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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands tbat this penit JaY be subject to Ddeed restrictionsD wbieb lilY be lOre restrictive than City
<br />regulations. !be undersigned assUles 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 JaY be required to be licensed in accordance witb
<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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!lents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />Furtheraore, if the owner bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of tbe
<br />UContractor Sections. of this application for wbieb they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating tbat you, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign
<br />as contractor that JaY be an indication tbat be is not properly licensed and is not entitled to penitting 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 uFlorida's Construction Lien Law - HOII!OWIler's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is sOleone other than the
<br />Rowner", I certify that I have obtained a copy of the above described dOCUJeDt and pIOlise in good faith to deliver it to the
<br />"owner" prior to coaencl!lent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in cOlPliance with all
<br />applicable laws regulating construction, loning, and land developaent.
<br />
<br />Application is bereby lade to obtain a penit to do work and installation as indicated. I certify that no work or
<br />installation bas c~ced prior to issuance of a penit and that all work will be perforaed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developaent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governleDtal agencies laY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lUst take to be in colpliance. Sueb agencies include but are not lilited to:
<br />* Departlent of EnvirOllll!Iltal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater !reatlent
<br />* Southwest Florida Water Hanagl!lent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />* AIIY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />* Depart:lent of Health & Rebabilitative Services, EnvirOJlle!ltal Health Unit - Wells, Wastewater Treat:lent, Septic Yanks
<br />* US EnviroDlelltal Protection Agency - Asbestos abatl!lellt
<br />I also certify tbat, if fill laterial is to be used in Flood Zone "AU or "A, etc. ", it is understood that a drainage plan
<br />addressing a uCOIpeDSating volllle" will be sulmitted lIbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to penit.issuance.
<br />
<br />A penit issued sball 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 tecbnical codes, nor sball issuance of a penit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code, Every peIlit issued sball beCOle invalid
<br />unless the work authorized by such peIlit is cOlleDced ,dthin six IOnths of issuance, or if work authorized by the peIlit is
<br />suspended or abandoned for a period of sixlOntbs after the tile the work is cOllenced. One 90 day extension of tile, laY be
<br />allowed for the perlit 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 eaeb six IOnth period, or the project will be considered abandoned.
<br />WAIUUHG TO OWNER: YOUR FAILURE TO RECORD A NO'I'ICE OF COHMEIfCBMBN'l MAY RESULT IN YOUR PAYIIG 'NICE FOR IHPROVEHBH'lS TO YOUR
<br />PROPERft. IF YOU IN'lEHD TO OBTAIN FItWlCIHG, CONSUL! "IfH YOOR LBMDER OR D AftORm ORDING YOUR NO'I'ICE OF
<br />COHHEIICBHEH'f. JOBS UHDER $2,500 III VALUE DO 10'1' HEED TO RECORD DD POST A II10000ICE C II
<br />
<br />SIGJlATURE: OWHER OR AGEH'l
<br />
<br />SIGJlA!lJRE: C
<br />
<br />
<br />STATE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STATE OF FLORIDA
<br />coum 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 />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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