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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands tbat tbis perlit lay be subject to .deed restrictions" wbich lay be lOre restrictive tban City
<br />regulations. Ibe undersigned assUles responsibility for cOlpliance witb any applicable deed restrictions.
<br />
<br />B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe owner bas bired a contractor or contractors to undertake work, tbey lay 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 owner and contractor lay be
<br />cited for a lisd8leanor violation under state law. If tbe owner or intended contractor are uncertain as to wbat licensing
<br />requir8lents laY apply for tbe intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if tbe owner bas bired a contractor or contractors, he is advised to bave tbe contractor(s) sign portions of the
<br />.Contractor Sections. 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 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 perlitting 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 with a copy of .Florida's Construction Lien Law - lfoIeowner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUJel' Affairs. If the applicant is so.eone other than the
<br />"owner II , I certify that I bave obtained a copy of tbe above described dOCUll!llt and prOllise in good faitb to deliver it to tbe
<br />"owner" prior to COIIeDceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and tbat all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas ~ced prior to issuance of a perlit and that all work will be perfoIJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlellt regulations in the jurisdiction. I also
<br />certify tbat I understand that tbe regulations of other goterDlleDtal agencies lay apply to the intended wort, and tbat it is
<br />If responsibility to identify wbat actions I lUst take to be in cOIIpliance. Sucb agencies include but are not lilited to:
<br />t Departlent of BnviroDleRtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDleDtally Sensitive Lands,
<br />Water/Wastewater freatlent
<br />t Southwest Florida Water Hanag8lellt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Healtb & Rebabilitative Services, EnvirODlental Healtb Unit - Wells, Wastewater !reatlent, Septic ranks
<br />t US EnvirODlental Protection Agency - Asbestos abate.ent
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood tbat a drainage plan
<br />addressing a IIcOJpeJ1sating volUle" will be suhlitted wbich is prepared by a professional engineer registered in tbe State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued sball be construed to be a license to proceed with the work 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 the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becOle invalid
<br />unless tbe work autborized by such perlit is COBeDced witbin six IOntbs of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sixlOntbs after the tile tbe work is co.enced. One 90 day eJtension of tile, laY be
<br />allowed for the perlit witb fee charge of $15.00. !be extension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sixlOntb period, or tbe project will be considered abandoned.
<br />If ARMING !O owm: YOUR FAILURI !O RECORD A NO'I'ICE OF COIHDCBHllfl MAY RESUL! IN YOUR PAYING DICE FOR IHPROVEHmS !O YOUR
<br />PROPER'lY. IF YOU IIl!IND '10 OB!AIN FIIWICIIG, CONSUL! WIm YOUR LIXDER OR 111 AnGRm BEFORE RECORDING YOUR IO'lICE OF
<br />COHHENCBHm. JOBS ormER '2,500 IN VALUE 00 Nor NEED '10 RECORD AND POST A -NorICE OF COHHDCEHm".
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<br />
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<br />.- .;- , - .I (/' ,
<br />( ?L~~- ~~C4~~~7
<br />SlID! : 0IIIlIII1II A, . !j; - 7 SIGUMI: COIIDAC!OII ~ /'
<br />
<br />Sf!!E OF FLOIIIOA f n" - - ~
<br />coum OF )- C=c"Y ~
<br />The foregoin instrument was acknowledged
<br />before me this 'I{ , 19_f1 by
<br />" :5 ~tt- . /GtUflA../A-
<br />
<br />who is per~ me or who has
<br />produced
<br />as identification and who did/did not
<br />take ~_ oath.. ~ '{j .
<br />'- <?to, 1./
<br />(Sign ture)
<br />L--AUt?-A Wi- ()~ '
<br />(Namt! Typed, Printe or Stamped),
<br />NOTARY PUBLIC
<br />
<br />
<br />S!A!E OF FLORIDA ;.{ _ () (7 A. ,,;J a
<br />CoumOF r 'J ~ . o~
<br />The foregoing i~s~ent was acknowledged
<br />before me this 51'; It.! , 19~ by
<br />, .
<br />
<br />~ huJ7ifJ1.-
<br />who is person 11y known t me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />take an O~th~ dt~
<br />(Signature) Ul:uJeA /N~ Uc;t:.
<br />(Name Typed, Printed or tamped)
<br />NOTARY PUBLIC
<br />
<br />
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