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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this penit lilY be subject to Ideed restrictions I wbich lilY be lOre restrictive than City
<br />regulations. Tbe undersigned aBSUHS responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES -
<br />If the owner bas bired a contractor or contractors to undertake work, they lilY 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 mmer and contractor lilY be
<br />cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain 'as to wbat licensing
<br />requirl!lents lilY apply for the intended work, they are advised to contact the City of Zephyrhi~ls Building Departlent, (813)
<br />788-6611. .
<br />
<br />FurtherJOre, if the owner bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />IContractor Sections I of this application for which 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 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 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, have been provided with a copy of IFlorida's Construction Lien Law - HoIeowner's Protection
<br />Guidel prepared by the Florida Departlent of Agriculture and ConsUll!I' Affairs. If the applicant is SOJeOne other than the
<br />lownerl, I certify that I bave obtained a copy of the above described dOCUJeDt and prOJise in good faith to deliver it to the
<br />lownerl prior to COlleDCeleDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforJation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developent.
<br />
<br />Application is hereby Jade to obtain a perait to do work and installation as indicated. I certify that no work or
<br />installation baa cc.unced prior to issuance of a perlit and that all work will be perfolled to Ieet 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!l1llleDtal agencies lilY apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lust take to be in COIpliance. Such agencies include but are not lilited to:
<br />t DepartJent of EnvirollleDtal Regulation - Cypress Baybeads, Wetland Areas and EnvirollleDtally Sensitive Lands,
<br />Water/Wastewater TreatJent
<br />t Southwest Florida Water HanageleDt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health' Rehabilitative Services, BnvirODJental Health Unit - Wells, Wastewater Ireat.lent, Septic lanks
<br />t US EnvirODJental Protection Agency - Asbestos abateleDt
<br />I also certify that, if fill Jaterial is to be used in Flood Zone IAI or IA,etc.l, it is understood that a drainage plan
<br />addressing a lCOIpensating VOl_I will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance. .
<br />
<br />A penit 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 sball issuance of a peIlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors iri plans, construction, or violations of any code. Every peIlit issued shall beCOJe invalid
<br />unless the lIork authoriled by such peIlit is coaenced lIithin sillOntbs of issuance, or if work authorized by the per.it is
<br />suspended or abandoned for a period of sil IOnths after the tile the work is couenced. One 90 day atension of tile, lilY be
<br />allowed for the peIlit with fee charge of $15.00. The atension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillOJlth period, or the project will be considered abandoned.
<br />WARMING 10 OIIlfER: YOUR FAILURE 10 RECORD A NOIICE OF COtHEHCBHBHI HAY RESULI IN YOUR PAYING ftlICE FOR IHPROVBHBHIS 10 YOUR
<br />PROPERlY. IF YOU IJlfEHD 10 OBfllJl iIWC'IKG, COISULI WIIB YOOI LlHDER OR AM AnORXBY BEFORE RECORDING YOUR NOIICK OF
<br />
<br />fJWDlmft~ ~ ~ IlIIIIID IV RmD lID POST I .~. _
<br />
<br />
<br />SIGNAIURE: OIIHER -- SIGNAIUHf: CONlRACIOR,
<br />
<br />STATE OF FLORIIJAJ
<br />COUNtY OF ttJ. <.f iJ
<br />Tbe foregoing instrument was acknowledged
<br />before me this J - 7 , 19:z.z. by,
<br />
<br />Il/h~/I I.- ')//YJ.8
<br />who is personally known to me or who has
<br />produced .
<br />as identification and who did/did not
<br />
<br />tp.:;:; ~~
<br />( ignature) ,
<br />
<br />SIAIE OF FLORIDA ,n
<br />COUNTY OF 'jQ S C ()
<br />The foregoing instrument was acknowledged
<br />before me this /.- 7 , 19..22.- by
<br />
<br />/llhp// S, /H (-
<br />who is 2ersonally knOllg! to me or who has
<br />produced
<br />as i tification and who did/did not
<br />t C?ath: / ;J./
<br />
<br />(
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~'-;;;''H''', - PATRICIA M. CAMPBELL
<br />I~ .~<< MY COMMI8SION , cc 2548311
<br />:.: i~ EXPIAES: JIIIII/Y 24. 1987
<br />IlondId 11IIu NoIIrY NlIc lJndINdn
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOT C
<br />..'$~:f~. PATRICIA M. CAMPBELL
<br />[.; . ~ MY COMMISSION , cc 254635
<br />~ EXPII&: .lIIury 24, 1997
<br />. .. IandId 1IlII NaIIIy I'lIIlIc lblIIwIlIn
<br />
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