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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />fbe undersigned understands that this perait laY be subject to Ideed restrictions I wbieb lilY be lOre restrictive than City
<br />regulations. !he undersigned assuJeS responsibility for co.pliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they laY 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 owner and contractor .ay be
<br />cited for a .isdelleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireElts laY apply for the intended work, they are advised to contact the City of Zepbyrbi11s Building Deparblent, (813)
<br />788-6611.
<br />
<br />Furthemore, if the owner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
<br />IContractor Sectionsl of this application for ldIieb they will be responsible. If you, as the lJII1er sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. 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 peraitting 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 IFlorida's Construction Lien Law - lIoIeoImer's Protection
<br />Guidel prepared by the Florida Departlent of Agriculture and COnsUller Affairs. If the applicant is SOII8OIle other than the
<br />lownerl, I certify that I bave obtained a copy of the above described docUIIent and prOlise in good faith to deliver it to the
<br />lownerl prior to COlll!llCl!IeDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoflation in this application is accurate and that all work will be done in co.pliance with all
<br />applicable laws regulating construction, loning, and land developent.
<br />
<br />Application is hereby lade to obtain a pemit to do work and installation as indicated. I certify that no IIOrt or
<br />installation bas CDlenced prior to issuance of a perait and that all wort will be perfomed to .et standards of all laws
<br />regulating construction, City codes, loning regulations, and land develo)llent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agencies IlaY apply to the intended wort, and that it is
<br />~ responsibility to identify wbat actions I lUst take to be in COIpliance. Sueb agencies include but are not laited to:
<br />t Departlent of EnvirOlllelltal Regulation - Cypress Bayheads, Wetland Areas and Envirolllelltally Sensitive Lands,
<br />Water /Wastewater freatlent
<br />t Southwest Florida Water Jlanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />t Deparbent of Health i Rebabilitative Services, Envirouental Health Unit - Wells, Wastewater freatlent, Septic fants
<br />t US EnvirOlllental Protection Agency - Asbestos abatellellt
<br />I also certify that, if fill llaterial is to be used in Flood Zone IAI or MA,etc.', it is understood that a drainage plan
<br />addressing a IcOllP8D8ating vol.' will be subllitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to pemit issuance.
<br />
<br />A perait issued sball be construed to be a license to proceed with the wort and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a pemit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perait issued shall becoIe invalid
<br />unless the work authorized by sueb pemit is COIIeDced within sillOnths of issuance, or if wort authorized by the pemit is
<br />suspended or abandoned for a period of sil IODths after the tHe the wort is COIIeDced. One 90 day l!Itension of taa, IlaY be
<br />allowed for the pemit with fee charge of $15.00. !be l!Itension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillODth period, or the project will be considered abandoned.
<br />WARMING !O omR: YOUR FAILORI !O RECORD I lIorICI OF COIMDCIIIIIIl' MAY RESULf III YOUR PIYIIG ftlICI FOR IMPROVBIImS !O YOUR
<br />PROPERft. IF YOU IIl'IBIID !O ODIIB FIIWICIIG, COJISOLf WIR YOUR LBIIDBR OR AI AnoRm BEFORE RICORDIIG YOUR DICE OF
<br />COMMDCIMIIf!. JOBS UKDBR $2,500 III. DE 00 lor lIDO !O RECORD AIfD POSf A "MorICE OF aJlHDCIIID'l".
<br />
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<br />
<br />SIGIA'fURI: COIl!llAC'f()R
<br />
<br />
<br />Sf An OF FLORIDI
<br />coum OF f?A c; C-p
<br />The foregoing instrument was acknowledged
<br />before me this ~, 19..:l.!:L by
<br />
<br />
<br />SfAfE OF FLORIDA
<br />coum OF fJA:S(7/)
<br />The foregoing instrument was acknowledged
<br />before me this , 19~ by
<br />
<br />
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<br />who is personally
<br />.pr _Q1Ieecf
<br />-as identificati9B and whocdidldid not
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<br />
<br />(Signa ure) ~
<br />k 4T7-1L ~ E AJ cT. RRcrWAJ
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />EL.
<br />who IS personally
<br />pl'sd.........d
<br />a. id__lif1eatien and who~did not
<br />take ~ath. . ~
<br />-.. ~..--Le~ -#. 'Jun A r.J
<br />(Sign~Ure)
<br />AIfI L-GcAJ' "<-7- J~eo-z..JAJ
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />KATHLE: '
<br />S~z,.;
<br />Uu Comm. '-,
<br />.." Comm.II cc t.;5". 1
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