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<br />CG~'"iD'i~~I01~S 0;"" PE::....MIT llFFIDA;\fIT
<br />A. N'OTICE OF DEED RES'l'RIC'I'10NS
<br />'tile undsrsignoo understands that this ;:ieldt loiay be subject to -aeed restdcticr,sH which Jay be lOre restricdvB than City
<br />rG~llatlons. The andersis,iec assUles +espDusihility for cOl?:j~mce with an1 applicable deed restrictions.
<br />
<br />B. UK'LICENSED CONTRJ..C~:;'ORS Al'ID CON'I....1ACTOR RESPONSIBI:::TIES
<br />If the o~~er has hir~d a contractor or contractors to undertake ~ork, they W~1 b2 required to be licensed in &ccordance ~Ith
<br />scate and local regulations. 1f the contrador is not licensed as requ.;:ec hy lall, both me vwer and contractor may be
<br />cit~d tor a lisGe!ew1or violation uncer Btdte law. If tae owner or intendec contractor are lli1certain as to ~hat licensing
<br />re\T~ireients jay apply for the inten~ed ~ork, tbey are dQvised to contact tfie Cit2 of Zepbyrfiills Building DepartMent, (613)
<br />788-6611 .
<br />
<br />Further~re, if the ~ner nas hired a contractor or contractors v be is advi~~d to have thE cOutractor(s) sign portioil8 of th8
<br />"Coutractor SectionsW of this application for ~bich they will be responsible. Ii you, as th~ owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are res,onsible for the work. If tte contractor wishes you to ~ign
<br />cs contractor that lay be an indicatio~ that h~ is not properly ~lC~lS2d ~t i~ not entitlerl to periitting privile~~ in the
<br />City of Zephyrbillc.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I ce:tify that I, the applicant, bav~ been provided with a copy of wFloriaa's Construction Liilil Law - HOIeOVner's Protection
<br />Gui.i:le" prepared by till:'! Florida Departlent of Agriculture and COilSUJer Affairo. If thl:; applicwlt is sGlllOne other than the
<br />."~l2rn, I certify ttat I bave obtained a copy of the above described dGC~~at and prOlise in good faith to deliver it t~ the
<br />"o~m0rn prior to COlllle!J1Cl!II2nt.
<br />
<br />E. CO~"TRACTOR J SlOWER [S AFFIDAVIT
<br />! cartif7 that all the inforuation in tbiJ application is accurate and that all work will b6 aone in co~pliance with all
<br />apJ'Iicable laws regulating constructieJ1" Iioiiing, and land developllent. .
<br />
<br />Application is hereby aade to obtain 2 ier~it to do work and ia~~&11ation as lndicat~j. I certify that no vor~ or
<br />inztaHat:iol1 bas couenced priDr to issuance of a perIl t and that all wori vBl be perfomed to lIleet standards of all laws
<br />regulatiug construction, City codes, lloning regulations, and land deielo~ent regulations in the jurisdiction. I alGo
<br />certHy t1JC1t I understcmii that the r-e~latiollS of other governaental agencies 1(.1[' O.:PP17 to the intended wrt, and l:11at it 1s
<br />~y responsibility to identify what ~ctioTIS I ~u6t take to be in cODpliance. Such aga~cies iaclude but are not limited to:
<br />* De9ar~ent of EnvironJental Requlatlon - Cypr.ass Bayheads, Wetland Areas and ~nviroDier.tdl1y Sensitive Lands,
<br />~aterfWasteuater !rea~ant
<br />* ~Guthwest Florida Water Hw1agemant District - Wells, Cypress Bayneads, ~etrand Areas, AlterIng ~atercour8es
<br />* ~r~1 Corps of Engineers - Seawalls, Dcc!~, Navigable WaterNays
<br />* DEpar~~it of Health & W~abijitati13 Services, Envir~eatal Health Unit - Wells, Wastewater 7reatlent, Septic Yanks
<br />w ~3 BrlvirODl~'taI Procection Agency - Asbestos &hat~ent
<br />I also certify that, if fill material is to be used in Flood ZOne aAw or ~A,etc.., it is under~tood that a drainage plan
<br />aadrsssing ~ ucompansating volU1eu will be suJtitted which is prapared by ~ prof~ssioLal engi~eer registered in the State of
<br />Florida prior to perzit issuance.
<br />
<br />b per~it issued shall be construed to ~e a lic~nse to proceed witJ the work ~1d not as authority to violate, cancel altElv or
<br />set &side any provi81G~a of the tedh,l~Jl codes, nor shall issuance of a peIiit prevent tte 3~~lding Official fro. th~re&fter
<br />requl~ing a correction Jf errora in plane, construction, or violations of any cod2. Every perjjt issued shall beCOle invalid
<br />unless U,e ~orJi: authorized by such perlilit is CGUlii!nced wltbin six oontlls of i33uance, or if worl: authorized by the ~er.iit is
<br />suspended or abandoned for a period of ziLl.: .l1Onths after the tile tDe lIork is -coa2l1ced. One 9G day eiItension of tie, ;a17 be
<br />allowed for the permit with fee charge of ~15.00. !be extension s~al1 be requested in wIiting to the Building Official. An
<br />il:ppro1ed inspection .lJ'JS;: be logged during i:!acn six Jjj()nth period, or tbe project .,ilI be considered abandoned.
<br />!fllRl4IHG TO OWNER: YOOll FAILURE TO RECORD t1 HOUCK OF C014HENCir.4Bflf FJl1l' l(KSilLf IN 'leUR PAYING 'i"~ICE FOR l~PROvmmNTS YO YOUR
<br />PROPRllfi. !F Y9lY1liT YO H FINANCING, cowsm.r IIIrH YOUR LENDER OR ,\li ~J70R)ih'Y BEFORE RECORDING YOUR HarICE OF
<br />CllllW~/ JOBS ~ IDl_ ;5Q Ii milE 00 NO! MIl YO liEClIlID lIIID POS'l/ L
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<br />
<br />COlilRAC'!OR
<br />
<br />
<br />
<br />
<br />+ as ~wledged
<br />g 19ZE. by
<br />
<br />S'l'ilj;/E 0[1 FW~ID;1
<br />COlrilY 'OF
<br />The foregoL1g
<br />before ili~ tild
<br />
<br />
<br />who is perBon~lly
<br />pro/.J.J.cea
<br />tiS identifica
<br />take an 0-
<br />
<br />W~~4Q has
<br />
<br />who ~s personally
<br />jJl.uducea
<br />as identi''''ic
<br />take
<br />
<br />( Signatu.
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