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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands tbat this perlit lay be subject to "deed restrictions" wbich JaY be lOre restrictive tban City .
<br />regulations. 'he undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe owner bas bired a contractor or contractors to undertake work, they lay 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 lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireJents Jay apply for the intended work, they are advised to contact the~City of Zepbyrhills BuIlding DepartJent, (813)
<br />788-6611.
<br />
<br />)
<br />
<br />FurtberlOre, if the owner bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />.Contractor Sections. of this application for whid! 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 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. I
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<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 .Florida's Construction Lien Law - HOJeOV:Der's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUJeI Affairs. If the applicant is sOleone other than the
<br />"owner", I certify that I have obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the
<br />"owner" prior to cOJJeJlcl!lent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforJation in tbis application is accurate and that all work will be done in cOJpliance with all
<br />applicable laws regulating construction, loning, and land developllent.
<br />
<br />Application is hereby Jade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has c-.mced prior to issuance of a perlit and that all work will be perfoCJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developllent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governJeJ1tBl agencies lilY apply to the intended wort, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />* Deparblent of KnviroDJen18l Regulation - Cypress Bayheads, Wetland Areas and EnviroOlen18lly Sensitive Lands,
<br />Water/Vastewater TreatJent
<br />* Southwest Florida Vater Hanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />* JrlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* Departlent of Health' Rehabilitative Services, KnvirODJeDtal Health Unit - Wells, Wastewater TreatJent, Septic Tanks
<br />* US BnvirODlental Protection Agency - Asbestos abateJent
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "COIpensating volUle" will be subJitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />
<br />A perlit issued sball be construed to be a license to proceed witb 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 perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becOle invalid
<br />unless the work authoriled by sucb perlit is cOlJenced within slllOnths of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of sil IOnths after the tile the work is coaenced. One 90 day extension of tlR, lily be
<br />allowed for the perlit with fee cbarge of $15.00. Tbe extension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned.
<br />WARMING TO OIlIER: YOUR FAILURE 'l'O RECORD A IOTICE OF COMMBICCBIIBU MAY RESULT IN YOUR PAYIIG DICE FOR IMPROVEMmS TO YOUR
<br />PROPERTY. IF YOU IUBMD TO OBTAII FIKAKCING, CONSULT IIITH YOUR LEIIDER OR AM AnORlIY BEFORB RECORDING YOUR NorICE OF
<br />COMMBNCBMBU. JOBS UNDER $2,50 N VALUE DO lOT IEED '1'0 RECORD AND POST A "lOT ICE OF COMMBICIlMIU".
<br />
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<br />SI : COURACTOR
<br />
<br />STATE OF FLORIDA
<br />coum OF .pI/ Sco
<br />The foregoing instrument was acknowledged
<br />before me this l)Ee.- .:3/ , 19.!1Z by
<br />
<br />)/EL,<'OJ.) 'ftY M AJJ
<br />who is persona ly known to me or ldl9 has
<br />"~ftrln~.cI
<br />as ideatificati6B and wbo-didjdid not
<br />
<br />take ~9'~
<br />(Signa ure)
<br />J! A7J.I LL,,~ A.J J B ..QoWN
<br />(Name Tjped, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />STATE OF FLORIDA
<br />coum OF tJA.<; t!-<)
<br />The foregoing instrument was acknowledged
<br />before me this:'lJI:;e 3t , 19 'f/_.by
<br />
<br />JJ~AJ'RYHMJ
<br />who is personally known to me gr wbo bas
<br />prodl1ced
<br />3S ideBtifisatiOB and who ~/did not
<br />take~ .. ~
<br />~-?L/ -fI- ,J C'-~
<br />(Signatur~ '
<br />. If-TJ-/ u.:=.. EAj v:. ..I3te-r17 )1\. j
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />l'~ PII~
<br />Q'\~ (,.. KATHL.EEN J BROWN
<br />.. W* My COn1mifllllon CC441)()29
<br />* . E;"pir.... Apr, 02. 199Q
<br />..~ JiI'"
<br />1", 0' f\~
<br />
<br />""l'~ PII~
<br />..'" fi <....
<br />~.~
<br />.,. ..~
<br />~ II, ,\0"
<br />
<br />KATHLEEN J BROWN
<br />My Commission CC44Q029
<br />Explr.. Apr. 02. 1lKla
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