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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />fbe undersignecl understands that this perlit IlaY be subject to 'deed restrictions' wbich llay be lOre restrictive than City
<br />regulatiOllS. !be undersigned asSUle& responsibility for cmpliance with any applicable deed restrictiODS.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIII1er bas bired a contractor or contractors to undertake lfOrt, they IIilY be required to be licensecl in accordance with
<br />state and local regulatiODS. If the contractor is not licensecl as requirecl by law, both the owner and contractor IIilY be
<br />cited for a lisdeleaDOr violation under state law. If the owner or intendecl contractor are uncertain as to wbat licensing
<br />requirellellu IlaY apply for the intended IIOrt, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611. .
<br />
<br />FurtberIore, if the OlOler bas birecl a contractor or contractoni, be is advisecl to bave the contractor(s) sign portions of the
<br />'Contractor SectiOllS' of this application for wbich they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the IIOrk. If the contractor wisbes you to sign
<br />as contractor that IlaY be an indication that be is not properly licensed and is not entitled to perlitting privileges in the
<br />City of lephyrbil18. ' . I
<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 providecl ,ith a copy of "lorida's construction Lien Law - JbIeoImer's Protection
<br />Guide' prepared by the 'lorida Departlent of Agriculture and ConsUl8l' Affairs. If the applicant is SOIeOIl8 other than the
<br />'OlOler', I certify that I have obtained a copy of the above described docuIent and p~ise in good faith to deliver it to the
<br />'owner' prior to c:c.enct8lt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all lfOrk will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developlellt.
<br />
<br />Application is hereby IIilcle to obtain a peIlit to do work and installation as indicated. I certify that no IIOrt or
<br />installation bas CDlenCecl prior to issuance of a pmit and that allllOrt will be perfoIJecl to .et standards of all laws
<br />regulating construction, City codes, loning regulations, and lanel develOplellt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gDVeIDlental agencies IIilJ apply to the intended wort, and that it is
<br />If responsibility to identify what actions I lUSt tate to be in COIIpliance. Such agencies include but are not lilited to:
<br />t Departlent of 8nviIOlllll!l1tal Regulation - Cypress Baybeads, Wetland Areas and 8nvirolll8lltaUy Sensitive Lands,
<br />Water/lfastewater !reatlent
<br />t Soutbwest 'lorida Water llanagell8Dt District - llells, Cypress Baybea4s, Wetland Areas, Altering Watercourses
<br />t lIlY Co[llS of lnQineers - Seawalls, Docks, lavigable Waterways
<br />t Depu1:lent of Health i Rehabilitative Senices, 8nviIOJ1lental Health Unit - Wells, Wastewater !reatlent, Septic !ants
<br />t US 8nvirODlental Protection Agency - Asbestos abatBl8Jlt
<br />I also certify that, if fill llaterialis to be used in 'lood Zone lA' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpen8ating vol_' will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issuecl 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 shall issuance of a perlit prevent the Building Official f1'Ol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery peIlit issuecl shall becoIe invalid
<br />unless the wort autborilecl by such peIlit is ~ced within sillODtbs of issuance, or if wort autborilecl by the peIlit is
<br />suspended or abanc10necl for a perioc1 of sil IODtbs after the tile the wort is co.enced. One 90 day 81tension of tile, IlaY be
<br />allowed for the perlit with fee charge of $15.00. !be 81tension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be loggecl during each sil IOIlth perioc1, or the project ,ill be considerecl abancloned.
<br />,WARlIIG !O~: YOOR '1ILUR1 !O RICORD AIO'I'ICI 0' C<>>fIlDCIIIBI! MAY RBSUL! II YOUR PAYIIG "'ICI FOR IMPROVIIIBI!S !O YOUR
<br />PROPIIm. I' YOU II!IIID !O OB!m FWlCIIG, COISOL! IIID YOUR LIIIDIR OR II AftORDY BBPORB RBCORDIIG YOUR IO!ICI OF
<br />COOIDCIIIII!. JOBS UJIDIR $2,500 II VALUI DO IO! lIED !O RBCORD lID POS! A 'IO!ICI OF COOIDCIIIBI!'.
<br />
<br />SIGIIA!URI: (lfllROI .IGIII!
<br />
<br />SIGIIA'fIJRI: CODRAC!OR
<br />
<br />SfAD 0' PLOIIDI
<br />COODY 0'
<br />The foregoing instrument was acknOWledged
<br />before me this , 19____ by
<br />
<br />SlAD OF PUlIDA
<br />cmm 0'
<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 OiJth.
<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 />(Rame Typed, Printed or Stuped)
<br />ROTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Ra.e Typed, Printed or Stamped)
<br />ROTARY PUBLIC
<br />
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