|
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perI1t JIilY be subject to "deed restrictions" wbieb JIily be lOre restricti"ethan City
<br />regulations. !he undersigned assUleS responsibility for cmpliance with any applicable deed restrictioos. ; .
<br />
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES . ....
<br />If the OWDer has hired a contractor or contractors to undertake work, they lilY be required to be licensed: iJl~i.ith,
<br />state and local regulaticms. If the contractor is not licensed as required by law, both the 0III1er and cqn~~~l't">
<br />cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to ~tU.i~8D,~ipg,.
<br />requireJellts JIilY apply for the intended work, they are advised to contact the City of Zepbyrbills Build,lng ~t,i (81. '" ~)
<br />788-6611. . ..' '"
<br />
<br />
<br />Furtberlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(8).~i9't~.f1PJ"0!~;~;
<br />"Contrac~or. Se~ons" of this application for 1fbieb they will be res~ible. If JOU, as the OIfDer sign ij18 'u.,~~~~~~~~;~. .'
<br />you are Indicating that you, rather than the contractor, are responsible for the work. If the COIltractor.~1!Oii~.tolligpF\;'~'f~.,~
<br />as contractor that .Iily be an indication that he is not properly licensed and is not entitled to peraittiDg P9,iWwI..~;tJit,gii:~.;<~~
<br />City of Zepbyrhills. . :
<br />
<br />TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />. ';1f~";s
<br />
<br />C.
<br />
<br />i;; "",',~
<br />
<br />'''';.~,.'..:
<br />"' !,'.{~ '
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS ~~.I;),)" . ~':
<br />I certify that I, the applicant, have been provided with a copy of "Plorida's COnstruction Lien Law .:. ~~f:'PJ;o~OD . ,~\' ,.
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsuIer Affairs. If the applicant is .... ~rJ~ftlae:)~!e~
<br />'owner", I certify that I have obtained a copy of the above described docuIent and prOlise in good faith to. de1iv8r"it:tQ tIIoe~ ,:. '~
<br />'OWDer' prior to COIIeI1CeJe1lt. "( .,' ': :7 .~' ':', ;f,
<br />
<br />E. CONTRACTOR' SlOWER'S AFFIDAVIT ,."Y'!'
<br />I certify that all the infomtion in this application is accurate and that all work will be done in COIplianceJlfith'all{'i:;;
<br />applicable laws regulating construction, zoning, and land develO{Elt.;" ~t~'~>~
<br />
<br />Application is hereby lade to obtain a perait to do work and installation as indicated. I certify that ,110 _t.ior'L,}Ar;:.~;:;;
<br />~ ., ,.' ':.,' "... -"',-";,,., "" '\ "".'t.l(,'~'\-',"><~:"'_:'
<br />installation has cc.enced prior to issuance of a pmit and that. all work .ill be perf OIled :to ..tiS~;9fEall.~JiP!IIi~i;2';':'i:;
<br />regulating construction, City codes, loning regulations, and land develOllEt reguIati~in~~;i~' ',."';"';'::~f,;~,:i,;~~,;'f;~;
<br />certify that I understand that the regulations of other goverJllBDtal agencies JIilf apply totl!e4.D~ec1, ," .~~. .
<br />If responsibility to identify what actions I lUSt take to be in COIpliance. Such agenciesinc:'~~~t~;J:lP, .,~,~
<br />t DepartJent of BnvirODlelltal Regulation - Cypress Bayheads, Wetland Areas and BnvirolllelltalIY!SeMiijve"'!'M",~t,i.;\,fj(1
<br />Water/waste1fater !reatlent. l : 'i: '{ ,',i;~;/;;~~~',:'
<br />t Southwest Florida Water Hanagl!ll!llt District - IIells, Cypress Bayheads, Wetland Areas, Altering Watercourses, ,.~;
<br />t lIlY Corps of Ingineers - Seawalls, Docks, Mavigable Waterways ;". .!~ ';~'
<br />t DepartJent of Health' Rehabilitative Services, InvirODlBDtal Health Unit - Wells, Wastewater !rea...t,~,~ ' .;;,.'
<br />t US InviIOllleJltal Protection )qency - Asbestos abatelt!Jlt" '. ;, .>/.,
<br />I also certify that, if fill JIilterial is to be used in Flood Zone 'A' or "I,etc.', it is understood that adt~epl1J1:,:..;, ';~,!
<br />Faddressl 'd ing, a 'CGlpeDSto ~ttin', g VolUle' will be subaitted wbieb is prepared by a professional engineerregistered{~,~.~~tO~"':.'i:....:......'...;.t.'<':,."
<br />OIl a prIor peIlI Issuance. .' '. " .' ..... ~,:
<br />.,[ , <f,;'<;:';,;~
<br />A pmit issued shall be construed to be a license to proceed with the work and not as authority to viOl$,,~al~,Q,r;+;'-:~{
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building;Off~fj,I~;.~~~,~4~~'''/;Z!i
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perait;,is8ut!4~.;~".~' .;'.~;;
<br />unless the work authoriled by su~ peIli~ is COIIeI1ced within sillODths of issuance, or if work autbor~~~*~P,It~i~,J~;;'Y:rt;,.;~:;,
<br />suspended or abandoned for a perIod of SlllOIlths after the tile the work is COIIeDced. One 90 daY;~I:enOOI,lf()f)tU!e';>~J!~'fX't'f:t"~r:
<br />allow~ f~r the ~it with fee charge, of $15.00: !he elt~ion shall be r~es~ in wri~ to the ~'~~,c;l.~~i~1q"r '" \;'l~
<br />approved lDSpection lUSt be logged dUIlng eaeb Sll IODth perIod, or the proJect WIll be CODS1dered~", + i >:;'>:.+:-.;~j
<br />IfIRIING !O (JDR: YOOR FAILURE ro RECORD I MO!ICI OF aIIMDCIIIIn' lilY RESUL! IN' YOOR PIYIlGDICI POB,~fO::JCIlRli,;;;;~'tt'~l'
<br />PROPER!Y IF YOU umm !O 0Bf1U PDlUCING COJISOL! 1fI!II YOOR LODER OlIN IftOJIIIY BIFOIBIICOJIDDGYOOIJOrlCBOli~~i;;,/i('~t::
<br />., ,I' '.,'~ ",'i;; '-.' '-.,', ,-,',.,-,',:.' ;~;~i{'
<br />a>>IHERCEMBRf. JOBS ORDER $2,500 1M VALUE DO MO! REED ro RECORD AND POS! A 'MO!ICE OF aJIIIDCBIIII!'. ' '. .:)i;~
<br />,~.:t~,,;
<br />
<br />.;'I;'p>
<br />
<br />
<br />b~;?i/~fJ-
<br />SIGRA!ORI: (JfJIU 01 AGIII! t::/
<br />
<br />z:b~~~Rpz
<br />SIGJfA!URE: COIDACTOR ,.
<br />
<br />,hi-
<br />
<br />S!AtE OF FLORIDA
<br />coom OF
<br />The foregoing instrument was acknOWledged
<br />before me this , 19____ by
<br />
<br />srAn: OF FLORIDA ,'''i
<br />coum OF .... .... '. ,. \"::
<br />The foregoing instI'WDelltwas af:,~~~\!'~%;~t~
<br />before me this , 19 '. "~~Y};1';:'J/" . :e' 'f!\.,
<br />;~,,'jt"f:'~:'~,l:"~;!l"'\" ::.:';t),~,~.:,,-,:, ;\;~i
<br />. . ,'< 1('. ~ .".; .... . ..i'l'i'\~~0
<br />who is personally known.to .~Pf~1II:l9'>,'~~:f:;:\,.t,k:";i.i&;':
<br />produced . . . '. .t?,:~:i",':it4;;);::;'0.';~~U'jJ"~/'
<br />as identification and,:.who d.icJi'4ii~,'AQt!'l';"",";:,~:I;:y:<:!:r'
<br />take an oct.th .... "'jl.'fi;;.f:;;~:"":i~';'::1?
<br />. . ;. ~,..'. ~J~~~" i~" )~4)
<br />f'-;: ~ II
<br />" .... 2;~; ..,.,~t.';'i
<br />(::"llBY ~i.I~riDted orSt;uIped) T" ;j~:;;~~
<br />
<br />i:'.)"
<br />t~,: ,:
<br />
<br />(Signature)
<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 />.>
<br />
<br />
<br />'.~ ,
<br />'~,(c.:':;,::
<br />,(if;
<br />
<br />, ,~";f
<br />
|