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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this pemit lay be subject to 'deed restrictions' wbich lilY be lOre restrictive than City
<br />regulations. !be undersigned asSUles responsibility for COIpliance with any applicable deed restrictions.
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<br />B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OlDer bas bired a contractor or contractors to undertake work, 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 owner and contractor lilY be
<br />cited for a lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!leDts JaY apply for the intended work, they are advised to contact the City of Zepbyrbil1s Building Departlent, (813)
<br />788-6611.
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<br />FurtherlOre, if the OlDer bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbicb they will be responsible. If you, as the OIfIler sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entiUed to peraitting privileges in the
<br />City of Zepbyrbills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<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 - 8oIeoIDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUIeI Affairs. If the applicant is sOftODe other than the
<br />'OIfIler', I certify that I bave obtained a copy of the above described docUJent and prOllise in good faith to deliver it to the
<br />'owner' prior to COllleDCl!IeDt.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIJation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is bereby Jade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas coaenced prior to issuance of a perlit and that all work will be perfoIJed to .et standards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulatfons of other goveIDJeDtal agenCies JaY apply to the intended wort, and that it is
<br />If responsibility to identify wbat actions I lust take to be in COJpliance. Such agencies include but are not liJited to:
<br />I DepartJent of Bnvirolll8lltal Regulation - Cypress Baybeads, Wetland Areas and BnviroDJeDtally Sensitive Lands,
<br />Water/Wastewater !reattent
<br />I Soutbwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY COIPs of Engineers - Seawalls, Docks, Havigable Waterways
<br />I DepartJent of Health & Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater !reatleDt, Septic ranks
<br />I US InvirODleDtal Protection Agency - Asbestos abateIPnt
<br />I also certify that, if fill Jaterial is to be used in Flood Zone "A' or 'A, etc. N, it is understood that a drainage plan
<br />addressing a 'COIPeD8ating volute' will be saitted .bich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
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<br />A perlit issued shall be construed to be a license to proceed with the IOrk 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 fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCOle invalid
<br />unless the work authoriled by such perlit is COll8llCed within sillOnths of issuance, or if work autboriled by the pemit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the IIOrk is C08!Ilced. One 90 day utension of tile, JaY be
<br />allowed for the perlit with fee charge of '15.00. fbe utension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sil IODth period, or the project "ill be considered abandoned.
<br />IIARJ1ING 'fO OIRIER: YOUR FAILURE fO RECORD A NO'I'ICB OF aIlMBICBIIBMI MAY RESULf IN YOUR PIYIHG "'ICI FOR IIIPROVIIIDIS fO YOUR
<br />PROPBIm'. IF YOU IIft'IND 'fO 081111 FIIIAIICIHG, COHSULlWIrH YOOR LINDO OR IN AftORUY BlFORB RBCORDIHG YOUR NO'I'ICB OF
<br />OIOIBHCBIIBIft'. lOBS UKDBR '2,500 IH VILUE DO HO'I' HOD fO RECORD AND POSf I -NO'I'ICI OF C(JfMDCBIIBMI'.
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<br />SIGNA,.-: . 0 / URIl: R 0 Sb? -If I.{ - 0 'i' ~ cr
<br />
<br />STA'l1 OF FLORI~
<br />coum OF 'f\~D
<br />The foregoing instrumen~ was ~~owledged
<br />before me this ~~, 19~ by
<br />
<br />_~"lf\~ 'K; ff\ IJA~,vM
<br />who l.S Perril I ~own to me or who has
<br />produced tbL. ~~
<br />as i entification and ho did/did not
<br />ta an oat .
<br />
<br />STArE OF FLOR~A
<br />coum OF It5CO
<br />The foregoing instrument was acknowledged
<br />before me this5tPTf'tll3t"'L;}..), 19~ by
<br />
<br />J~ (!,. ""5ft./J/VV
<br />who is pr!pnally kn~ to me or who has
<br />produced ?tPc.. J ~L-- ':::;?€/.; u,fL JTJ. ri/ILD f.- ~,,-.))~
<br />as i ification\\\\~~'I~/ho di did not
<br />t th 'I III
<br />e an if. . ,,\\' 1\ ~~/II,
<br />'!<..,-' .~~:.. .'V/. '/
<br />
<br />
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<br />
<br />(Name Typedj ~iDt8d. lft7 Stiujed)
<br />NOTARY PUB~I~"" No. AA 722596,.: ff
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