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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perait lilY be subject to "deed restrictions" wbich lilY be lOre restrictive than City
<br />regulations. !be undersigned assWleS responsibility for cmpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIftler bas bired a contractor or contractors to undertake work, they lilY be required to be licensed in accordance ..ith
<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 lisd_anor violation under state la... If the mmer or intended contractor are uncertain as to wbat licensing
<br />requiruents lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the OIftler has bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for wbich they ..ill be responsible. If you, as the mmer 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 he is not properly licensed and is not entitled to peraitting 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, have been provided with a copy of "Florida's COnstruction Lien Law - lReowner's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is SOJeODe other than the
<br />"OIftler", I certify that I bave obtained a copy of the above described docuIent and promse in good faith to deliver it to the
<br />"mmer" prior to coaencuent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all work ..ill be done in cOlpliance ..ith all
<br />applicable laws regulating construction, laning, and land developleDt.
<br />
<br />Application is herehy Iilde to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has CDleDced prior to issuance of a perait and that all work will be perfoIJed to leet standards of all laws
<br />regulating construction, City coeles, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDllental agencies lilY apply to the intended work, and that it is
<br />Ii responsibility to identify what actions I lUst take to be in COJpliance. Such agencies include but are not lilited to:
<br />t Departlent of EnvirOllllelltal Regulation - Cypress Bayheau, Wetland Areas and Invirolllelltally Sensitive Lands,
<br />Water/Wastewater !reatlent
<br />t South1lest Florida Water Managl!lll!llt District - "ells, Cypress Baybeads, "etland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Sea..alls, Docks, lavigable "atmays
<br />t DepartJent of Health & Rehabilitative Services, EnvirODJental Health Unit - Wells, Wastewater !reatlent, Septic !ws
<br />t US InviIODlelltal Protection Agency - Asbestos abatl!lll!llt
<br />I also certify that, if fill laterial is to be used in Flood ZOoe "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "~ating volllle" will be suDitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perllt issuance.
<br />
<br />A perlit issued shall 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 coeles, 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 coele. Svery perlit issued shall beCOle invalid
<br />unless the work authorized by sucb perlit is COII8Ilced within sillODtbs of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sil IODths after the tile the work is co.enced. One 90 day utension of tile, lilY be
<br />allowed for the perlit with fee charge of $15.00. !be 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 will be considered abandoned.
<br />WARRING t'O OWRER: YOUR FAILURE t'O RECORD A 10UCE OF COIIDCBIIIN! MAY RESUL! IN YOUR PAYING nICE FOR IMPROVBMmS !O YOUR
<br />PROPSm. IF YOU III'fDD 'fO OB'fADI FIIWICING, COIISUL! WID YOUR LBIIDIR OR 11 AnomY BEFORE RICORDIKG YOUR DICE OF
<br />COMMBICEMEK'f. JOBS UKDBR '2,500 II VALUE DO IO! IBID 'fO RBCORD AID POS! A "IO!ICE OF aJUlBKCBMBII!".
<br />
<br />
<br />~(~ V~ /(~, [S~,
<br />
<br />SIGlfA'fURI: OWRER OR AGIK'f SIGIIA'fURI: CONJJIAC'lOR
<br />
<br />sun: OF FLORIDA
<br />coum OF f' A 5 Cd
<br />The foregoing instrument was acknowledged
<br />before me this 21) DA'1' 19.!1!:i- by
<br />
<br />Ht/ De Ie ., )3 \I ,~ /.,. '
<br />who is personally known to me or who has
<br />produced
<br />as ident.
<br />.
<br />take
<br />
<br />
<br />StAn: OF FLORIDA
<br />coum OF PAs r, r}
<br />The foregoing instrument was acknowledged
<br />before me this ::< d 'bA 1 ' 19 -.:i!:L by
<br />
<br />/-( L/ il e1c / )3 cJ..s~
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an 0
<br />
<br />
<br />OFFICIAL SEAL
<br />L, BUSH
<br />My Commission Expires
<br />
<br />i
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