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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this penit lilY be subject to "deed restrictions" Ibich lilY be lOre restrictive than City
<br />regulations. !be undersigned asSUJe8 responsibility for ~liance lith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the Dlmer bas bired a contractor or contractors to undertake IOrt, they lilY be required to be licensed in accordance lith
<br />state and local regulations. If the contractor is not licensed as required by lill, both the mmer and contractor lilY be
<br />cited for a lisdeleanor violation under state lal. If the OIfI1er or intended contractor are uncertain as to wbat licensing
<br />requireleDts lilY apply for the intended IOrt, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788.6611.
<br />
<br />FurtherlOre, if the Dlmer has bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for Ihich they lill be responsible. If JOU, as the mmer sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the IOrt. If the contractor lisbes JOU to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to penitting 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, bave been provided lith a copy of "Florida's Construction Lien La1r - lbIeoImer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUll!I' Affairs. If the applicant is SOMODe other than the
<br />"01IIlern, I certify that I have obtained a copy of the above described docUIent and pralise in good faith to deliver it to the
<br />n01lllern prior to COII8DC8leDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infollation in this application is accurate and that all IOrt lill be done in COIpliance lith all
<br />applicable Ian regulating construction, loning, and land deve1Op1ent.
<br />
<br />Application is bereby lade to obtain a penit to do IIOrt and installation as indicated. I certify that no IOrt or
<br />installation bas cc.lenced prior to issuance of a penit and that all IOrt lill be perfolled to teet standards of all lil1l8
<br />regulating construction, City codes, loning regulations, and land develOplent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverD.lental agencies lilY apply to the intended 1fOIt, and that it is
<br />IY responsibility to identify Ibat actions I lUst take to be in COIpliance. Such agencies include but are not liaited to:
<br />t Departlent of EnvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and InvirolllelltaIly Sensitive Lands,
<br />Water /Wastelater Treatlent
<br />t Soutlnfest Florida Water Manaqelellt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t A[If Corps of Inqineers - Sealalls, Docks, Mavigable Waterways
<br />t Departlent of Health' Rehabilitative Services, InvirODlental Health Unit - Wells, Wastelater Treatlent, Septic Tanks
<br />t US InvirODll!lltal Protection Igency - Asbestos abateleDt
<br />I also certify that, if fill laterial is to be used in Flood Zone nA" or DA,etc.", it is understood that a drainage plan
<br />addressing a DCOIpenSating volue" lill be sulllitted Ibich is prepared by a professional engineer registered in the State of
<br />Florida prior to pellit issuance.
<br />
<br />A Perlit issued shall be construed to be a license to proceed lith the IOrt and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a penit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCOle invalid
<br />unless the IIOrt authoriled by such penit is COII8DCed litbin sillODths of issuance, or if IIOrt authoriled by the perlit is
<br />suspended or abandoned for a period of sil IOnths after the till! the IOrt is COII8Dced. One 90 day l!Itension of tile, lily be
<br />allOlfed for the penit lith fee charge of $15.00. Tbe l!Itension 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 abandoned.
<br />WmUG 'fO (MfER: YOUR FIILURI 'fO RICOHO I MorlCH OF COIIDCIIIID' lilY RESULf 1M YOUR PIYIMG DICE FOR DIPROVIIIII!S TO YOUR
<br />PROPBRft. IF YOU IIDlID 'fO OmAIM FIIIDCIMG, COISOLT WI'IH YOUR LBIIDER OR D IrroRDY BBFORB RICORDUG YOUR DICE OF
<br />COMMBMCEHD'l. JOBS UNDER '2,500 1M VALUE DO lor ffDD TO RECORD UD POST I "MorICH OF C<IIIDCIIIEKf..
<br />
<br />SIGJIlfURI: (MIIR OR IGBlI!
<br />
<br />SIGJI1!UR1: COURAC'fOR
<br />
<br />STAfB OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknOWledged
<br />before me this , 19____ by
<br />
<br />STATE 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 />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
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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