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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to Hdeed restrictions I wbicb lay be lOre restrictive than City
<br />regulations. !be undersigned assutes responsibility for coapliance 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 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 tay be
<br />cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireaents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the OWDer bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor 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 he 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 IFlorida's Construction Lien Law - HOJeOWJ1er's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and Consuaer Affairs. If the applicant is sOleone other tban the
<br />uowner", I certify that I bave obtained a copy of the above described dOCutent and prOlise in good faith to deliver it to the
<br />"owner" prior to colteDceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infortation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developaent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no wort or
<br />installation bas cOllenced prior to issuance of a perait and that all work will be perforted to teet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developtent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governaental agencies tal apply to tbe intended work, and that it is
<br />.y responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not litited to:
<br />* Departlent of Environaental Regulation - Cypress Baybeads, Wetland Areas and Environaentally Sensitive Lands,
<br />Water/Wastewater 'I'reattent
<br />* Southwest Florida Water Hanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />* Arty Corps of Enqineers - Seawalls, Docks, Kavigable Waterways
<br />* Departtent of Health & Rehabilitative Services, Environaental Health Unit - Wells, Wastewater rreattent, Septic 'I'anks
<br />* US Environaental Protection Agency - Asbestos abateaent
<br />I also certify that, if fill laterial is to be used in Flood Zone .'AI or "A, etc. " , it is understood that a drainage plan
<br />addressing a .co,pensating volute" will be subtitted wbich 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 tbe work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a pertit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued sball beCOle invalid
<br />unless the work authorized by such perlit is cOllBDced within six IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of Sil IOntbs after the tite the work is COlteDced. One 90 day extension of Ute, tay be
<br />allowed for tbe pertit with fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each Sil IOnth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A KO'l'ICE OF COIlJIDCEHEK'l' HAY RESULT IN YOUR PAYING !VICE FOR IHPROVEMBH'l'S TO YOUR
<br />PROPERTY. IF YOU IK'l'EKD TO OB'I'AIN FIKAHCIKG, COKSUL'I' WI'I'H YOUR LEIDER OR AK A'l"l'ORRBY BEFORE RECORDIKG YOUR DICE OF
<br />COHMEKCEHENT. JOBS UNDER $2,500 IN VALUE DO KO'I' KEED '1'0 RECORD AND POST A HNO'I'ICE OF COHHEKCEHEKT'.
<br />
<br />SIGKA!URE: OWHER OR AGEK'l'
<br />
<br />SI GKA'l'URE: COK'l'RACTOR
<br />
<br />S'I'ATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STATE OF FLORIDA
<br />COUN'l'Y OF
<br />The foregoing instrument 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 />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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