the owner or intended contractor are uncertain as to lbat licensing
<br />reguiretents JaY apply for the intended IIOrt, they are advised to contact the City of Zepbyrhills BuildiDg Departlent, (813)
<br />188-6611. .
<br />
<br />FurtherlOre, if the orner bas hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />IContractor Sectionsl of this application for ldIich they lill be responsible. If JOU, as the orner sign as the contractor,
<br />you are indicating that JOU, rather than the contractor, are responsible for the IIOrt. If the contractor lisbes you to sign
<br />as contractor that Jay be an indication that he is not properly licensed and is not entitled to peIIIitting 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 lith a copy of 'Plorida's Construction Lien Lal - lDeoImer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUIeI Affairs. If the applicant i8 8OI8OD8 other than the
<br />lowner', I certify that I bave obtained a copy of the above described docUIent and prOlise in good faith to deliver it to the
<br />lownerl prior to co.enCllleDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work lill be done in cOJpliance lith all
<br />applicable lals regulating construction, loning, and land developleDt.
<br />
<br />Application is hereby Jade to obtain a perlit to do IOrt and installation as indicated. I certify that DO IOIt or
<br />installation baa ~cea prior to issuance of a perlit and that alllOrk lill be perfcned to _t standarc1a of all Ius
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdictiOll. I also
<br />certify ~t I understand that the regulations of other goveIDll!lltal agencies JaY apply to the. intenc1edlOrl, and that it is
<br />If responsibility to identify what actions I lUst take to be in cmpliance. Such agencies include but are not lUlted to:
<br />t Depart:Jent of BnviIOlll8l1tal Regulation - Cypress Baybeads, letland Areas and InvirODll!Dtally Sensitive Lands,
<br />. .Iater/Vastewater !reatlent
<br />I Southwest Florida Water Managuent District-Wells, ~ypress Bayhead8, Wetland Areas, Altering Watercourses
<br />I Anly Corps of Ingineers - Seawalls, Doc", lIavigable laterways
<br />I Departlent of Health & Rehabilitative Senices, InvltonleDtal Health Unit - Wells, lastewater !reatleDt, Septic ranks
<br />I US InvirOlilental Protection. Aqancy -. Asbestos ibatllleDt .. ...,
<br />I also certify that, if fllLlaterialis to be used in Flood Zone 'A"or 'A,etc.', it is understood that a drainage plan
<br />addressing a lCOJpeDBating volute' lIill be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it issuance., "
<br />
<br />A perlit issued shall be cOnstrued to be a license to proceed with the Work and not as authority to violate, cancel lIter, or
<br />set aside any provisions of the ~cbnical.cod~, nor shall issuance of a perlit prevent the Building' 9fficiill. frOl, ~er~fter
<br />requiring a correction of errors in plans, construction, or violations of any code. ' Ivery perlit issued sball becoIe invalid
<br />unless the wortautbodle.I by such peIlit is. ~ced lithin, sUlODths. of issllaDce, or ,if IIOrt authorued by. the peIIIit is
<br />suspended or abandoned, for a period of. sillODths after the tile the IOrk is ~ced. One 90, day: <ension of tile, JaY be
<br />allowed for the pmit lith fee charge of $15.00. !be eltension sball.be requested in writing .to.~ Building Official. An
<br />approved inspection lUSt ;be logged during eBcb sUlODth period~ oIthe project lill be considerld abandoned. '.
<br />WARIIIIIG 'fO MIl: YOUR FAILURI !O RECORD A IIO!ICI OF CCRlUCBIIBII! MAY RBSUL! III YOOR PIYIIIG NICI FOR lJIPROVBIIBI!S 'fO YOUR
<br />PROPBm. IF YOU IJI'DIID 'fO 0Bf1I1I FlIlAllCIIIG, COISUL! WI!" YOOR.LBIDBR OB D InOBDY BBFOU IICORDIIIG YOUR IIOrICI OP
<br />COMMBIICIIIBII!. ' JOBS UlDIR. $2,500 III VALUE DO KO!IIOD fO. RBCOBD DO POS! A -IIO!ICI OF ClJIIBICBIIBIII.
<br />
<br />SIGJIA!URB: 0IfIIBR OB AGBIlI
<br />
<br />. r/1. el/A L/Y~ / ,,:___ l~'~
<br />SIGJIA!URB: COIIIRACfOR
<br />
<br />S!A!B OF FLORIDA
<br />coum OF
<br />The foregoing. instrument was acknowledged
<br />before me this ' , 19_ by
<br />
<br />S'fA'I'B OF FLORIDA
<br />coum OF
<br />The foregoing.1nstrument 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 />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 />(Signature)
<br />
<br />(Name. Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Nue Typed, Printed or Stuped)
<br />NOTARY PUBLIC
<br />
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