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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this pemit lily be subject to 'deed restrictions' .bieb lily be lOre restrictive than City
<br />regulations. !be undersigned assU1e8 responsibility for COIpliance .ith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they lay be required to be licensed in accordance .ith
<br />state and local regulations. If the contractor is not licensed as required by law, both tlIe owner and contractor lilY be
<br />cited for a lisdueanor violation under state la.. If the owner or intended contractor are uncertain as to "bat licensing
<br />requirl!lents lily apply for the intended work, they are advised to contact the City of ZepbyrhiUs Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbieb they .ill 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 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 perlitting privileges in the
<br />City of Zepbyrbills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILI'l'Y CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided .ith a copy of 'Florida's COnstruction Lien Law - lIoIeolmer's Protection
<br />Guide' prepared by the Florida DepartJent of Agriculture and ConsUEI' Affairs. If the applicant is SOl8Oll8 other than the
<br />'owner', I certify that I have obtained a copy of the above described docuIent and prolise in gool1 faith to deliver it to the
<br />'owner' prior to COll8llceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infOIlation in this application is accurate and that all work will be doBein COIpliance with all
<br />applicable laws regulating construction, loning, and land developaent.
<br />
<br />Application is hereby Jade to obtain a perlit to do .ork and insWlation as indicated. I certify that no vork or
<br />installation bas CDlencecl prior to issuance of a pemit and that all vork will be perfOlll!d to Jeet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developaent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIDJelltal agencies lily apply to the intended vork, and that it is
<br />Ii responsibility to identify uat actions I lust take to be in cOJpliance. Sueb agencies include but are not lilltec1 to:
<br />t Departlent of BnvirolllellW Regulation - Cypress Bayheads, Vetland Areas and BnvirolllellWly Sensitive Lands,
<br />Vater/Vastewater !reatlent
<br />I Southwest Florida Vater "anaglllent District - VeIls, Cypress Baybeac1s, Vetland Areas, Altering Watercourses
<br />I Arty Corps of Engineers - Seawalls, Docks, lavigable Vatenays
<br />I DepartJent of Health' Rehabilitative Services, BnvirODlBDtal Health Unit - Vells, Wastewater !reatlent, Septic lanks
<br />I US InvirOJlllental Protection Agency - Asbestos abatl!lellt
<br />I also certify that, if fill IIterial is to be used in Flood Zone 'A' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpensating voluae' will be sublitted "bieb is prepared by a professional engineer registered ill the State of
<br />Florida prior to perlit issuance. .
<br />
<br />A perlit issued sball be construed to be a license to proceed with the vork and not as authority to violate, c:anc:el alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beeme invalid
<br />unless the vork authoriled by sueb perlit is co.enced within sillOntbs of issuance, or if vork authoriled by the perait is
<br />suspended or abandoned for a period of sillODtbs after the tile the vork is ~cecl. One 90 day 81tension of tile, lilY be
<br />allowed for the pemit with fee ebarge of $15.00. tbe 81tension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb ail IODth period, or the project will be considered abancJoned.
<br />WARMIIIG to OVIIIR: YOUR FAILURE 10 RlCORD I 1I0lICI OF aJIIIDCIIlBIf lilY RlSULr III YOUR PIYlIG "'ICI FOR DIPROVIIIIIIS 10 YOUR
<br />PBOPmY. IF YOU IJIDIID 10 -OB'IIII -Fll1A1CIIG, COISULI'VIIB YOOR LBIIDIR OR U AnORllY BIFORI RICORDIIG YOUR 1I00ICI OF
<br />_" ',',/:-Jl1JS _, ~'2. 0 U ,_ ~.1IJr IIEIII !O BIClIIIIIIIIl POlIr I '1IJrlCl OF _'. .
<br />
<br />
<br />;:;1 tW~ ~ A'~ r;t..Q
<br />SIGJII_~ OR AGm ,.. SIGllIURI: C / ,-
<br />
<br />StArB OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before IDe this , 19_ by.
<br />
<br />SfllB 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 me or who has
<br />produced '
<br />as identification and who did/did not
<br />take an oiJth.
<br />
<br />(Signature)
<br />
<br />(Rame Typed, Printed or Sta.,ped)
<br />ROTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Rame Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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