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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'lbe undersigned understands that this penit lilY be subject to 'deed restrictions' Ibieb lilY be lOre restrictive than City
<br />regulations. !be uildersigned assUle& responsibility for CCIIpliance lith any applicable deed restricti0D8.
<br />
<br />B.UNLICENSED, CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIfIIer baS. bired a contractor or contractors to undertake IOrt, they lilY 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 OIIDelanc1 CODtractor Iilr be
<br />cited for a lisc1eleaDor violation under state lal. If the 0IIIIer or intended contractor are uncertain as to Ifbat licensiDq
<br />reguirl!leDts lilY apply for the intendedlOrt, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the 0IIIIer bas bired a contractor or contractors, be is advised to have the contractor(s) sign portiODS of the
<br />'Contractor Sections' of this applicatioo for which they lill be responsible. If you, as the OlDer sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the IIOrt. If the contractor lisbes you to sign
<br />as contractor tbat lilY be an indication tbat be is not properly licensed and is not entitled to perlittiDg privileges in the
<br />City of Zepbyrbills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided lith a copy of 'Florida's construction Lien Law - lkIIeoImer's Protection
<br />Guide' prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is -.one other than the
<br />'OIfDer', I certify that I bave obtained a copy of the above described docUIent and pro.ise in good faith to deliver it to the
<br />'OlDer' prior to co.enCl!leDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIliltion in this application is accurate and that all IOrt lill be done in COIpliance lith all
<br />applicable 1_ regulating construction, loning, and land developleDt.
<br />
<br />Application is hereby lade to obtain a perllt to do IIOrt and installation as indicated. I certify that 110 IIOIt or
<br />installation bas CDl8Dced prior to issuance of a perlit and that all IIOfk li11 be perfOll8d to _t st:aDdards of all 1_
<br />regulating construction, City codes, loning regulations, and land develO(lll!J1t regulations in the jurisdictim. I also
<br />certify that I understand that the regulations of other goveruenW agencies lilY apply to the intended IIOfl, and that it is
<br />If responsibility to identify Ibat actions I lUst take to be in COJpliance. Such agencies include but are not liaited to:
<br />t DepartJent of EnvirOllll!lltal Regulation - Cypress Blyheads, letland Areas and EnvitollleDWly Sensitive Lands,
<br />lfater/last8later !reatJent
<br />t Southwest Florida later IlanageleDt District - lells, Cypress Baybeads, letland Areas, Altering laterCOllises
<br />t AllY Corps of Bngineers - Sealalls, Docks, lavigable laterways
<br />t DepartJent of Health i Rehabilitative Services, BnviIODl8Dtal Health Unit - lells, lastewater rreablent, Septic ranks
<br />t US BnvirODl8Dtal Protection Agency - Asbestos abatl!leDt
<br />I also certify that, if fIll Iilterial is to be used in Flood Zone lA' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'c~ating volue' lill be sulllitted lhich 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 lith the IIOrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball i88uance of a perlit prevent the Bullc1ing Official f~ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery pentt 188ued sball becoIe invalid
<br />unless the IIOrt authoriled by sueb penit is co.encecl1fithin sUlDDtbs of i88uance, or if IIOrt authoriled by the peIllt is
<br />suspended or abandoned for a period of 8il IODtbs after the tile the IIOfk is ~cecl. One 90 day 81tensloo of tile, ., be
<br />allOlfed for the perlit lith fee ebarge of $15.00. rhe 81tension shall be requested in Iriting to the Building Official. An
<br />approved inspection lUSt be logged during each sil IODth period, or the project lill be considered abaDlJoDed.
<br />IAlUtIIG !O (MIl: YOOR FAlLURI !O RECORD A IOIICE OF CCIlIIDCIIaI lilY RESULT II YOOR PAYIIG niCE fOR IIIPROVIIID!S !O YOOR
<br />PROPIRft. IF YOU II'DIID !O OB'IAII FIIAlCIIG, CONSUL! II!B YOOR LIIDIR OR D AnoRDY BlFORB RICORDIIG YOOR DICE OF
<br />allMllCIMBIIr. JOBS UIDIR '2,500 1M VALUE 110 101 IBID !O RECORD AID POSr A 'IOl'ICE OF ClJIIIIICIIID!'.
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<br />SrATI OF FLORIDA
<br />coum OF
<br />The foregoing instI'Ullent was acknowledged
<br />before me this , 19____ by .
<br />
<br />STArB OF FLORIDA
<br />coum OF
<br />The foregoing instrument was aCknowledged
<br />before me this , 19_ by
<br />
<br />who is personally know.o to ~ or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath. .
<br />
<br />who is personally know.o to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oiJth.
<br />
<br />(Signature)
<br />(Rame. Typed, Printed or Stamped)
<br />ROTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Rue Typed, Printed or Stuped)
<br />ROTARY PUBLIC
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