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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A.- NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to .deed restrictions" whicb lay be lOre restrictive tban City
<br />regu~ations. the undersigned assUles responsibility for cOlpliance witb any applicable deed restrictions.
<br />
<br />B_ UNLICENSED CONTRACTORS AND CONTRACTOR 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 owner and contractor lay be
<br />cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requireaents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner has hired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections. of this application for whicb they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating tbat you, rather tban the contractor, are responsible for tbe work. If tbe contractor wishes 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.
<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 .Plorida's Construction Lien Law - HOleowner's Protection
<br />Guide" prepared by the Plorida Departlent of Agriculture and Consuaer Affairs. If the applicant is sOleone other than the
<br />"owner", I certify that I bave obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the
<br />"owner" prior to couenceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in tbis application is accurate and that all work will be done in cOlpliance witb all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOllenced prior to issuance of a perlit and that all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveI1llental agencies lay apply to the intended work, 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 />* Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and Environaentally Sensitive Lands,
<br />Water/Wastewater treatlent
<br />* Southwest Florida Water Manageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />* ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* Deportlent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater treatlent, Septic tanks
<br />* US EnviroDlental 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 issuance.
<br />
<br />A perlit issued sball be construed to be a license to proceed witb tbe work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOt 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 authorized by such perlit is cOllenced within sil IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six IOntbs after the tile the work is coaenced. One 90 day l!Itension of tile, laY be
<br />allowed for the perl)t with fee charge of $15.00. the extension shall be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eacb sil IOnth period, or the project will be considered abandoned.
<br />WARNING TO OIINER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT HAY RESULT IN YOUR PAYING twICE FOR IMPROVEMENTS TO YOUR
<br />PROPERTY. IF YOU INTEND TO OBTAIN PINANCING, CONSULT WITH YOUR LENDER OR All ATTORBBY BEFORE RECORDING YOUR NOTICE OF
<br />COHHENCEHENT. JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COtIMBNCEMENT..
<br />
<br />~ ~ ~~~~~
<br />SIGNATURE: OWNER OR AG NT
<br />
<br />"""-
<br />
<br />----s:._~~~
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF Hernando
<br />The foregOing instrument
<br />before me this June 25,
<br />
<br />was acknowledged
<br />, 19~ by
<br />
<br />STATE OF FLORIDA
<br />coum OF Hernando
<br />The foregOing instrument
<br />before me this- June 25
<br />
<br />SaIlUlel R. Pearson
<br />who is personally known to me or who has
<br />produced
<br />as identification and who ~/did not
<br />~.! ke. a n oath. ~ 0-
<br />--- ()~. ~ I~A. ~"-j~
<br />19nature) ~
<br />
<br />(Name ~;~~d, M pr7rt~~ or Stamped)
<br />NOTARY PUBLIC
<br />
<br />was acknowledged
<br />, 19~ by
<br />
<br />Samuel R. Pearson
<br />who is personally known to me or who has
<br />produced
<br />as identification and who~/did not
<br />t~k o~t~ (\
<br />~~~-^~~ -
<br />( 1 nature) ~
<br />Helen M. Crosby
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />p..~V P{J~ OFFICIAL NOTARY SEAL
<br />0'" -ff'(., HELEN .. CROSBY
<br />~.1 ~ CO....ISSION NUMBER
<br />~ <:(' CC3$1282
<br />-y~ ~ "Y CO....ISSlON EXP.
<br />:(' O;:J"'O
<br />
<br />
<br />..\\V P{J~ OFFICIAL NOTARY SEAL
<br />0" ~ HELEN .. CROSBY
<br />~.- ~ CO....ISSION NUMBER
<br />~ <:(' CC3e1282
<br />-y~ ~ lilY CO....ISSION EXP.
<br />~ OFf:,.O
<br />
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