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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />rbe undersigned understands tbat this pecait Jay be subject to IIdeed restrictions II wbieb Jay be lOre restrictive tban City
<br />regulations. !be undersigned assUJes responsibility for CCIIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractors to undertake work, they JaY 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 lilY be
<br />cited for a lisdeJl!anor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />reguirl!leDts lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Depart:lent, (813)
<br />788-6611.
<br />
<br />Furtberlore, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />IIContractor Sectionsll of this application for wbieb they will be respoosible. If you, as the owner sign as the contractor,
<br />you are indicating tbat you, rather tban the contractor, are responsible for the work. If the contractor wishes you to sign
<br />as contractor that lilY be an indication tbat be is not properly licensed and is not entitled to perJitting 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 tbat I, the applicant, have been provided with a copy of IIFlorida's Construction Lien Law - lkIIeow.ner's Protection
<br />Guidell prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is 8OIeOIl8 other tban the
<br />lIownerll, I certify that I have obtained a copy of the above described docuIent and prOlise in good faith to deliver it to the
<br />lIowner. prior to COll8llCl!l8llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and tbat all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify tbat no work or
<br />installation bas cc.lenced prior to issuance of a perlit and that all work will be perfoIled to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land develOpl8llt regulations in the jurisdiction. I also
<br />certify that I understand tbat the regulations of other gOY8IDI8Iltal agencies lily apply to the intended worl, and tbat it is
<br />., responsibility to identify what actions I lUSt take to be in COIpliance. Sueb agencies include but are not lilited to:
<br />t Departlent of EnvirODlelltal Regulation - Cypress Baybeads, Wetland Areas and BnvirolllellWly Sensitive Lands,
<br />Water/Wastewater rreatlent
<br />t Southwest Florida Water ManageJl!Jlt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AllY Corps of Engineers - Seawalls, Docks, Mavigable Waterways
<br />t DepartJent of Health' Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater rreatlent, Septic ranb
<br />t US BnvirOlllental Protection Agency - Asbestos abatl!leDt
<br />I also certify tbat, if filllilterial is to be used in Flood Zone IIAII or III, etc. " it is understood that a drainage plan
<br />addressing a llCOQenSating vol.' will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A pecait issued shall be construed to be a license to proceed with the Ifork 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 frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCGle invalid
<br />unless the wort authorized by such peIlit is ~ced Ifithin sillOOths of issuance, or if wort authorized by the peIlit is
<br />suspended or abandoned for a period of sillOOths after the tile the wort is co.enced. ODe 90 day utension of tile, lilY be
<br />allowed for the peIlit with fee charge of $15.00. roo utension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillODth period, or the project Ifill be considered abandoned.
<br />WARNIIG 1'0 OIlIER: YOUR FIILURI 1'0 RlCORD A MorICI OF aJIMIICIIIIIft' MAY RESULr 1M YOUR PIYlIG !'IIICI FOR DIl'ROVIIIIftS 70 YOUR
<br />PROPER'lY. IF YOU Ift'BKD ro OBrW FIIIDCIMG, CONSULI' WI'IH YOUR LIKDBR OR AI IftORDY BEFORI RICORDIKG YOUR IO'rICI OF
<br />aJIMIICBMm. JOBS~ '2,500 1M VAtUl 00 Mor lIED ro RECORD AID POsr I -MoriCi OF aJIIBICIIIIIft'lI.
<br />
<br />
<br />X ~ ~...~ Cl):j. __~
<br />SIGJlAfURI: lJIJfBR OR AGm SIGlAfURI: COIi!RIC'fOR
<br />
<br />S7Arl OF FLORIDA
<br />coum OF OOf)
<br />The foregOing instrument was ~ClSOWledged
<br />before me this \~ - RP~'L, 19 by
<br />
<br />lEU) A. ___<)AK-
<br />who is personally known to me or who has
<br />produce
<br />as i en
<br />take
<br />
<br />
<br />d who did/did not
<br />
<br />
<br />srAD OF ~
<br />commOF 0
<br />The foregoing instrument was acknowledged
<br />before me this 12..- ~["~ \ , 19~ by
<br />
<br />e...
<br />own to me or who has
<br />
<br />'C-
<br />
<br />lJ~ JJ~
<br />(Name. TYPed, prin~ed;r~ Stamped)
<br />NOTARY PUBLIC ~ \J-:rt(o
<br />
<br />(Name TYPed, Printed or Sta1lped)
<br />NOTARY PUBLIC
<br />
<br />~l\~ ~!J(J
<br />.r:,'" A ,{{~ TARA N ALFORD
<br />. ~~-'~ '. My Commission CC263392
<br />. ( '!"' . Expir_ Mar 09,1$197
<br />. !n'11 . Huckleberry Associates Ina
<br />.r~,.. _<i.$'''' 800-422.1555
<br />< 0;; h""
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