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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />rhe und!rsigned understands that this perin ~y ~ subject to 'deed restrictions' which lay be lOre restrictive than City
<br />regulatIons. the undersigned USUles responsIbilIty for COIpliance with any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has bired a contractor or contractors to undertue work, they MY 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 lisd_anor violation under state lalf. If the OIfIler or intended contractor are uncertain as to wbat licensing
<br />requireJeDts lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Deparllent, (813)
<br />788-6611.
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<br />FurtheIlOre, if the owner has bired a contractor or contracton, be is advised to ha'e the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for whieb they will be responsible. If fOu, as the owner sign as the contractor,
<br />you are indicating that fOu, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign
<br />as contractor that MY be an indication that he is not properly licensed and is not entitled to peraitting privileges in the
<br />City of Zepbyrhills. \
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<br />t
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<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 'Florida's Construction Lien Law _ lkIIeoImer'. Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is SOEODe other than the
<br />'mmer', I certify that I have obtained a copy of the above described clocUIent and pIOlise in good faith to deliver it to the
<br />'owner' prior to C~CeJeJlt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation 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 Mde to obtain a perlit to do Ifort and installation as indicated. I certify that no work or
<br />installation bas ~ced prior to issuance of a perlit and that all Iork will be perfolled to .et standards of all laws
<br />regulating construction, City codes, loning regulations, and land developll!Dt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agencies lilY apply to the intended wort, and that it is
<br />If responSibility to identify wbat actions I lUSt take to be in COIpliance. Such agencies include but are not liJited to:
<br />t Deparl:lent of EnviroDlN!l1tal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water /Ifastewater treatJent
<br />t Southwest Florida lIater Jlanageant District - Wells, Cypress Haybeads, lIetland Areas, Altering Watercourses
<br />t ArIy Corps of Engineers - Seawalls, Docks, Ravigable Waterways
<br />I DepartJent of Health' Rehabilitative Services, EnvirODlental Health Unit - lIel1s, lIastewater treallent, Septic tanks
<br />t US EnvirODl8Dtal Protection Agency - Asbestos abateJellt
<br />I also certify that, if fill uterial is to be used in Flood Zone 'A' or 'A, etc. ., it is understood that a drainage plan
<br />addressing a lCOIpeDSating vol_I will be subJitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A pertit 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 technical codes, nor sball issuance of a perait prevent the Building Official fIOl thereafter
<br />requiring a correction of errori in plans, construction, or violations of any code. Ivery perait issued shall becoJe invalid
<br />unless the wort authoriled by sucb Perlit is c~ced within sil IODths of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of sil IODths after the tile the vork is ~cec1. One 90 day extension of tile, lay be
<br />allowed for the perlit with fee charge of $15.00. tbe extension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eacb sil IODth period, or'the project lIill be considered abandoned.
<br />"ARIIUG ro (MER: YOUR FIILURI '10 RECORD A RatlCE OF COIIIBIICIIIm MAY RESULt II YOUR PAYIIG niCE POR IIIPROVIIIDfS ro YOUR
<br />PROPERlY. IF YOU IIItIND to OBtlll FlNAlCIIG, COlSULt II'lH YOUR LDDBR OR AN AnoRIBY BBPORB RICORDIRG YOUR IOrICE OF
<br />-. JllIIB IIIDIR 12 II YILIIlIlllIlllr IIiID 10 IIIIlDlD ~ POSr A "IllrIClIll ~..
<br />
<br />
<br />~
<br />/' SIGIA'IURIl: CO R
<br />
<br />
<br />srAR OF FLORIDA
<br />coum OF f' A Sc {/
<br />Tbe foregoing instrument was acknowledged
<br />before me this l.Js<:.. / , 19~ by
<br />
<br />IV E)..5oIJ 7? Y M A IV
<br />wbo is personally known to me cr wile lias
<br />pt:oQueed
<br />"as ideBtifieatioB and wbo 4i4l/did not
<br />tak!! --'" oa~b~ I' ~
<br />::A2.:T ~~-fj' ~o~
<br />(Signature) .
<br />KATH t..-i:€tJ v: J3l?ovJ,J
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />SrArE OF FLORIDA
<br />COUI!Y OF "pAc5cO
<br />Tbe foregoing instrument was acknowledged
<br />before me this~. J , 19~ RY
<br />
<br />AI &LSo IV tcY U/f AJ
<br />wbo is personally known to me 81' wile has
<br />prodtu::ed
<br />as identifieatiOD and wbo 4idtdid not
<br />
<br />take ~ fl.&~
<br />(Signature)
<br />k4/H'-~ v:. J3R"NAl
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />:\~l\Y Pile
<br />.~ n,~~
<br />~~~
<br />"" ~~
<br />~ OF f~\\
<br />
<br />KATHLEEN J BROWN
<br />My Commission CC....9029
<br />expires Apr. 02,1999
<br />
<br />:\~l\Y Pile
<br />.\\,0. .......
<br />~.~
<br />
<br />.,..... OF F~6'
<br />
<br />KATHLEEN J BROWN
<br />M)r Oommlnion CO....9029
<br />..".. Apr. 02, 18Qe
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