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<br />COND1T10NS'. orJPEtuuT~AFFIDA VIT
<br />A. NOT1C! OF DJS!D RESTR1CTJ:ONS "I;NiN~li;. ,~." '.n
<br />the undersigned understands t~at tbl. petllt .a, be .ubJec~\jto~dtld.re8trittions- whicb .af be lOre restrictive than Cily
<br />regulation.. Ibi undirllgned a18U11. respoh8iblllt, tor COIPl1~ct ~llh in' applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTttACTOnS AND CONtRAcTOR RESPONSIBILITIES
<br />If the owner has hired a tofttractot or contractors to undertake work, they .ay be required to be licensed in accordance with
<br />state and local. ugul.Uon'~ If lIIe cootractor 18 not llc:enltc1 II t~lred by law, botb the owner and contractor .ay be
<br />cited tor a .1sd~ndr .lola~lon under Atati l&w. It the owner ur intended contractor are uncertain as to what licensing
<br />requirelentl II; applt tor the intended worl, the, Ire ad,lsed to contact the City of Zephyrbills Building Departlent, (813)
<br />788-661t.
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<br />Furtheriore, if the owner has hired a contractor or contractors, he IB advised to have the contractor(s) sign portions of the
<br />-contractor Sections' of lIIi. application for which they will b@ tesponBible. If you, as the ONDer sign as the contractor,
<br />you are indicating that you, rather than the contractor, art r@sponslble tor the worl. If the contractor wishes you to sign
<br />as contractor that la' be an indication that be is not properl, licensed and iB not entitled to per.itting privileges in the
<br />City of Zepbyrhill..
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<br />C. TRANSPORTAtION IMPACT F!ES AND UT1LITt CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN ~AW ' (CHAPTER 113. FLORIDA STATUTES, AS AMENDED)
<br />I certify that It the applicant, ba,e been provlded wlth a copy of -Plorida's Construction Lien Law - Hoaeowner's Protection
<br />Culde- prepared b, tbl 'lbrida Departlent of Agriculture and Conlu.er Affairs. If the applicant is so.eone other than the
<br />"owner-, I certif, that t ha,@ obtained a coPt of the abo,e described docuaent and pro.lse in good faith to deliver it to the
<br />"owner- prior to toIIent~nt.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlatlon in tbis application is accurate and that all work will be done in cOlpliance with all
<br />applIcable law8 regulating construction, loning, and land de,eloplent.
<br />
<br />lIppllcaUon II hereb, lade to '1bta1n a perin to do work and installation as indicated. I certify that no work or
<br />Installation hat toIIedcta frlbr to lssuahce ot a perllt ana that all work .111 be perfor.ed to .eel standards of all laws
<br />regulating conltruction, eit, tode., toning regulations, and land developaent regulations in the jurisdiction. I also
<br />certlf, that t underltan~ that the regUlations uf otber gottrhlental agentle. lay apply to tbe'intended work, and tbat it is
<br />If responsibility to Idefttlf1 what action. 1 .ust take to be,td cotPliance. Such agencies include but are not li.ited to:
<br />. DePlrtlent of Invironledtal Regulation ~ Cyprell Bsybeadl;Vetland Ar.as and Environaentall, Sensitive Lands,
<br />VaterfNaltewater frealjent
<br />A Southwest Florida Watet Managelent District .. Wells, rypte.. ba,beaas, Wetland Areas, Altering Watercourses
<br />i Ar.y Corp. of Inglneerl .. Seawall., Docls, la,igable Vaterwa,.
<br />. Deparllent of Healtb , Jebahl1Itatl,~ S~rtltei, .n,ltonaental Heaith Unit - NeIls, Wastewater treatlent, Septic Tanks
<br />i US IndrOJllt!dtal 'lotecUOJl Agency .. AlbeAtOll lIbatuent . '
<br />( a1Bo certlff th3~. If fill '3terlal II ~o b@ used In '1004 Ioh@ 'AI or -A,etc.-, it is understood that a drainage plan
<br />addressing d 'cOlptnBatlng '01018' will be subtltted which 18 prepared by a professional engineer registered in the state of
<br />Florida prior to perlit" I..uanc@.
<br />
<br />, A per.lt tSBued shall be conBtrued to be a licenBB to proceed with the work and not as authority to violate, cancel alter, or
<br />set asIde any pro,ilionl.of the technical,codel, nor shall iiluanee of a perlit prevent the Building Official frOl tbereafter
<br />reguirlng . corr@ction ~f error. tn planl, cOhBttucilon, ot 'lolatlons of any code. Ivery per.lt issued shall beCOle invalid
<br />unlesl the Work lIutborll@d bf luch per.lt il tolMence4 within 811 IDntbs of issuance, or if work authori.ed by the per.it is
<br />Ruspemled or abandoned for a perlod of sillORtbs afhr tbe U. the work is cOdenced. One 90 day eltension of li.e, I8Y be
<br />allowed tor tbe petllt w1th let charge of tI5.00. . 'he etledsion,lball ~e requested in writing to the Building Official. An
<br />Bpproved inlpectlon IUlt be togged during each Bix ~nth petlba, ot the project will be conuidered abandoned.
<br />V"RIIIIC to OlfIlR: YOUR tAlLURI '0 RIlCORD A lotteR or c....CIM8MT MAt RIlSULT IN YOUR PAYING TWICK FOR IHPROVEHIiJfTS TO YOUR
<br />PROPIlRtf. IF tOU 111I1110 to t$tAlJ' ,nAIClIG, COISULt "ltdttMt t'.DIlR OR AIf ATTORIIEY BIFORI RECORDING YOUR HOTlCR OF
<br />C_ICllMDTalJoBS U;l'OO tl LUI DO lot HIID to RltiJRIJ'Ad POS' A" ICI OF C;z(INCKM .
<br />
<br />~. ,I"~ ~~.
<br />- ~~. ~
<br />9IGRAtURIl. UIfIBR OR IGlllll . UR!: CONTRACTOR ~.
<br />~., ~.
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<br />STAT! or FLORIDA IJ A __ . '. SfArR 0' FLORIDA j} !Iff. i( )
<br />COUI" OF ty!j(' /) '\ coom OP ;1'1 '
<br />The foregoing in~strument wa~ ac~owledged :,Th~ foregoing instrument was ac~nfoWledged
<br />before me this J, ~1- , 19U by f before me t,~lB} ).. I ' 19 1_ by
<br />
<br />/dt..- ,A'}:'~L ". .'.' t2jJ~4 ,~A'lAc
<br />
<br />who s perB~ known to me or who has I "who ~perBolla.!!J known to me or who has
<br />prod . - . l)toduced ~
<br />~~idC!. fl. cat. i.... "di did 0 : ,"~. id@ntic~ti.... ~ "ho _ did/d'
<br />tak" 'oakf\. take O~~. ~ _-
<br />. 1...~-CV ~ ...-c t,."t~,;. ~
<br />
<br />(S ~atj,r@J 'I) ".lSi1,:~~~I~ (]o",. dJ
<br />
<br />(Name T ped, inted or stamped) ~Name Typ , ]Printed or stamped)
<br />NOTARY PUBLI ~ Randy Alle,n, Daniels . NOTARY. PUBLIC
<br />Notarv Public. State of Florida A Randy Allen Danl'els
<br />My Comm. Exolres J8n 18,2001
<br />No. CC614195 . My ~arv Public, Stat. of Florida
<br />Bonded Thru: Official Notary Service mm. Exolres J.n 1B 2001
<br />No. CC614195 I
<br />1 800 723-0121 Bonded Thru: Official Notary Service
<br />1-(8001 723-0121 .
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