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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'rile undersigned understands that tbis penit JaY be subject to IIdeed restrictionsll ,bieb JaY be lOre restrictive tban City
<br />regulations. !be undersigned assUJeS responsibility for CDpliance ,itb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe OIfIler bas bired a cOntractor or contractors to undertake wrt, tbey JaY be required to be licensed in accordance ,itb
<br />state and local regulations. If tbe contractor is not licensed as required by In, botb tbe dImer and contractor JaY be
<br />cited for a lisdl!lleandr violation under state la". If tbe ower or intended contractor are uncertain as to ,bat licensing
<br />reguirl!l8Ilts lilY apply for the intended wrt, tbey are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />Furtbenore, if the owner bas hired a contractor or contractors, be is advised to have tbe contractor(s) sign portions of tbe
<br />IIContractor Sectionsll of tbis application for ,bieb tbey ,ill be responsible. . If you, as tbe OIIIler sign as the contractor,
<br />you are indicating that you, ratber tban tbe contractOr, are responsible for the lIOrt. If tbe contractor lIisbes you to sign
<br />as contractor tbat JaY be an indication that be is not properly licensed and is not entitled to pemitting privileges in tbe
<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 ,itb a copy of IIFlorida's construction Lien LaII - lIoIeoImer's Protection
<br />Guidell prepared by the Florida DepartJent of Agriculture and COnsUler Affairs. If tbe applicant is 8OJIC!OIl8 otber tban tbe
<br />IImmerll, I certify tbat I bave obtained a copy of tbe above described docuIent and prolise in good faitb to deliver it to tbe
<br />IImmerll prior to coaenCl!lent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all tbe inforaation in tbis application is accurate and that all work ,ill be done in cOlpliance ,itb all
<br />applicable lalls regulating construction, loning, and land developent.
<br />
<br />Application is bereby lade to obtain a perlit to do IIOrt and installation as indicated. I certify tbat no wrt or
<br />installation bas CDleDced prior to issuance of a penit and that allwrk ,ill be perfoIJed to teet standards of all Ins
<br />regulating construction, City codes, loning regulations, and land developlent regulations in tbe jurisdiction. I also
<br />certify tbat I understand that the regulations of other goveruental agencies .y apply to tbe intended IIOIt, and that it is
<br />Jy responsibility to identify ,bat actions I lUst take to be in ampliance. Sueb agencies include but are not lilited to:
<br />t Departlent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and BnvirollleDtally Sensitive Lands,
<br />Water /Wastnater !reablent
<br />t Soutbwest Florida Water Hanagelellt District - Wells, Cypress Bayheads, Wetland Areas, Altering IlatercourseB
<br />t ArIY Corps of Engineers - Seall8lls, Docks, lavigable Watenays
<br />t Departlent of Bealtb i Rehabilitative Services, EnvirOJllelltal Bealtb Unit - Wells, Wastl!1later !reatlent, Septic tanks
<br />t US EnviIODlelltal Protection Agency - Asbestos abatuent
<br />I also certify that, if fill aaterial is to be used in Flood Zone IIAII or IIA,etc.lI, it is understood that a drainage plan
<br />addressing a IICQ1PBD8ating voluell ,ill be sublitted ,bieb is prepared by a professional engineer registered in tbe State of
<br />Florida prior to penit issuance.
<br />
<br />A petlit issued shall be construed to be a license to proceed ,itb the lIOrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of tbe technical codes, nor sball issuance of a penit prevent tbe Building Official fIOl tbereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beaIIe invalid
<br />unless tbe work authorized by sueb petlit is COIIeIlced ,itbin slllODtbs of issuance, or if IIOrt authorized by the penit is
<br />suspended or abandoned for a period of sll IODtbs after tbe tile tbe IIOIk is co.mced. One 90 day atension of tile, .y be
<br />allOlled for tbe penit ,itb fee ebarge of $15.00. 'rile atension shall be requested in ,riting to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillODtb period, or tbe project ,ill be considered abandoned.
<br />IIAR11IIG ro <*IBR: YOUR FAILURE ro RECORD A lorICE OF COIHBRCBIIIH! MAY RBSULr II YOUR PAYIIG fiICE FOR IHPROVBIIBII!S ro YOUR
<br />PROPERtY. IF mJ IIft'IIfD ro OBtAII FIIIDCIIG, COISUL! WID YOUR LBlfDBR OR AI AftORDY BIFORB RICOIIDIIG YOUR DICI OF
<br />aJlHBlCEHm'::)JOBS OlDER $2,500 II VALUI DO lor IfBID ro RECORD AID POsr A 'lorICI OF aJIIBIICIIIDfll.
<br />
<br />
<br />Sl'A'fI OF FLORIDA . SrA OF F~
<br />coum OF ::..pASC('!, coum OF 'U5{.StJROIJ(;, /1
<br />The foregoing 1ns~ent was acknowledged The foregoing instrument was aCknowledged
<br />before me this ~ :1--, 19~ by before me this :;2.-2f)~ 19~ by
<br />
<br />. ~6~ S-~6L€- C~ ~
<br />who iapersonally known to r who has (:11110 1S Dal or who has
<br />produced produced
<br />as identification and wh did id not) as identification and who did/did not
<br />t h. ~~\\,~t\l "'" ,!;~~"'-' take oat.
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<br />NOTARY PUBLIC
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