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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned UDder8taDds that tbis penit uy be subject to wdeed restrictl_- wbieb uy be .re restrictive than City
<br />reguJatlODl. !be undersigned assU188 responsibility for COIpliance witb any applicable deed restrictiOll8.
<br />
<br />B. UNLICENSED'CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe OImer bas bired a contractor or contractors to undertake IOrk, tbey uy be required to he liceD8ed in accordance tlitb
<br />state and local regulatiODl. If tbe contractor Is not licensed as required br lal, botb tbe DIller and contractor uy be
<br />cited for a lisd8leaDOr violation under state lal. If tbe OlDer or intended contractor are uncertain as to .bat liclDling
<br />reguiraents uy apply for tbe intended IOrk, tbey are advised to contact tbe City of Zepbyrhi11s Building Departlent, (813)
<br />788-6611.
<br />
<br />Furtberlore, if tbe DIller bas bired a contractor or contractors, be is advised to have tbe contractor(s) sign portiODS of tbe
<br />wContractor SeCtiODlw of this applicatioo for wbieb they lill be responsible. If JOU, as tbe DIller Sign as the contractor,
<br />you are inc1icating that JOU, ratber than tbe, contractor, are responsible for tbe IOrt. If tbe contractor lishes you to sign
<br />as contractor that uy be an indication that be is not properly liceD8ed and is not entitled to peraittlng privileges in tile
<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 litb a copy of wFlorida's COnstruction Lien Law - lkIIeoImer's Protection
<br />Guide- prepared by tbe Florida DepartJent of Agriculture and Consu.r Affairs. If tbe applicant is 80180II8 other than the
<br />wownerw, I certify that I bave obtained a copy of tbe above described docUIent and pro.ise in good faitb to deliver it to the
<br />wowner- prior to co.enct!llellt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infonation in tbis application is accurate and that all IOrk lill be done in COIpliance with all
<br />applicable Ius regulating construction, 1OIliDg, and land developlent.
<br />
<br />Application is hereby lade to obtain a perlit to do IOrt and installation as inclicated. I certify that no IOrk or
<br />installation bas ~ prior to i88uance of a pmit and that alllOrt lill he perfonecl to _t stan4ards of all 1_
<br />regulating construction, City codes, loning regulations, and land develO(lMl1t regulatiODS in the jurlBdicUoo. I also
<br />certify that I understand that the regulations of other gov8IDlental agencies uy apply to the intended IOrt, and that it Is
<br />If responsibility to identify wbat actiODS I lUSt take to be in COIpliance. Sueb agencies include but are not liBted to:
<br />I DepartJent of Invil'Olllelltal Regulation - Cypress Bayheads, Wetland Areas and Invil'Olllelltally SensiUve Lands,
<br />Water/llastellater 'Ireatlent
<br />I Soutlnteat Florida Water ManaQeleDt District - llells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />I lrJy Corps of Ingineers - Seawalls, Docb, lavigable Watenays
<br />I Departlent of Health i Rehabilitative Services, InvirOOllDtal Healtb Unit - Wells, Wastewater 'Ireaf:lent, Septic 'Ianks
<br />I US Invil'ODlelltal ProtecUon AgeDCJ - Asbestos abataent
<br />I also certify that, if fill IIterial is to be used in Flood ZOne wA- or wA,etc.w, it is understood that a drainage plan
<br />addressing a -COIpeII8ating vol.w lIill be sw.itted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit iBluance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with tbe IOrk and not as autbority to violate, cancel alter, or
<br />Bet aside any provisions of the technical codes, nor shall iBluance of a perlit prevent the Builc1ing Official fra. thereafter
<br />requiring a correction of errors in plans, CODltruction, or violatiODS of an, code. Ivery penU issued sball becme invalid
<br />unless the IOrt autborlled by sueb perlit is ~ced lithin sUlOIltbs of iBlIJaDC8, or if work autboriled by the perllt is
<br />suspended or abandoned for a period of sUlODtbs after the tile the IOrt is co.enced. ODe 90 day atensicm of tile, u, be
<br />allOlled for the perlit litb fee charge of tI5.00. !he atension shall be requested in writing to the BuildiDg Official. An
<br />approved inspecticmlll8t be logged during eaeb slllOl1tb period, or the project lill be considered abandoned.
<br />IfARRIffG '10 OIIIBR: YOUR PllLURI '10 BICOID I IO'IICH OF CClllllCllllfflIIY RISUL'I Iff YOUR PIYlffG 'filCH PUR 1IIPROVIIIIDS '10 YOOR
<br />PROPIR'lY. IF YOO InDO '10 OB'IIIJI FIUlCIIG, COISUL'IWI'IB YOUR LIIDIIl OR II I'I'IORIIY BI10RI RICORDIIG YOUJlIlO'lICH OF
<br />aJIIDCIIIIff'I. JOBS UlDIR. t2, 500 Iff VILOI DO 10'1 ffDD '10 RICORD IffD POSr I -IO'IICH OF CCJlllllCIIID'Iw.
<br />
<br />.8~.B,,$~
<br />SIGa : OIIIBR OR IGIIft'
<br />
<br />'&~~IlA41 d~'
<br />S 'lUll: tomIAC'IOR
<br />
<br />8'1A'II OF FLORIDA
<br />coum OF
<br />The foregoing instI'UIIeDt was acknowledged
<br />before me this , 19____ by
<br />
<br />SrA'II OF FLORIDA
<br />COODY OF
<br />The foregoing instl'Ullent was aCknowledged
<br />before me this , 19_ by
<br />
<br />wbo is personally known to .e or wbo bas
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />wbo is personally known to _ or wbo bas
<br />produced
<br />as identification and who did/did not
<br />take an oetb.
<br />
<br />(Signature)
<br />
<br />(Rue, Typed, Printed or Stamped)
<br />ROTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Rue Typed, Printed or Stuped)
<br />ROTARY PUBLIC
<br />
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