|
<br />~"'...u.LL.l.Vn.:> V... l'.t;HMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />. The lIndersigned understands Lhat Lhis perlit lay be subject to "deed restrictions" which lay be lOre restrictive than City
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictionso
<br />
<br />B 0 . UNLICENSED CONTRACTORS AND CON'I.RAC'I'On RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they lay 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 OWDer and contractor aay be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zephyrbills Building Departlent, (813)
<br />788-66110
<br />
<br />Furtherlore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for which they will be responsibleo If you, as the owner sign as the contractor,
<br />you are indicating that you, raUler than the contractor, are responsible for the work. If the contractor wishes fOU to sign
<br />as contractor that lay be an indication that he is not properly licensed and is not entitled to peflitting privileges in the
<br />City of Zephyrbills.
<br />
<br />Co TRANSPORTATION IMPACT FEES AND U'fILITY CONNECTION FEES
<br />
<br />I l
<br />,
<br />
<br />Do CONSTRUC'I'ION LIEN M\W (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 _ HOIeOMDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If tbe applicant is sOl8ODe 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 cOllenceaent.
<br />
<br />E. CONTRACTOR IS/OWNER'S AFFIDAVrf
<br />I certify tbat all the inforlation in tbis application is accurate and tbat all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />I
<br />
<br />Application is hereby lade to obtain a perlit to do work and instailation as indicatedo I certify that no worl or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perfofled to leet standards of all law8
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdictiono I also
<br />certify that I understand that the regulations of other governtental agencies aay apply to the intended wort, and that it is
<br />IY responSibility to identify what actions I lUSt take to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />I Departlent of EnviroDlental Regulation,- Cypress Bayheads, Wetland Areas and HnviroDlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />I Southwest Florida'Water Hanag8lent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />I ArlY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />I Departlent of Healtb & Rehabilitative Services, Environtental Healtb Unit - Wells, Wastewater Treallent, Septic Tanks
<br />I US BnviroDlental Protection Agency - Asbestos abateaent
<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 "cOlpensating volUle" will be sublitted wbicb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit, issuanceo
<br />
<br />. A perlit issued sball be construed to be a license to proceed witb tbe work and not as autbority to violate, cancel alter, or
<br />set aside any provisions of tbe technical codes, nor sball is~u~nce of a perlit prevent the Building Official IrUl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Hvery pBrlit issued sball beCOle invalid
<br />unless the work authorized by such perlit is cOllenced within six IOntbs of issuance, or if work autboriled by the peIllt is
<br />suspended or abandoned for a period of sil IOnths after tbe tile the worl is cOllencedo One 90 day 81tension of tile, IiY be
<br />allowed for the perlit with fee cbarge of $15000. Tbe extension shall be requested in writing to the Building Offlcialo An
<br />approved inspection lust be logged during eacb six IOntb period, or tbe project will be considered abandoned.
<br />WARKING TO OWIER: YOUR FAILURB TO RBCORD A 10TICH OF COHHHKCBHBIT MAY RBSULT 11 YOUR PAYING nlCl FOR IMPROVEllBIl'S TO YOUR
<br />PROPIRTY. IF YOU INTEND TO OBTAII FIIAICING, COISULT WITH YOUR LBNDIR OR AN AnORllY BIFORB RICORDIIG YOUR 1fOlICB OF
<br />
<br />aMlC~~:~~ to RlCURD AID MWrA:I~~:~~
<br />
<br />SIGlnUR~:(/~h01rAGINT 'p/kJl- C"o~r;(, s~:cONiRACTOR P'+Utr (~~uolt
<br />
<br />, I
<br />
<br />STATH OF FLORIDA
<br />COUHlY OF
<br />
<br />f:t6CO
<br />
<br />The foregoing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<br />
<br />//f'SC:()
<br />The foregoing instrument was aCknowledged
<br />before me this , 19 by
<br />
<br />STATB OF FLORIDA
<br />COUITY OF
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification an,~d, ~ w, 0 did/did not
<br />take an oath~t--{/ ~
<br />
<br />(Signature)
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oatho,i~ ~~
<br />
<br />(Signature)
<br />
<br />
<br />H
<br />MY COMMISSION' CC 451416
<br />EXPIRES: May 13. 1999
<br />Bonded TImI NotIIy PubIc lIndIrwlflIrI
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />KEITH CORREIA
<br />MY COMMISSION' CC 451416
<br />~RES:May13.1999
<br />Bonded lllru NotaIy PubIc ~
<br />
|