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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this peIlit lilY be subject to 'deed restrictions" ,bieb lily be lOre Iestrictive than City
<br />regulations. !be undersigned asSUle& responsibility for COIpliance lith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIfIIer bas bired a contractor or contractors to undertake IOrk, they laY be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by la" both the 0IIIIer and contractor lilY be
<br />cited for a lisdel8anor violation under state law. If the owner or intended contractor are uncertain as to Ifbat licensing
<br />reguirl!leDts lilY apply for the intended IOrk, they are advised to contact the City of Zepbyrbills 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 whieb they ,ill be responsible. If you, as the OIfIIer sign as the contractor,
<br />you are indicating that you, lather than the contractor, are responsible for the IIOrt. If the contractor ,isbes you to sign
<br />as contractor that laY be an indication that be is not properly licensed and is not entitled to penitting pri,ileges 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 lith a copy of 'Florida's Construction Lien Law - HaIeoImer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and COnsUler Affairs. If the applicant is 8OI8ODe other than the
<br />"owner", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"OIfIIer" prior to co.enCl!IeDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all wort ,ill be done in COIpliance ,ith all
<br />applicable lalB regulating construction, zoning, and land develOpleDt.
<br />
<br />Application is hereby lade to obtain a pelllit to do IIOrk and installation as indicated. I certify that no IOIk or
<br />installation bas <<DIeDcecl prior to issuance of a perlit and that allllOlk ,ill be perforled to .et standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agencies lilY apply to the intended lOll, and that it is
<br />If responsibility to identify what actions I lUSt take to be in COIpliance. Such agencies include but are not luited to:
<br />t DepartJent of EnvirODleDtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDleDtally Sensitive Lands,
<br />Water /lfast8later !reatJent
<br />t Soutb,est Florida Water Hanagl!leDt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t Al1Iy Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />t DepartJent of Health i Rehabilitative Services, BnvirODleDtal Health Unit - Wells, Wastewater !reatJent, Septic !anks
<br />t US BnvirODlental Protection Agency - Asbestos abat8leDt
<br />I also certify that, if fill laterial is to be used in Flood Zone "A' or "A,etc.l, it is understood that a drainage plan
<br />addressing a '~ating volUle" ,ill be sublitted ,bich is prepared by a professional engineer registered in the State of
<br />Florida prior to pelllit issuance.
<br />
<br />A peIlit issued shall be construed to be a license to proceed lith the IOrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official fIOI thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall beCClle invalid
<br />unless the IOrk authoriled by such pelllit is COIIllDced within sillOnths of issuance, or if IIOrk authorized by the peIlit is
<br />suspended or abandoned for a period of six IODths after the tile the work is couencecl. One 90 day extension of tile, lilY be
<br />allowed for the peIlit lith fee ebarge of $15.00. !be extension shall be requested in writing to the. Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or the project ,ill be considered abandoned.
<br />WARlUG !O (JIIR: YOUR FAILURE !O RECORD A IO!ICE OF aJIIIICEIIDl' BY RESUL! II YOUR PAYIHG !lICE FOR IIIPROVIIID1'S !O YOUR
<br />PROPmY. IF YOU III'IDD !O OB'lAII FIIAICIIG, COISOL! WID YOUR LBIIDIR OR AI AftORDY BEFORE RECORDIIG YOUR IfO!ICI OF
<br />momlCEHM. JOBS OlDER $2,500 II VALUE DO IO! mD !O RECORD AID POS! A 'IO!ICE OF crJIMBICBIIII!".
<br />
<br />.r~~~'<-~L<O
<br />SI !URI: (JJIR AGm
<br />
<br />~~Lv---
<br />
<br />S'l'A!E OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S!A'fE OF FLORIj)I-~
<br />ComrrY OF . C-o
<br />The foregoing inJtrument was acknowledged
<br />before me this ~ I L/ , 19 qL{ _ by
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />who is personally kn.\\'t.WI\~ 0:. f. ..IlA k_
<br />od 8d ,~,' R "r A '~'"
<br />1'1. u"'" ,';-' J.. ....' '
<br />
<br />(Signature)
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />llI- .".....
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