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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perlit lay be subject to .deed restrictions" wbich Jay be lOre restrictive than City
<br />regulations. fbe undersigned asSUles responsibility for cOlpliance 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 1fOrt, 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 JaY be
<br />cited for a lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!lents JaY apply for the intended work, they are advised to contact the City of Zephyrbills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtherJOre, if the owner bas hired 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 1fOrk. If the contractor wisbes you to sign
<br />as contractor that JaY be an indication that he is not properly licensed and is not entitled to peraitting priVileges in the
<br />City of Zepbyrbills.
<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 - HOIl!OIIDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUll!I' Affairs. If the applicant is lKlIeOne other than the
<br />"owner", I certify that I bave obtained a copy of the above described dOCUJent and proJise in good faith to deliver it to the
<br />"owner" prior to COlleDCeJeDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify tbat all the infoIJation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developient.
<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 ~ced prior to issuance of a perlit and that allwrk will be perfoIJed to Jeet standards of all 1_
<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 govl!IDlental agenCies JaY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not li8ited to:
<br />.. Deparblent of EnviroDlental Regulation - Cypress Baybeads, lIetland Areas and EnvirollleJltally Sensitive Lands,
<br />lIater/llastewater TreatJent
<br />.. Southwest Florida lIater ManageJeDt District - lIells, Cypress Baybeads, lIetland Areas, Altering lIatercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, Navigable lIatenays
<br />t DepartJent of Health & Rebabilitative Services, EnvirODJental Health Unit - lIells, lIastewater rreablent, Septic ranks
<br />.. US EnvirODlental Protection Agency - Asbestos abateJeDt .
<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 .cOQenSating volUJeu will be sublitted 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 the wrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official fIOl 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 perlit is COIIeJlced within sil IOntbs of issuance, or if work authorized by the perait is
<br />suspended or abandoned for a period ofsil IODths after the tile the wrt is co.enced. One 90 day eztension of tile, Iiy be
<br />allowed for the perlit with fee charge of $15.00. The eztension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned.
<br />IIARMING '1'0 0IfNER: YOUR FAILURE ro RECORD A NorICE OF COMMDCEJIBH'f MAY RESULt' IN YOUR PAYING 'fIfICE FOR IMPROVIIIBftS TO YOUR
<br />PROPER'fY. IF YOU lJi!EMD '1'0 OBfAIlf FlIfAICIIG, CONSULT 1I1'IH YOUR LBJIDBR OR 11 Af'I'OIIDY BEFORE RECORDING YOUR IfO'IICE OF
<br />COMHENCEMElft'. JOBS UJfDER $2,500 IN VALUE DO Nor NEED '1'0 RECORD AND POsr A uMorICE OF ClJIlENCEMEM!N.
<br />
<br />.~~
<br />~: OWIIIR 0
<br />
<br />
<br />SrATE OF FLOR1DA
<br />coum OF ~'JC:6::>
<br />The foregoing instrument was acknowledged
<br />before me this2.8 D:=to&~, 19-.&. by
<br />
<br />,\.0 \..ll'J t1. K~u \~
<br />~~is personally known/to me or who has
<br />produced
<br />as identification and who did/~t
<br />~ake .oath:J). ~ ."",J
<br />/]A J( ~ _Vl22IL.L.
<br />( ure) .
<br />
<br />~r~~
<br />SIGNA : COJi!RAC'I'OR ,
<br />
<br />~~O~F~C;C~
<br />
<br />The foregoing instrument was aCknowledged
<br />before me this2-R' ~ e-, 19.1L_ by
<br />
<br />"~oeCK--r ~ !f:~
<br />w!!!? is personall e or who has
<br />proaucecr-
<br />as identification and who did/did not
<br />
<br />t~ an ""~,. t; r1
<br />I< i-1Aj-~_f2i fJ'710
<br />(Signature) I .
<br />
<br />-
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~~
<br />
<br />Dl.Vi:J J';0l\:;JA
<br />STATE OF PeORjDA
<br />COM EXPIRES: MARCH 27, 2000
<br />COM lIICC IW3432
<br />
<br />~;:_ ~. . __,,~7D; l~~
<br />
<br />~EXF~;;CS: MARCH 21,:iIDlIlt
<br />L _..1 #CC 54ol3Z
<br />
<br />DAVID ....
<br />8TAlIIClI'''-
<br />ClClM__...._
<br />ClClM_"
<br />
<br />G.l
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