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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'Ibe undersigned understands that this penit IlaY be subject to 'deed restrictions' Ibich IlaY be lOre restrictive than City
<br />regulations. lbe undersigned as8UIeB respcmsibility for COIpliance lith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tile owner bas hired a contractor or contractors ' to undertake IOrk, tIIey lay be required to be l1ceD8ed in accorclance Ii tII
<br />state and local regulations. If tile contractor is not licensed as reguired by law, botll the 0I0ler and contractor IlaY be
<br />cited for a .isdeJeallor violation under state law. If the OlDer or intended contractor are uncertain as to lbat licensing
<br />requireJents llay apply for the intended IOrk, they are advised to CODt.act the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtlleIlOre, if tile 0IIJIer bas lIired a contractor or contractors, be is advised to bave the contractor(s) sign portions of tile
<br />.Contractor Sectionsl of this application for Ibiell 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 work. If tile contractor wishes you to sign
<br />as contractor that IlaY be an Indication that be is not properly licensed and is not entitled to penittlng privileges in the
<br />City of Zepbyrllills.
<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 1, the applicant, bave been provided lith a copy of 'Plorida's construction Lien Law - BoIeoImer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and Consl1ler Affairs. If the applicant is SOIl!OIIe other than the
<br />lowner', I certify tIIat I bave obtained a copy of the above described docUIent and pnmse in good faith to deliver it to tile
<br />1000er' prior to co.mCl!IeJlt.
<br />
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />I certify that all the infoIlliltion in this application is accurate and that all work lill -be done in CCJlpliance lith all
<br />applicable laws regulating construction, zoning, and land developlellt.
<br />
<br />Application is hereby Be to obtain a peIlit to do lork and installation as indicated. I certify that no work or
<br />installation bas CDlenced prior to issuance of a penit and that alllOrk lill be perfoned to .8t standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlellt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gOYernllental agenCies IlaY apply to the Intended work, and that it is
<br />If respcmsibility to identify lbat actions I lUst take to be in COIpliance. Such agencies include but are not lilited to:
<br />t Departlent of EnvlrOlllelltal Regulation - Cypress Baybeads, Wetland Areas and EnvirODlentally Sensitive Lands,
<br />Vater /IIastelater 'Ireatlent
<br />t Southwest Florida Water NanageleDt District - Veils, Cypress Bayllea4s, Wetland Areas, Altering Watercourses
<br />t Any Corps of Engineers - Sealalls, Docks, lavigable Waterways
<br />t Departlent of Health i Rebabilitative Services, lnvirOJllental Health Unit - Wells, Wastewater 'IreatBt, Septic lanD
<br />t US EnviI'Olllental Protection Agency - Asbestos abatellellt
<br />I also certify that, if fillllaterial is to be used in Flood Zone 'A' or "A, etc. " it is understood that a clrainage plan
<br />addressing a 'COIpeJl8ilting volUll!' lill be sw.itted lhiell is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A ~it issued sball be construed to be a license to proceed lith the work and not as autbority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a peIlit prevent the Building Official fa thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery penit iasued aball becoIe Invalid
<br />unless tile IOrk autborized by suell penit is COIIllIlced litllin sillODths of issuance, or if IOrk authoriled by the penit is
<br />suspended or abandoned for a period of sil IODths after the tile the work is CDlenced. One 90 day atension of tile, IIilf be
<br />allowed for tile penit lith fee cllarge of $15.00. 'II1e atension shall be requested In writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or the project lill be considered abandoned.
<br />VARlfIIfG fa MIR: YOOR FAILURE fa RICORD A IIO!ICH OP COIIIIICIIIIft MlY RESUL'I 11 YOOR PAYING !IIICH FOR DIPROVIIIII!S fa YOUR
<br />PROPER!Y. IF YOU IIIIIID fa OB!1IJf PIIIDCIIfG, COIf SOLI VI'IH YOOR LBIDIR OR 1II1'1fOBDY BIPORI RICOIIDIIG YOOR IfO'IICH 0'
<br />WlHBlCIMBH'l. JOBS UlfDm $2,500 11 VALUI DO IIO! IIDD 10 RICORD AID POS'I A WI F aJIIBJICBMIIl'Il.
<br />
<br />~~ b. (yD&~
<br />SIGII : (MIIR OR AGBlIt
<br />
<br />
<br />SfA'R OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STAR OF FLORIDA
<br />coom OP
<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 who did/did not
<br />take an oath.
<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 />(Name Typed, Printed or St~d)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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