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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS ,
<br />Ibe undersigned understands tbat this pecait IiIf be subject to 'deed restrictions' wbieb IiIf be lOre restrictive than City
<br />regulations. lbe undersign!!d assU1e8 responsibilitf for COIpliance with anf applicable deed restrlctiOO8.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OlDer has hired a contractor or contractors to undertake work, thef laf 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 laY be
<br />cited for a lisc1eleanor violation under state lal. If the OlDer or intended contractor are uncertain as to wbat licensing
<br />regoireJIenb Jaf applf for the intended work, they are advised to contact the City of Zepbyrhl11s Building Departlen~, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the OIIler has bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbieb thef will be responsible. If you, as the OIOler 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 Jaf 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, bave been provided with a COPf of 'Florida's construction Lien Law - lIoIeoImer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUlleI' Affairs. If the applicant is 8OIH!OI1e other than the
<br />'owner', I certiff that I have obtained a COPf of the above described dOCUlent and prOlise in good faith to deliver it to the
<br />"owner' prior to Cu.eDCI!Il!Ilt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and tbat all lUrk will be done in COIpliance with all
<br />applicable lalS regulating construction, loning, and land develoPEllt.
<br />
<br />Application is berebf Jade to obtain a pecait to do work and installation as indicated. I certiff that no work or
<br />installation bas CDlenced prior to issuance of a pecait and that all work will be perforaed to _t standards of all laws
<br />regulating construction, Citf codes, loning regulations, and land developlH!l1t regulations in the jurisdiction. I also
<br />certify that I understand tbat the regulations of other goveIDleDtal agencies laY Ipply to the intended work, and that it is
<br />If responsibility to identify Ihat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />t Deparuent of InvirOllleDtal Regulation - Cypress BlYbeads, Vetland Areas and InviroDlleDtally Sensitive Lands,
<br />Vater/Vastewater Treatlent
<br />t Southwest Florida Vater ManageleDt District - VeIls, Cfpress Baybeads, Wetland Areas, Altering Vatercourses
<br />t AIl' Corps of Engineers - Seawalls, Docks, lavigable Vaterways
<br />t Departlent of Health & Rebabilitative Services, BnYirODlental Health Unit - Wells, Vastewater Ireatlent, Septic lanks
<br />t US EnYirOJlll!lltal Protection Agenc, - Asbestos abatelellt
<br />I also certiff tbat, if fill aaterial is to be used in Flood ZOne 'A' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpensating volUlll!' will be sublitted wbieb is prepared bf a professional engineer registered in the State of
<br />Florida prior to pecait issuance. .
<br />
<br />A pecait issued &ball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />set aside anf provisions of the technical codes, nor sball issuance of a perait prevent the,Building Official fIOl thereafter
<br />regoiring a correction of errors in plans, construction, or violations of anf code. Ivery perlit issued shall beCOle invalid
<br />unless the wrk authoriled by such pecait is COBeIlCed within sil IODthS of issuance, or if IOrk authorlJed by the petlit is
<br />suspended or abamloned for a period of sillODths after the tile the IOrk is ~cec1. One 90 day elteD8ion of tile, lay be
<br />allowed for the petlit with fee charge of $15.00. the !!Itension 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 CODSidered abandoned.
<br />WARNING 10 0IfDR: YOOR FAILURI 'fO RECORD A IOIICE OF aJIIIDCEllDlIlAY RESULt II YOUR PAYlIfG niCE FOR IMPROVIIIBll1'S 10 YOUR
<br />PROPERlY. IF YOU IDBIID 'fO 0Bf11Jl 'FIWCIIG, COISULI WIIB tOOR LBIIDIR OR AI A'l'fORIIY BEFORB RBCORDIJIG YOUR JIOfICE OF
<br />COMHEKCEMBIff. JOBS OlDER '2,500 II VALUE DO KO'f IfUD to RECORD AIfD POSt A 'NOIICE OF C(JIMBIfCBllllff'.
<br />
<br />
<br />Slu-k16 .. SIW~
<br />
<br />STATE OF FLORIDA
<br />COUIf1'Y OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by.
<br />
<br />~~O~F FLOR~~ .
<br />
<br />The foregoing inst~t was aCknowledged
<br />before me this Q-<t:Ib , 19~ by
<br />
<br />JA)~~.~a~O/\-
<br />who is personally Immm to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />~i..l'~l rt-n1~
<br />
<br />~ature) -
<br />I ~rr.. n--... ~ W ('/ttL1""CC-L F
<br />(Hue Type , Printed or Stuped)
<br />HOTARY PUBLIC
<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 />(Signature)
<br />
<br />(Hame Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />TAMMY W. METCA\;f:'
<br />NOTARY puBLIC, STATE OF FLORIDA
<br />My commission expires Aug. 17. 1996
<br />Commission No. C C 2 2 1 9 7 4
<br />
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