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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this pertit lay be subject to "deed restrictions" wbieb lay be lOre restrictive than City
<br />regulations. !be undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertake work, tbey 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 wbat licensing
<br />requireJents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtberlOre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />DContractor Sections" of this application for wbieb 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 tbe 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 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 - HOIeOIDer's Protection
<br />Guide" prepared by tbe Florida Depart:lent of Agriculture and Conslller Affairs. If the applicant is sOleone other tban the
<br />Downer", I certify that I bave obtained a copy of the above described dOCUJent and prOlise in good faith to deliver it to the
<br />"owner" prior to cOlllellceJent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify tbat all tbe 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 developlent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas cOllenced prior to issuance of a pertit and that all work will be perfolled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developJeDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIDIeDtal agencies laY apply to the intended work, and that it is
<br />If responsi~ility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />· Depart:lent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater freatJent
<br />· Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />· ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />· DepartJent of Health & Rehabilitative Services, EnvirODJental Health Unit - Wells, Wastewater !reatlent, Septic Yanks
<br />· US BnviroDlental Protection Agency - Asbestos abateJent
<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 DCQlpensating volute" will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued sball be construed to be a license to proceed with the work and not as autbority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a peIlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery pertit issued shall beCOle invalid
<br />unless tbe work authorized by sucb perlit is cOllenced within six IOnths of issuance, or if work authorized by the pertit is
<br />suspended or abandoned for a period of six IOntbs after the tile the work is cOllenced. One 90 day extension of tile, lilY be
<br />allowed for tbe pe~it'with fee cbarge of $15.00. The extension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eacb six IOnth period, or the project will be considered abandoned.
<br />WAIUlING TO OWNER: YOUR FAILURB TO RECORD A NOTICE OF COMHENCBHBNt HAY RESULT IN YOUR PAYING flUCH FOR IHPIlOVEIIEIft'S TO YOUR
<br />PROPBRTY. IF YOU IIft'BND TO OB!AIN FINANCING, CONSULT WITH YOUR LINDBR OR AIf AnOIlMEY BEFORE RECORDING YOUR 1I0001CH OF
<br />ClIIIIIIlJIlm. JlIIS UIIlEJl12,500 II VAWIIIlO IOII111lD 10 REClIRIlIID POS'l A 'IOIICI OF _'. j)
<br />
<br />
<br />~~(~ c;~ Jo-m
<br />- SIGJlAfURK: OWIIBR OR AGBNT SIGNATURE: COIft'RACTOR !
<br />
<br />STATB OF FLORID~
<br />coum OF ~
<br />The foregoing instrument was acknowledged
<br />before me this ~-- -.3 0 , 19~ by
<br />
<br />STATE OF FLORID~
<br />coum OF ~~
<br />The foregoing instrument was acknowledged
<br />before me this ...!,-- ~ 30 , 19 1'--6 by
<br />
<br />
<br />who i~ODall~o .. or who bas
<br />produce
<br />as identification and who did/did not
<br />take an o~th. ~ a < )Jr.~
<br />
<br />(Signature) !J!., ~ A If. / . .
<br />_8 11 c-- V - _c/lJ q r-
<br />(Name Typed, Printed of Stamped)
<br />NOTARY PUBLIC
<br />
<br />who is p~nallY known to me or who has
<br />produced L~ T.5:2~ - r;R:j-3Y- '7Jf- D
<br />as identification and who did/did not
<br />take an oath. '-/7 a JJ1. 4
<br />
<br />(Signature) kio.~ A If "oj .
<br />
<br />(Name Typed, Printed :f Stamped) 7
<br />NOTARY PUBLIC
<br />
<br />....,~~';~~, Nancy A~ r~i..;."'
<br />l~~"'J. MY COMMISSION' CCSi' .
<br />~*~. : j FebruarY 21. I:;'
<br />~iif.;nl ~ 8ONDEO THRU 1lIOV fAIN INS!;;,.
<br />
<br />"'''''''' Nancy A Mor,
<br />4-i!\'f.r~.. . ."....:
<br />f*: L.'~.>J~*\ MY COMMISSION # CC~,..
<br />~.~~: February 21.' ,
<br />.....1.r.........~" BONDED THRU TROY FAIN iN:.:"
<br />IRf..".\
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