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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />rbe undersigned understands that this perlit lilY be subject to -deed restrictions- wbich lily be lOre restrictive than City
<br />regulations. !be undersigned asSUle& responsibility for co.pliance with 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 IIY be required to be lIcensed in accordance witb
<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 law. If tbe owner or intended contractor are uncertain as to wbat licensing
<br />requiruents lilY apply for tbe intended work, they are advised to contact tbe City of ZepbyrhUls Building Departlent, (813)
<br />788-6611,
<br />
<br />FurtherlOre, if the owner bas hired a contractor or contractors, be is advised to bave the 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 wort. If the contractor wishes 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 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 - HoIeoImer's Protection
<br />Guide- prepared by the Florida Departlent of Agriculture and COnsUIeI Affairs, If the applicant is 8OI8OD8 other than the
<br />-owner-, I certify that I bave obtained a copy of the above described c10cuIent and prOl.ise in good faith to deliver it to the
<br />-owner- prior to co.encuent,
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIliltion in this application is ,accurate and that all wort will be done in cu.pliance with all
<br />applicable laws regulating construction, loning, and land developll!llt.
<br />
<br />Application is hereby Iilde to obtain a perlit to do worl and installation as indicated, I certify that no wort or
<br />installation has ~ced prior to issuance of a perlit and that all wort will be perfOlled to _t standards of all laws
<br />regulating construction, City codes, loning regulations, and land develOpll!llt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gOYeIDI8Iltal agencies lilY apply to the intended worl, and that it is
<br />IY responsibility to identify what actions I lUSt tate to be in co.pliance. Such agencies include but are not lilited to:
<br />t Departlent of InvlrOllll!l1tal Regulation- Cypress Baybeads, Wetland Areas and InviroDleDtally Sensitive Lands,
<br />Water /lfastewater !reabent
<br />t Southwest Florida Water Hanaguent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArIy COlliS of Engineers - Seawalls, Docks, lavigable Waterways
<br />t Deparbent of Health' Rehabilitative Senices, InvirODleDtal Health Unit - Wells, Wastewater !reatlent, Septic !anb
<br />t US Invil'ODlelltal Protection Agency - Asbestos abatuent
<br />I also certify that, if fill literial is to be used in Flood lone -A- or -A,etc, -, it is understood that a drainage plan
<br />addressing a -COIp8D8ating vol.- will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance, . .
<br />
<br />A perlit issued shall be construed to be a license to proceed with the wort and not as authority to violate, caacel alter, or
<br />Bet aside any provisions of the technical codes, nor sball 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 perIlt issued sball hecme invalid
<br />unless the wort authoriled by such perlit is ~ced within sil IODtbs of issuance, or if wort autboriled by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after. the tile the wort is c-.mced. ODe 90 day atension of tile, lilY be
<br />allowed for the perlit with fee charge of $15.00. !be atension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sil IOnth PeriOd, or the project will be considered abanc1oDec1.
<br />IfARlfllfG TO (lOR: YOUR FIILURI TO RlCQRD l. lorlCE OF <XIIMDCIIIBIf lilY RESULt II YOUI PAYIlfG !IIICE FOR IIIPROVIIIII!S !O YOUl
<br />PROPIIm'. IF YOU IIDIID !O OB!IIJI irWClXG"COISULf WID YOOi LIIDIR OR II AftORIIY BI10RB RICORDIIG YOUIIorICE OF
<br />C(JtMIICIHIH!. 'JOBS UI..D.IR.. f2.500 II tILiIl DO IIll IBID 10 IIIIlllIID lID POIlI~~~
<br />
<br />..' ..~~ / . ..",.,,....-:,. ............
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<br />SIGII!URI: .ilr-i ..--.'. SIGllIURI:-=- COIIRAC'IOR
<br />
<br />STATI OF FLORIDA /)
<br />coum OF t' ifS C 0
<br />The foregoing instrument was acknowledged
<br />before me this I 11/ , 19 q( I by
<br />I ....L.::F-
<br />
<br />~~ O~F FLORIDA 1!t-;5"CYJ
<br />
<br />The foregoing instruaent was a~~ledged
<br />before me this I / II , 19 by
<br />I
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />take an ~< If G.-n.,:
<br />(Signatur K (I,
<br />c,( rn () /!.. /2. EA A-
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />who is personally known to me or wbo has
<br />produced
<br />as ideotifi~.atiCD..and who did/did not
<br />take an oat~ . ~ ~~
<br />
<br />(Signature~~ ~
<br />/ rtlo,&ec.IA.
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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