|
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />rbe undersigned understands that this pemit lily be subject to Ideed restrictions I wbieb lily be lOre restrictive than City
<br />regulations. !he undersigned asSUle& responsibility for cmpliance with any applicable deed restrictiODS.
<br />
<br />B. UNLICENSgp CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OlDer bas bired a contractor or contractors to undertake wort, they lilY 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 ower and contrac. lilY be
<br />cited for a lisdeleanOr violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireaenu lilY apply for the intended wort, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />IContractor SectiODSI of this application for wbieb they will be responsible. If you, as the OlDer sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor ,ishes you to sign
<br />as contractor that lily be an indication that be is not properly licensed and is not entitled to perJit.ting 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 AMBHDED)
<br />I certify that I, the applicant, have been provided with a copy of IFlorida's construction Lien Law - Imeolmer's Protection
<br />Guidel prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is SOHODe other than the
<br />lownerl, I certify that I bave obtained a copy of the above described docUIent and premse in good faith to deliver it to the
<br />"owner I prior to co.enCl!lellt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all wort will be done in cOlPliance with all
<br />applicable laws regulating construction, loning, and land developleDt.
<br />
<br />Application is bereby lade to obtain a perlit to do wort and installation as indicated. I certify that no wort or
<br />installation has cmIl!Dced prior to issuance of a perlit and that all wort will be perfoIled to Ieet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develoPJellt regulations in the jurisdiction. I also
<br />certify that I understancl that the regulations of other goverDll!Dtal agencies lilY apply to the intended IOrt, and that it is
<br />IY responsibility to identify wbat actions I lUst tate to be in CDplianee. Sueb agencies include but are not Uaited to:
<br />t Departlent of Environaental Regulation - Cypress Baybeads, Wetland Areas and Environaentally Sensitive Lands,
<br />Water/Wastewater rreatlent
<br />t Soutbwest Florida Water Manageaent District - Wells, Cypress Baybea4s, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docb, Havigable Watenays
<br />t Departlent of Health r. Rehabilitative Smices, Environaental Health Unit - Wells, Wastewater rreatlent, Septic Iws
<br />t US Environaental Protection Agency - Asbestos abateaent
<br />I also certify that, if fill Iilterial is to be used in Flood ZOne III or IA,ete.l, it is understood that a drainage plan
<br />addressing a lCOIpeD8ating vol_I will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with the IOrt 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 flOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perJit Issued shall beCClle invalid
<br />unless the wort authoriled by sueb pemit is co.enced within sillOlltbs of issuance, or if IOrk authoriled by the perlit is
<br />suspended or abandoned for a period of sillOnths after the tile the IOrt Is CDIeIlced. One 90 day atension of tile, lilY be
<br />allowed for the perlit with fee charge of $15.00. 'fbe atension shall be requested in writing to the Bunting Official. In
<br />approved inspection lUSt be logged during each sil IODth period, or the project will be considered abandoned.
<br />MARlING TO 0IfIf1R: YOUR FAILURI 'f0 RICORD A NO'fICI OF tlIIIIDCIIIIIfI MAY RESUL'f IN YOUR PlYING 'fIfICI FOR IIIPROVIIIIIIS 10 YOUR
<br />PROPERlY. IF YOU IIfIDD 10 OBIAIJI FIIWICIIG, COIISULI WIIB YOOR LIIDIR OR II AftORDY BEFORB RECOJIDIJIG YOOR DICK OF
<br />aHlEHCEMBIfI. JOBS OlDER $2,500 IH VALUE DO 101 IfDD 10 RECORD lID POSI A 'HOlICK OF aJIIDCEIIEIfI'.
<br />
<br />SIGllAfURI: (MIER OR IGEJI1'
<br />
<br />SIGlfA'fURE: COJmIAC'fOR
<br />
<br />SIATB OF FLORIDA
<br />COOllY 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 _ 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 />(Namt!. Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
|