|
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'Ihe undersigned understands that this perlit aay be subject to "deed restrictions" which lilY be lOre restrictive than City
<br />regulations. !he undersigned assUJeS responsibility for COIpliance with any applicable deed 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 he licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor aay be
<br />cited for a lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirl!lll!Jlts laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas hired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for wbich they will he 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 perlitting 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, have been provided with a copy of "Florida's Construction Lien Law - HmII!OlfJler's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUlll!I Affairs. If the applicant is sOlleOne other than the
<br />"owner", I certify that I bave obtained a copy of the above described dOCUJel1t and prOlise in good faith to deliver it to the
<br />"owner" prior to COlll!llCl!lent.
<br />
<br />E. CONTRACTOR'S/OWNER'S 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, loning, and land developlent.
<br />
<br />Application is hereby lade to obtain a peIlit to do work and installation as indicated. I certify that no work or
<br />installation has COIIeDced prior to issuance of a perlit and that all work will be perfoIJed 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 gOYernJeIltal agenCies lilY apply to the intended work, and that it is
<br />If responsibility to identify what actions I lUst take to be in colpliance. Such agencies include but are not lillited to:
<br />t Departlent of Envirolllel1tal Regulation - Cypress Bayheads, Wetland Areas and Envirolllel1tally Sensitive Lands,
<br />Water/Wastewater !reatlent
<br />t Southwest Florida Water Hanagelellt District - Wells, Cypress Baybea4s, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, Ifavigable Waterways
<br />t Departlent of Health & Rebabilitative Services, EnvirOJlleJltal Health Unit - Wells, Wastewater 'Ireatlent, Septic 'Ianks
<br />t US EnvirODleDtal Protection Agency - Asbestos abatl!lll!Jlt
<br />I also certify that, if fill aaterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "cOlpenSating volllle" will be saitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit 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 alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOle invalid
<br />unless the work authorized by such peIlit is COIIenced within sillOlltbs of issuance, or if work authorized by the pmit is
<br />suspended or abandoned for a period of sillOlltbs after the tile the work is coaenced. One 90 day stension of tile, laY be
<br />allowed for the peIlit with fee charge of $15.00. 'Ihe stension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sil IODtlI period, or the project will be considered abandoned.
<br />WARlfIIfG '10 0VIfBR: YOUR FAILURE '10 .~COJ.D A.IfO'lICE OF aJDIB~CBMm MAY RESUL'I IIf YOUR PAYlIfG DICE FOR IMPROVBIIBII'IS '10 YOUR
<br />PROPERfi. IF YOU IBBIfD '10 OBlIIlf FIJI1IfCIIfG, COISOL'I 11'18 YOOR LlllDBR OR 111 AftORDY BEFORE RBCORDIIfG YOUR 1I000ICE OF
<br />COMHBIfCBHBIf'I. JOBS UllDBR $2,500 IN VALUE DO NO'I NEED '10 RECORD AIID POS! A "NO'IICE OF COHMBIfCEHBlft'''.
<br />
<br />
<br />~JJ' g~
<br />SIGIIA'IURB: CON'I
<br />
<br />. .
<br />
<br />SIGIIAfURE: OIOIBR OR AGm
<br />
<br />S'IATE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this f 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 />srAD OF F~
<br />coum OF -t'Ctsc: <::)
<br />The foregoing inst~t was acknowledged
<br />before me this I ~ 19~ by
<br />
<br />~ \.>.... c:., c:,{' \ \ Y'Y'\' ~ ro lA.) V\
<br />who 18 pp-rRonally known to me or who has
<br />produced
<br />as identification and who didl9id ~oD
<br />
<br />~~KY~
<br />. ure)
<br />
<br />(Signature)
<br />
<br />(Name. Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />~"';'~f..\:fP;';;;-_ DEBORAH R. PERKINS
<br />>.:' i'~ MY COMMISSION' CC 221775
<br />~l EXPIRES: Au"lIIt 16, 1998
<br />"lX,.- Bonded Thru~bIIc UndeIwrIters
<br />
|