|
<br />_ _,~,..."" v '.'~~~.:p:'.,( ~~"V: .~
<br />
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'fbe undersigned understands that this penit IlaY be subject to 'deed restrictions' Ibich IlaY be lOre restrictive than City
<br />regulations. !be undersigned ass_ respcmsibility for COIpliance lith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OlDer lias IIired a contractor or contractors ' to undertake IOrk, tIIey lilY be required to be licensed in accorclance litll
<br />state and local regulations. If the contractor is not licensed as reguired by law, both the 0IIIlef and contractor IlaY be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to "bat licensing
<br />reguireaents IlaY apply for tile intended work, they are advised to COBtact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner bas lIired a contractor or contractors, be is advised to bave the contractor(s) sign portions of tile
<br />-Contractor Sections' of this application for Ibicll they lill be responsible. If you, as the OlDer sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor lIiabes you to sign
<br />as contractor that IlaY be an Indication that be is not properly licensed and is not entitled to penitting privileges in the
<br />City of Zepllyrbills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN' LAW (CBAPTER 713, FLORIDA STATUTES, AS .AMENDED)
<br />I certify that I, tile applicant, bave been provided lith a copy of 'Florida's construction Lien Lal - lReoImer's Protection
<br />Guide- prepared by tile Florida Departlent of Agriculture and Consuaer Affairs. If tile applicant is soaeone other than the
<br />-OIDer-, I certify that I bave obtained a copy of the above described dOCllleDt and praUse In good faith to deliver it to the
<br />-OlDer' prior to co.enceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the Infonation in this application is accurate and that alllOrk lill -be done In COIpliance lith all
<br />applicable laws regulating construction, zoning, and land develo(lK!llt.
<br />
<br />Application is bereby Be to obtain a penit to do work and installation as Indicated. I certify that no IOrk or
<br />installation bas CDlenced prior to issuance of a penit and that alllOrk .ill be perfoned to .et standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developaent regulations in the jurisdiction. I also
<br />certify tIIat I understand that the regulations of other gOYeI1IIIeIltal agencies IlaY apply to the Intenc1ed work, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in coapliance. Such agencies include but are not lwted to:
<br />t Departlent of BnvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and BnvironRlltally Sensitive Lands,
<br />Vater/Vastewater 'lreatlent
<br />I Southwest Florida Vater Manageaent District - Veils, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />I ArIy Corps of BnqineeIS - Seawalls, Docks, Ravigable Waterways
<br />t Departaent of Health i Rehabilitative Services, BnvirOlllental Health Unit - Wells, Vastelater 'lreatlent, Septic lants
<br />I US BnviIOJlll!lltal Protection Agency - Asbestos abateaent
<br />I also certify that, if fillllaterial is to be used in Flood Zone -A' or -A,etc. -, it is understood that a drainage plan
<br />addressing a 'COQ8IlSating volute- lill be sublitted Ibicll is prepared by a professional engineer registered in the State of
<br />Florida prior to penit issuance.
<br />
<br />A peJ;lit issued shall be construed to be a license to proceed .ith the IOrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a penit prevent the Building Official fICII thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perait i88ued aball becaIe invalid
<br />unless the IOrk authorized by such penit is co.enced .ithin sillODths of issuance, or if work authoriled by the penit is
<br />suspended or abandoned for a period of sillODtbs after the tile the work is co.enced. One 90 day atension of tile, IlaY be
<br />allOlled for the penit .ith fee cIIarge of $15.00. file atenslon sball 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 />WARMUG 10 CMIR: YOUR PIILURI '10 RlCORD I ROIlCE OF CIJIIIBICIIIBII MAY RISOLf II YOOI PIYIIG niCE FOR IIIPROVBIIIIIS 'fO YOUR
<br />PROPERlY. IP YOU IJIIIID 'fO OBtAIII' FlllAlCCllG, COISOLI WIIB YOUR LIIIDIR OR All IftORIIY BIPORI BICOBDIIG YOUR JIOIICI OF
<br />OIIMEICBMm. JOBS utmlR $2,500 II VALUE DO IOIICIID 'fO RECORD AID POSI A 'IOIICE OP CCIIIIICCIIIIIC'f'.
<br />
<br />SIGIA'lURI: COIIRIC'fOR
<br />
<br />SIGIA'lURI: (MIIR OR AGm
<br />
<br />SUfi OF FLORIDA
<br />coum OP
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'lIU OF FLORIDI
<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 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 o."th.
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stuped)
<br />NOTARY PUBLIC
<br />
|