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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that tbis perlit lilY be subject to Ideed restrictions" wbich lily be lOre restrictive than City
<br />regulations. !be undersigned assUIeB responsibility for cmpliance witb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe owner bas bired a contractor or contractors to undertake wort, tbey tay be required to be licensed in accordance witb
<br />state and local regulations. If tbe contractor is not licensed as required by law, botb tbe mmer and contractor lilY be
<br />cited for a .isdl!leBDor violation under state law. If tbe mmer or intended contractor are uncertain as to wbat licensing
<br />reguireteDts tay apply for tbe intended work, tbey are advised to contact tbe City of Zepbyrbills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtberlOre, if tbe owner bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of tbe
<br />.Contractor Sections I of tbis application for wbich tbey will be responsible. If JOU, as the OIIIIer sign as tbe contractor,
<br />you are indicating that JOu, rather than tbe contractor, are responsible for tbe work. If tbe contractor wisbes you to sign
<br />as contractor that lily be an indication that be is not properly licensed and is not entitled to pertitting 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 tbat I, the applicant, have been provided witb a copy of IFlorida's Construction Lien Law - lkIIeolmer's Protection
<br />Guide" prepared by tbe Florida Departlent of Agriculture and Consuter Affairs. If tbe applicant is SOJIl!ODe otber than tbe
<br />"owner", I certify that I bave obtained a copy of tbe above described dOCUleDt and prOtise in good faitb to deliver it to tbe
<br />"owner" prior to coaenCl!leDt.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all tbe inforJation in tbis application is accurate and that all work will be done in cOlpliance witb all
<br />applicable laws regulating construction, loning, and land developteDt. .
<br />
<br />Application is hereby tade to obtain a pertit to do work and installation as indicated. I certify tbat no wort or
<br />installation bas' ~ced prior to issuance of a perlit and that all wort will be perforted to teet stanc1ards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in tbe jurisdiction. I also
<br />certify tbat I understand that tbe regulations of otber governtental agencies tay apply to tbe intended 1IOI't, and that it is
<br />If responsibility to identify wbat actions I lUSt tate to be in coapliance. Such agencies include bot are not laited to:
<br />t Departlent of EnvirOllll8lltal Regulation - Cypress Baybeads, Wetland Areas and InviroDlentally Sensitive Lands,
<br />Water /Wastewater !reatlent
<br />t Southwest Florida Water JlaDagl!lellt District - lIells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArtY Corps of Engineers - Seawalls, Docks, Xavigable Watenrays
<br />t Depart:lent of Healtb i Rehabilitative Services, EnvirOJlleDtal Healtb unit - Wells, Wastewater !reatlent, Septic !ants
<br />t US EnvironteDtal Protection Agency - Asbestos abatl!lll!llt
<br />I also certify that, if filllilterial is to be used in Flood Zone IAI or IA,etc. I, it is understood tbat a drainage plan
<br />addressing a ll3peDSating volutel will be subtitted which is prepared by a professional engineer registered in tbe State of
<br />Florida prior to perlit issuance.
<br />
<br />A pemit issued sball be construed to be a license to proceed witb tbe wort 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 tbe Building Official frot tbereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall beCOle invalid
<br />unless tbe wort authoriled by such pertit is ~ced witbin sillOnths of issuance, or if IIOrt authoriled by the perlit is
<br />suspended or abandoned for a period of sil IOnths after tbe tite tbe 1101'11 is ~ced. One 90 day utension of tile, lilY be
<br />allOlfed for tbe pertit witb fee charge of $15.00. !be utension shall be reguested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sil IODtb period, or tbe profect ,ill be considered abandoned.
<br />IIAR1lING 'fa (Jflf!R: YOUR FAILURE 'fa RlCORD A mICE OF ctIlMDCEIlm MAY RESUL! IX YOUR PAYIXG niCE FOR DIPROVIIIIOS 'fa YOUR
<br />PROPER'fY. IF YOU IIIUIID 'fa OBlAIX FIMAlCIIG, COISULf WID YOUR LIJIDIR OR 11 AftOIIRIY BlFORI RECORDING YOUR DICE OF
<br />COMMEXCEMBRf. JOBS OlDER $2,500 IX VALUE DO NO! tIUD 'fa RECORD AND POS! A 'mICE OF COIIIIfCBlllll!'.
<br />
<br />
<br />sti/lnJj.t!-.fr?
<br />
<br />
<br />SfA!E OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S!A'fE 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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