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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />fbe undersigned understands that tbis perltt JaY be subject to Ideed restrictions I wbieb laY be lOre restrictive than City
<br />regulations. !be UDc1ersigned asSUIe& responsibility for capllance witb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIIIler bas blred a contractor or contractors to undertake IIOrt, tbey Jay be reguired to be licensed in accordance witb
<br />state and local regulations. If tbe contractor is not licensed as required by law, botb tbe 0IIIler and contractor JaY be
<br />cited for a lisdeJeallOr violation under state law. If tbe OIfIler or intended contractor are uncertain as to wbat licensing
<br />reguiruenu JaY apply for the intended IIOrt, they are advised to contact tbe City of Zepbyrbi1ls Building Departlent, (813)
<br />-788-6611.
<br />
<br />PurtbeIlOre, if the OIfIler bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of tbe
<br />IContractor Sections I of tbis application for wbieb tbey will be responsible. If you, as tbe OIIner sign as the contractor,
<br />you are indicating that you, ratber than tbe contractor, are responsible for tbe wort. If tbe contractor wisbes you to sign
<br />. as contractor tbat JaY be an indication that be is not properly licensed and is not entitled to perIltting 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 that I, the applicant, bave been provided witb a copy of IFlorida's Construction Lien Law - lkIIemmer's Protection
<br />Guidel prepared by tbe Florida Departlent of Agriculture and ConsUEl' Affairs. If tbe applicant is 8OMOIle otber tban the
<br />10000erl, I certify tbat I bave obtained a copy of the above described c10cuIent and pmUse in good faitb to deliver it to tbe
<br />lOIfIlerl prior to co.eDC8IeIlt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infollation in tbis application is accurate and that all IIOrt will be done in COIpliance witb all
<br />applicable IDS regulating construction, loning, and land develolllent.
<br />
<br />Application is hereby Jade to obtain a perait to do lort and installation as indicated. I certify that no IOrt or
<br />installation bas ~ced prior to issueDce of a perIlt and that all1101't will be perfOIJecl to _t standards of all 188
<br />regulating construction, City codes, loning regulations, and land developEDt regulations in the jurisdiction. I also
<br />certify tbat I understand tbat tbe regulations of other gDYerDI8Jltal agencies JaY apply to tbe intendec1lOrt, and that it is
<br />IY responsibility to identify Ibat actions I lust tate to be in COIpliance. Sueb ag!!Jlcies include but are not lilitec1 to:
<br />t Departlent of EnYil'Ollll!Dtal Regulation - Cypress Baybeads, IIetland Areas and Envirolllelltally Sensitive Lands,
<br />IIater/lfastnater freat:lent
<br />t Soutbwest Florida IIater Manage.unt District - IIells, Cypress Baybeac1s, IIetland Areas, Altering IIatercourses
<br />t AllY Corps of Engineers - Sealalls, Dods, laVIgable Vaterways
<br />t DepartJent of Healtb , Rehabilitative Senices, InYirOllll!lltal Healtb Unit - IIells, Wastewater freallent, Septic rants
<br />t us EnYifOllll!Jltal Protection Agency - Asbestos abatuent
<br />I also certify that, if fill IIterial is to be used in Flood Zone IAI or IA,etc.l, it is understood tbat a drainage plan
<br />addressing a lCOIp8II8ating VOIUleI will be sublitted wbieb is prepared by a professional engineer registered In the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued sball be construed to be a license to proceed witb tbe IIOrt and not as authority to violate, cancel alter, or
<br />set aside any provisions of tbe tecbnical codes, nor shall issuance of a perlit prevent the Building Official frOl thereafter
<br />reguiring a correction of errors in plans, construction, or violations of any code. Jvery perIlt issued shall becme invalid
<br />unless tbe IOrt authoriled by sueb perlit is COB8Ilced witbin sillOllths of issuance, or if wort authoriled by the perait is
<br />suspended or abandoned for a period of sil IODtbs after tbe tile the 1I01't is ~ced. One 90 day atension of tile, IIY be
<br />allowed for tbe perait with fee charge of $15.00. !he atension shall be requested in lriting to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sil IODtb period, or the project will be considered abandoned.
<br />WARJIIIG ro (JfIIR: YOUR FAILURE ro 'RICORD A lorICI OF CCllMllCIIIIIT JIIY RlSULr II YOUR PAYDfG DICE FOR DIPROVIIIIIIS 'fO YOUR
<br />PHOPIIm'. IF YOU IIlmD ro OBfm FIIIIICIIG, COIISULf WID YOUR LIIDIIl OR IIlftORDY BIFORI RECORDIIG YOUR DICE OF
<br />CCIDIIffCIMDI. JOBS UIDIR $2,500 II VALUJ DO lIor ffIID to RECORD lID POSf A IlorICI OF aJINIffCIIIIIIf'.
<br />
<br />SIGlAfURI: CMIIR OR AGDr
<br />
<br />SIGUfURI: COII!IIAC'fOR
<br />
<br />SrArJ OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this t 19____ by
<br />
<br />SfAR 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 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 oi'f,th.
<br />
<br />(Signature)
<br />
<br />(Hue Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Haile Typed, Printed or Stamped)
<br />HOTARY PUBLIC
<br />
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