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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this pel'lit laY be subject to .deed restrictions" wbich lay be lOre restrictive than City
<br />regulations. !be undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertake work, they lay be required to he licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lilY be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zepbyrhills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections. of this application for wbich 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 wort. 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.
<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, have been provided with a copy of .Florida's Construction Lien Law - RlIIllOlIIIer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is ~one other than the
<br />"owner", I certify that I bave obtained a copy of the above described dOCUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to cOllBDceaent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable law8 regulating construction, loning, and land developleDt.
<br />
<br />Application is hereby Jade to obtain a perlit to do work and installation as indicated. I certify that no IIork or
<br />installation bas ~ced prior to issuance of a perlit and that all work ,ill be perfoIJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governtental agenCies laY apply to the intended wort, and that it is
<br />If responsibility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />t Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater !reatlent
<br />t Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departtent of Health & Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater !reatlent, Septic tants
<br />t US InvirODll!Jltal Protection Agency - Asbestos abatetent
<br />I also certify that, if fill Jaterial is to be used in Flood Zone "A. or "A,etc.., it is understood that a drainage plan
<br />addressing a .COI(I8Ilsating volUl8" ,ill be subtitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to pel'lit issuance.
<br />
<br />A pe,rtit issued sball be construed to be a license to proceed ,ith 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 fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every Pl!I1lit issued shall becoe invalid
<br />unless the IOrk authoriled by such pel'lit is COII8Dced within sillODtbs of issuance, or if lork authoriled by the pl!I1lit is
<br />suspended or abandoned for a period of sillOntbs after the tile the IOrk Is COMeJlced. One 90 day utension of tile, IIY be
<br />allowed for the perlit IIith fee charge of '15.00. !be utension shall be requested in writing to the.Building Official. An
<br />approved inspection lUSt be logged during eacb sillODth period, or the project will be considered abandoned.
<br />WARNING TO OIlIER: YOUR FAIWRE TO RECORD A NOIlCE OF COIIIfDCEIIm MAY RESULT IIf YOUR PAYING DICE FOR IMPROVIIIIftS fO YOUR
<br />PROPIIIfY. IF YOU IJIIBND to OBtAIM FlIlARCIMG, COIfSULt Ium YOOR LlRDIR OR AI AnoRRBY BBFORE RBCORDIMG YOUR IfOfICll OF
<br />COMKENCBIIBNf. JOBS UlfDIR' $2,500 1M VALUE 00 NOt IfDD to RECORD AIfD POSt A "DICE OF ClIIHDCBHIIff".
<br />
<br />
<br />rtr }1(0 lt~('J.c Ji)Y\
<br />SIGMAfURI: OIIIfER OR Iff
<br />
<br />
<br />SIA'lE OF FLOR~ !..I<
<br />COUIIfY OF
<br />The foregoing instrument was acknowledged
<br />before me this ~ / , ~01 by
<br />
<br />tI1l { k-~ (.fl J/l c. kS O/lJ
<br />who is per onallv known to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />~.~UJ~
<br />(Sign~ture)
<br />
<br />~~ O~/LORIDA~ / I<
<br />The foregoing instrument was acknowledged
<br />before me this c:;; , ~ 7 by
<br />If); { /; <IJ II of 3Ac Ks u/V
<br />who is personally kn~ to me or who has
<br />produced
<br />as identification and who did/did not
<br />ta~~l~~~ Wd1;;~
<br />(Si ature)
<br />
<br />(Name Typed
<br />NOTARY PUSL
<br />
<br />
<br />orFrs~
<br />~ Notary Public . State of FIclIIdI
<br />. \My CommlSSIOf' EJPIIllS Sel' 18. 2010
<br />~~l CommtSSlor II DO 593146
<br />\\.~ 8of1d~ 'i. '~,.' '4 "'''!;Jrv AIIft.
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