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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. ;NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perJit lay be subject to Ideed restrictions" which Jay be lOre restrictive than City
<br />regulations. The 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 work, they JaY 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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtbeClOre, if tbe owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections I of this application for wbich they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, ratber tban the contractor, are responsible for the work. If tbe 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 Zepbyrbills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN ~AW (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 - BOIeOWDer's Protection
<br />Guide" prepared by tbe Florida DepartJent of Agriculture and ConsUler Affairs. If tbe applicant is sOJeQne other than the
<br />Rowner", I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the
<br />"ownerR prior to cOlleDcl!lent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify tbat all tbe inforlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land develop.ent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of a perJit and that all work will be perf oIled to teet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develop.ent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDllental agencies JaY apply to the'intended work, and that it is
<br />If responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />I DepartJent of EnviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater TreatJent
<br />* Southwest Florida Water Hanagetent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />I ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* DepartJent of Health & Rebabilitative Services, EnvirODJental Health Unit - Wells, Wastewater TreatJent, Septic Tanks
<br />* US EnvirODleDtal Protection Agency - Asbestos abatetent
<br />I also certify that, if fill laterial is to be used in Flood Zone "AR or "A,etc.', it is understood that a drainage plan
<br />addressing a 'cOlpensating voluteR will be subJitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perJit. issuance.
<br />
<br />A perlit issued shall 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 tecbnical codes, nor shall issuance of a perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued shall beCOJe invalid
<br />unless tbe work authorized by such perlit is cOllenced within six IOnths of issuance, or if work authorized by the perJit is
<br />suspended or abandoned for a period of six IOntbs after the tile the work is cOllenced. One 90 day extension of tile, Jay be
<br />allowed for the perJit with fee charge of $15.00. The extension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each six IOnth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHIlHNCHMlNT HAY RESULT IN YOUR PAYING !VICE FOR IHPROWIlBHTS TO YOUR
<br />PROPERTY. IF YOU IMmD TO aMAIN FIHAlC.ING, COHSULf WITH YOUR LElfDER OR All AnOIlREY BEFORE RECORDIHG YOUR HOTICB OF
<br />COMHHHCEHEHT. JOBS UNDER $2,500 IN VALUE DO HOT NEED fO RECORD AlfD POST A "NOfICE OF COMMENCEMENTR.
<br />
<br />4h/ us: ?z-
<br />SIGlAflJllE: OWNER OR AGENT
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STAfE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was aCknowledged
<br />before me this , 19____ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The fDregoing 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 o~th.
<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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