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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'be undersigned understands that this perlit laY be subject to "deed restrictions" wbich laY be lOre restrictive than City
<br />regulaticms. !be undersigned assUIeB responsibility for cmpliance with any applicable deed restrictions.
<br />
<br />B.UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIOIer bas hired a contractor or contractors to undertake work, they laY 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 mmer and contractor laY be
<br />cited for a lisdl!leallOr violation under state law. If the 01IIler or intended contractor are uncertain as to wbat licensing
<br />requirellellu laY apply for the intended work, they are advised to contact the City of Zepbyrbllls Builc1ing Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the OIOIer bas bired a contractor or contractors, be is adviBed to have the contractor(s) sign portions of tbe
<br />"Ccmtractor Secticms~ of this applicaticm for wbich they will be respoosible. 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 wishes you to sign
<br />aB contractor that laY be an inllication that be is not properly licensed and is not entitled to perli~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 AMBNDED)
<br />1 certify that I, the applicant, bave been provillell with a copy of "Plorllla's Construction Lien Law - lIcIIeoImer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and COnsUI8I AffairB. If the applicant is 8OIeOI18 other than the
<br />"owner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to co.enCl!IeDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />1 certify that all the infoIlation in this application iB accurate and that all work will be Ilone In COIPllance with all
<br />applicable law. regulating construction, 10ning, and land develo~ent.
<br />
<br />Application iB hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />inBtallation bas C31eDced prior to issuance of a perlit and that all work will be perfomed to Jeet staDc1ards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understanll that the regulations of other govB1'DleDtal agencies lilY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions 1 IUBt tate to be in coapliance. Such agencies include but are not lilited to:
<br />. Departlent of Bnvironaental Regulation - Cypress Baybeads, Wetland Areas anll Bnvironaentally Sensitive Lands,
<br />WaterjVastewater 'l'reatlent
<br />. Southwest Florida Water Managellellt District - lIells, Cypress Baybeac1s, Wetland Areas, Altering Watercourses
<br />. ArIy Corps of Bnglneers - Seawalls, Docts, Havigable Waterways
<br />. Departlent of Health & Rehabilitative Services, BnvirODleDtal Health Unit - Wells, Wastewater !reatlent, Septic !ants
<br />. US BnvirOllleDtal Protection Agency - AsbeBtos abateaent
<br />1 also certify that, if fill aaterial is to be used in Flood Zone "A" or "A, etc. ", it is understood that a cJrainage plan
<br />addressing a "COIpeII8ating voluae" will be Baitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit iSBued 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 codes, nor sball issuance of a peIlit prevent the Building Official fa thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued &ball becme invalid
<br />unless the work authoriled by such perlit is COIIeJlced within sillODtbs of iuuance, or if work authoriled by the peIlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work Is lDIeDeed. One 90 day 81tension of tile, lily be
<br />allowed for the perlit with fee charge of $15.00. !be 81tenslon shall be requested in writing to the BuilcUng Official. AnEapproved inspection lUSt be logged during eaeb Bil IODth period, or the project will be considered abandoned.
<br />WARRING TO (MID: YOUR FAILURE TO RlCORD A IIO!ICI OF OJIIIBICIIIIIIf ItAY RESUL! IN YOUR PAYING !VICI FOR lIIPROYIIIBftS '1'0 YOUR
<br />PROPBIm'. IF YOU IIIDIID !O 0B1AIJ1 PIIfAIICIIG, COISUL! IUD YOUR LBIIDIR OR AI AnoRDY BIFORI RBCORDIIG YOUR IIO!ICI OP
<br />COMMBIICBIIBII. JOBS OlDER '2,500 II VALUE DO 101 IIBBD fO RBCORD DO POS! A -HO!ICB OF ClIIMBICBMm".
<br />
<br />SIGIIA!URB: COII!RAC'fOR
<br />
<br />SIGIIA!URB: OIIIBR OR AGm
<br />
<br />S'I'ATB OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19 by
<br />
<br />STAR 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 wbo bas
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />who is personally known to me or wbo bas
<br />produced
<br />as identification and who did/did not
<br />take an oct,th.
<br />
<br />(Signature)
<br />
<br />(Namp. Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Sta.ped)
<br />NOTARY PUBLIC
<br />
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