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<br />CONUl'l'IONS OF PERMIT AFF'IDAVI'l'
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that 'this perlit lav be subject to "deed restrictions" which lay be lOre restrictive tban City
<br />regulations. The undersigned a881111es responsibility (or cOlpliance wilh any applicable deed restrictions.
<br />
<br />B. UNLICENS~D CONTUACTOHS AND CON'l'RA~'l'OH HESPONSIBILI'l'IES
<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, botb the ONner and contractor aay be
<br />cited for a lisdeleanor violation under state law, If the owner or intended contractor are uncertain as to wbat licensing
<br />reguirelents lay apply (or the inlended work, they are advised to contact the City of Zepbyrhills Building Departaent, (813)
<br />788-6611.
<br />
<br />Furtberlore, if the ollner bas hire.d a cuntractor or contractors, he is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections" of this application (or which 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 tbe contractor wishes you to lign
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to per.itting privileges in the
<br />City of Zepbyrbills.
<br />
<br />c. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES ,{
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<br />D. CONS1'HUC'l'ION LIEN L1\W (CIlAPTEH '113, FLOHIDA STA'rUTES, AS AMENDED) .
<br />I certify tba~the applicant, bave been provided with a copy of "Florida's Construction Lien Law - HOIeOIlDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and Consuler Affairs. If tbe applicant is sOleone other than the
<br />"owner", I certify that I have obtained a copy of the above described 11ucUlent and prolise in good faith to deliver it to the
<br />"owner" prior to couencelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in co.pliance with all
<br />applicable laMS regulating construction, zoning, and land developaent.
<br />,
<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 perf OIled to .eet standards of all 1118
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governlental agencies lay apply to tbe intended work, and that it is
<br />IY responsibility to identify what actions I lust lake to be in cOlpliance. Sucb agencies include but are not Ii.ited to:
<br />. DepartJent of Knvironlental Regulation - Cypress Bayheads, Wetland Areas and Bnvironaentally Sensitive Lands,
<br />Naler/Wastewater Treatlent
<br />t Southwest Florida Nater Hanageaent District - Wells, Cypress Bayheads, Netland Areas, Altering Watercourses
<br />. Ar.y Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health' Rehabilitative Services, Environlental Health Unit - NeIls, Wastewater Treatlent, Septic Tanks
<br />t US KnviroDlental 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 tbat a drainage plan
<br />addressing a "colpensating volllle" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit. issuance. _
<br />"'1,' ".,-
<br />
<br />.i.i~~~ " . ','r;"":';" .:', ,~~-, ,.:,::: : , "", ',,~
<br />. A perlit issued shall u,~~.tr.~~ a liceose t~pr~ lfit:Jl tbe Mork and no,t8S autbority.to v.iolale.CadCel alter, or
<br />set aside any provisio~:~f ~ the,tecJu.l\~Bl codea,..o,r Shall is,u~. of a peuit prevent the Building Official frol ther.-(J;8r
<br />requiring a cor[ection,q(~e[[o[~~:J,l1;pMns, construc;Uon, orvl01a\lons of any cocle. Ivery perlit iSBUed sball becoIe invalid
<br />unless the wod author~I~: bY8uCh.~.~erlit is cOII,encedwithin BixlOnths of issuance, or if IIOrt authorized by the perlll.ia
<br />suspended or abandoned tor a.perioe}. of six IOntha'after the tile the work is cOlElcod. One 90 day utwian of tile, aar he
<br />allowed for the perlit~~!Ub f~e.ga~m~of $15.00.~~e elltenlli~BIJ~all be request.ell in wriUng to the Building Official. An
<br />approved inspection lust,.balQgg~;i~qring each .i1,~tb pe~iodnl,lt the project ,111 be conlJidered abandoned.
<br />NARNIHG TO ONNER: YOUQi'~lLURB TO, l.CORD A NOTICK OFCO""EKCEHBN'f,.HAY RESULT IN ,YOUR PAYING !VICK FOR IKPRQVIllEUS TO YOUR
<br />PROPERTY. IF YOU lNTKNI) '1'0. 08TAn,Il"CIH , CONSULT WITH: YOUR ,tlIWBR OR AN ATTORNEY BEFORE RE Y ROrie! OF
<br />CO ENCIlHIlNT. JOBS UND.~;.'2,500 l,~ . NOTKaE~TO RECORD.. POST A "NOTICE OF COKHBNC
<br />
<br />
<br />
<br />
<br />was acknowledged
<br />,. '19_ by
<br />
<br />STATK OF FLORID~
<br />COUNTY OF ,...,as eo
<br />The foregoing instrument was aCl910wledged
<br />before me this I/+h ~ 19 '-jq by
<br />
<br />l!ex-OMe ,W- faAker
<br />who is personally known to me or who has
<br />pro~uced
<br />as.identification and who did/did not
<br />
<br />~ '1,~~ f) d.D<~
<br />
<br />~ ture) .. .[5
<br />... P liSt/.- 'j). rot-U~
<br />(Hame Typed, Ptinted or Stamped)
<br />NO'rA
<br />
<br />STATK OF FLORIDA
<br />COUNTY OF
<br />The foregoing instr:ument
<br />before me this .
<br />
<br />who is persOllallY.~l1oWll to ~ me or who has
<br />produced ,', .
<br />as identificatioQd.8.lld who',did/did not
<br />take an oath.
<br />
<br />~."L '
<br />
<br />(Signature)
<br />
<br />.
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
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