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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />fbe undersigned understands that tbis perlit lilY be subject to Ideed restrictions I wbich lily be lOre restrictive than City
<br />regulations. !be undersigned assUJeS responsibility for ~liance witb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OlDer bas bired a contractor or contractors to undertake work, tbey lilY be required to be licensed in accordance lith
<br />state and local regulations. If the contractor is not licensed as required by law, botb the owner and contractor lilY be
<br />cited for a lisdeEanOr violation under state lal. If the mmBr or intended contractor are uncertain as to lbat licensing
<br />requirl!ll!Dts lilY apply for tbe intended IOrk, tbey are advised to contact the City of Zepbyrbil1s Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the OlDer bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of tbe
<br />'Contractor Sections I of tbis application for wbich they lill be responsible. If you, as the OlDer sign as the contractor,
<br />you are indicating that you, ratber than the contractor, are responsible for the IOrt. 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 pertitting pdvileges 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 witb a copy of IFlorida's construction Lien Law - lkIIeoImer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUIeI Affairs. If the applicant is 8OIIeOI1e otber than the
<br />'OIDerl, I certify that I have obtained a copy of the above described dOCUlf!llt and prcmse in good faith to deliver it to the
<br />-OlDer I prior to co.enceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all tbe infOrlation in tbis application is accurate and that alllOrt will be done in COIPliance with all
<br />applicable laws regulating construction, zoning, and land developent.
<br />
<br />Application is hereby lade to obtain a perIIit to do IOrt and installation as indicated. I certify that no IOrk or
<br />installation bas cmlenced prior to issuance of a perlit and that alllOrt will be perfoIJed to Jeet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developll!Jlt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other QOVeI1IIeDtal agencies lilY apply to the intended wort, and that it is
<br />If responsibility to identify lbat actions I lUst tate to be in COIpliance. Such agencies include but are not lilited to:
<br />I Departler1t of BnviroDlelltal Regulation - Cypress Baybeads, Wetland Areas and !nviroDleDtally sensitive Lands,
<br />Water /Wastewater freatlent
<br />I Southwest Florida Water Manageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />I AI'lY Corps of Engineers - Seawalls, Docks, Xavigable Waterways
<br />I Depart:lent of Healtb i Rehabilitative Services, EnvirODleDtal Healtb Unit - Vells, Vastewater freatlent, Septic !ants
<br />I US BnviIODlental Protection Agency - Asbestos abateaent I
<br />I also certify that, if fill Jaterial is to be used in Flood ZOne HAl or 'A,etc.l, it is understood that a drainage plan
<br />addressing a lCOIpeD8ilting volutel will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to peI'lit issuance.
<br />
<br />A ~it issued shall be construed to be a license to proceed witb 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 perlit prevent the Building Official fl'Ol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becDe invalid
<br />unless the IIOrt authoriled by such peIlit is co.enced witbin sillOntbs of issuance, or if IIOrt authoriled by the perlit is
<br />suspended or abandoned for a period of sillODtbs after the tile tbe work is co.enced. One 90 day atension of tile, IilJ be
<br />allowed for tbe pertit litb fee charge of $15.00. fbe atension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODtb period, or the project will be considered abandoned.
<br />WAIUUXG fO 0VlfD: YOUR FAILURE to RECORD A XO'I'ICE OF CCIlMEICEIIBR! MAY RESULf IX YOUR PAYIIG fllICE FOR IIIPROVEIIBftS fO YOUR
<br />PROPIRft. IF YOU II'IIIID 'fO OBtAIX FIIIlXCIIG, COISULf VIm YOUR LllDER OR IIAftORIIY BIFORI RICORDIKG YOUR JIO'IICE OF
<br />llIlIIDCIIIIIII. JOIllI - 12,500 II VILIlIl 00 lOr IIID III lIECOIlIl ~4
<br />
<br />
<br />
<br />SIGIA!URI: omR OR AGm
<br />
<br />Sf!!! OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SUfi 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 who has
<br />produced
<br />as identification and wbo did/did not
<br />take an oath.
<br />
<br />wbo is personally known to me or wbo has
<br />produced
<br />as identification and wbo did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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