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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit JaY be subject to Ideed restrictions" wbieb lay be lOre restrictive than City
<br />regulations. Tbe undersigned asSUles responsibility for co.pliance 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 .ay 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 lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirellents .ay apply for the intended work, they are advised to contact the City of ZephyrhillsBuilding Departlent, (813)
<br />788-6611.
<br />
<br />FurtheI'lOre, if the owner has hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections I of this application for wbieb they will be responsible. If you, as the orner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes 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 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 IFlorida's Construction Lien Law - HOIeOWDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and Consl1ler Affairs. If the applicant is SOHOne other than the
<br />Rowner", I certify that I have obtained a copy of the above described rJocUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to couenCl!lellt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation 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 .ade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOlleDced prior to issuance of a perlit and that all work will be perfoIled to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govl!I1llleDtal agencies laY apply to the intended wort, and that it is
<br />IY responsibility to identify what actions I lust take to be in COIpliance. Sueb agencies include but are not luited to:
<br />t Depart:lent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnvirollleDtally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />* Southwest Florida Water ManageIeDt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* DepartJent of Health & Rebabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tants
<br />* US EnvirODleDtal Protection Agency - Asbestos abatellent .
<br />I also certify that, if fill laterial is to be used in Flood ZOne IAR or RA,etc.R, it is understood that a drainage plan
<br />addressing a Bco.pensating vollllel 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 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 perlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued &ball becoIe invalid
<br />unless the work authorized by sueb perlit is COIIeJ1ced within sixlOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is co.enced. One 90 day extension of tile, lay be
<br />allowed for the peIlit with fee ebarge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eaeb sixlOnth period, or the project will be considered abandoned.
<br />WARJUNG TO ONHER: YOUR FAILURE TO RECORD A NOTICE OF C<llMBlCEIIBMT MAY RESUL! IH YOUR PAYING !WICE FOR DIPROVBIIDIS TO YOUR
<br />PROPERrY. IF YOU IHrEHD TO OBTAIN FIMANCIHG, COBSULT WIrH YOUR LIJIDIR OR AN ArroRIIY BIFORE RlCORDING YOUR ICE OF
<br />COMHENCEMEln'. JOBS UNDER $2,500 IN VALUE 00 NOT NEED TO RECORD AHD POST A INOTICE OF COIIIDCEIlEMI'B.
<br />
<br />_u~
<br />SIGlfApJSII: OWIIIlR 0 .
<br />
<br />
<br />STATE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19 by
<br />
<br />Sf ATE OF FLORIDA
<br />COUNTY 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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