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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RE~;TRICTIONS
<br />The undersigned understands that this perJit tay be subject to 'deed restrictions' which tay be lOre restrictive than City
<br />regulations. tbe undersigned assUles responsibility for cOlpliance with any applicable ueed 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 lisdeleanor violation under state law. If the. owner or intended contractor are uncertain as to what licenSing
<br />reguirelents lay apply for the intended work, they are advised to contact the City of Zepbyrbil1s Building Departlent, (013)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner basbired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />UContractor 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 work. 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 pemitting 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, bave been provided with a copy of 'Floridars Construction Lien Law - HOJeOMnerrs Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is 8OIeOne other than the
<br />"owner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owneru prior to cOlleDcelent.
<br />
<br />E. CONTRACTORrSjOWNERrS AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developleDt.
<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 CDIIeDced prior to issuance of a pemit and that all work will be perfoIled to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverJlleDtal agencies lay apply to the intended wort, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in colpliance. Such agencies include but are not lilited to:
<br />* Departlent of EnviroDlental Regulation - Cypress Baybeads, lIetland Ireas and EnviroDleDtally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />* Southwest Florida Water Hanagelent District - Wells, Cypress Baybeads, lIetland Ireas, Altering lIatercourses
<br />* ArlY Corps of Engineers - Seawalls, Docks, Kavigable lIaterways
<br />* Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - lIells, lIastewater freatlent, Septic tanks
<br />* US EnvirODleDtal Protection Agency - Asbestos abateleDt .
<br />I also certify that, if fill laterial is to be used in Flood ZOne 'A' or "I,etc. u, 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 pemit issuance.
<br />
<br />A pemit issued shall 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 shall issuance of a pemit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every petlit issued shall beCOle invalid
<br />unless the work authorized by such pemit is cOlleDced within sil IOnths of issuance, or if work authorized by the pemit is
<br />suspended or abandoned for a period of sillOntbs after the tile the work is cOlleDced. One 90 day extension of tile, lilY be
<br />allowed for the pemit with fee charge of $15.00. fbe extension shall be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each sil IODth period, or the project will be considered abandoned.
<br />WARHIIG TO omR: YOUR FAILURE fO RECORD I KOlICH OF COHMDCEJlBIIf HAY RESULT II YOUR PIYIKG 'NICH FOR IMPROVIMDfS fO YOUR
<br />PROPERTY. IF YOU IJlfDO fO OBlAIK FIKUCIKG, COISULf IIlfH YOUR LINDER OR D AnomY BEFORE RECORDIKG YOUR KOIICE OF
<br />COHHBIICBHEtn' . JOBS UlfDER $2,500 III VILUE 00 1101 HEED fO RECORD AIfD POSf A t'HOfICH OF ClIfHBIfCBllEllfu.
<br />
<br />SI~d{ r2r:/if
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<br />SIGlflfURE: CO R
<br />
<br />STATE OF FLORIDA
<br />COUIffY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />-
<br />
<br />SfAfE OF FLORIDA
<br />COUIffY OF
<br />The foregoing instrument was acknowledged
<br />before me this
<br />
<br />wbo is personally known to me or wbo bas
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identificat'
<br />take an oath.
<br />
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />lName Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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