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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'fbe undersigned understands that this perlit lilY be subject to 'deed restrictions' "bieb I8Y be lOre restrictive than City
<br />regulations. 'fbe undersigned ass~ responsibility for cmpliance "ith any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIIIler bas hired a contractor or contractors to undertake work, they I8Y be required to be licensed in accordance "ith
<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 .isd_anor violation under state law. If the owner or intended contractor are uncertain as to "hat licensing
<br />requiruents I8Y apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
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<br />FurtheIlOre, if the OIIIler bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbieb they "ill be responsible. If JOU, as the OIfJler sign as the contractor,
<br />you are indicating that JOU, rather than the contractor, are responsible for the wort. If the contractor wishes JOU to sign
<br />as contractor that I8Y be an indication that be is not properly licensed and is not entitled to perlitting 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 "ith a copy of 'Florida's construction Lien La" - lkIIeoImer's Protection
<br />Guidell prepared by the Florida Departlent of Agriculture and ConsUll!I Affairs. If the applicant is SUJI80De other than the
<br />limmer', I certify that I have obtained a copy of the above described docUIent and prlllise in good faith to deliver it to the
<br />lIownerll prior to COIIeDcuent.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all work "ill be done in COIpliance "ith all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas CDlenced prior to issuance of a perlit and that all work "ill be perf OIled to _t stanc1arda 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 gOYeIlllental agencies I8Y apply to the intended work, and that it is
<br />.y responsibility to identify wbat actions I lUst take to be in COIpliance. Sueb agencies include but are not U.lited to:
<br />t Departlent of EnvirOlllelltal Regulation - Cypress Baybeada, Wetland Areas and Envirolllelltally Sensitive Lands,
<br />Water /Wastewater 'freablent
<br />t Southwest Florida Water Mana!Juent District - Wells, Cypress Baybea4s, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, Havigable Waterways
<br />t Deparblent of Health' Rehabilitative Services, InvirODleDtal Health Unit - Wells, Wastewater 'freatlent, septic 'fants
<br />t US InviI'OllleDtal Protection Agency - Asbestos abatuent
<br />I also certify that, if fill I8terial is to be used in Flood zone IIA' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'cOlpeJl8ating volUle' "ill be sublitted .bieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
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<br />A pertit issued shall be construed to be a license to proceed "ith the "ork 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 fl'Ol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall becDe invalid
<br />unless the work authoriled by sueb perlit is COIIeDced "ithin sillODthe of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work is ~ced. one 90 day 81tension of tile, lIy be
<br />allowed for the perlit "ith fee charge of $15.00. !be 81tension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sil IODth period, or the profect "ill be considered abandoned.
<br />WAIUIIIfG ro lMIR: YOUR FAILURE ro HlCORD A 10rICI OF COIIIIICIIIBIT MAY RlSUL! IH lOOK PAIIHG "'ICI FOR DIPROYIMIIIS 10 lOOK
<br />PROPBRrY. IF YOU III'fDIi 'f0 OBYIDI FUAICIHG, CG.'fSUL'f WID YOOR LOOIR OR All AnomY BIFOHI RICORDIHG YOOR DICE OF
<br />~f DIDIR $2,50011 VILlIlIlO 101' IIIIID to IIIIlllIlD UD POS'/ I "IOIICKIll' CIIIIIICIIIIIII". "-
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<br />SIGlAfORI: fJIIF,~ b:G \~~ ~.
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<br />1;
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<br />SIA'fE OF FLO~
<br />coum OF ~
<br />The foregoing instrument was acknowledged
<br />before me this /11 ~. 19 C;Y by
<br />
<br />.J)~ (J ~
<br />who is p ~~lY known to me or who has
<br />'produced dha~~~~
<br />as identification and who did/did not
<br />
<br />take ;n~d ~-fL
<br />(.Si~Ure) f 'rl-tf
<br />_ 0 e i/ ).. l in
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />I'l'""'"'" .fUIT MITt, Jfcrf. of Fror1ltJ
<br />
<br />... Com~';'''''''' f,v.-,'." "'~..l. J ~ 1"0,5
<br />p" ~MlIlf:;....r'.., .::....li"-:. S:J ~".""~ tu ,1;., ')' 7
<br />&lQnded Toru T101 f;.:in.. k'~iJ,-';W(:J IiI';..
<br />
<br />S'fAB OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19_____ 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 />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
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