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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIOJ(S
<br />fbe undersigned understancls that tbis perIIit tay be subject to "deed restrictions I Ibich tay be lOre restrictive than eltJ
<br />regulations. !be undersigned as&1IIeB responsibility for cmpliance litb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND eONTRACTOR RESPONSIBILITIES
<br />If the OIIJIer bas bired a contractor or contractors to undertake IIOrt, they tay be required to be llcensed In accorc1ance 11th
<br />state and local regulations. ~f the contractor Is not licensed as required by law, both the 0IIIIeI and contractor tay be
<br />cited for a Ilsclell!anor violation 'under 'state lal. If the O101er or Intended contractor are uncertain as to .bat licensing
<br />requirl!ll!llu tay apply for the intended IIOrt, they are advised tq contact t;beCity of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the OIIJIer bas bired a contractor or contractors, be Is advised to bave the contractor(s) sign portions of the
<br />"Contractor Secti_" of this applicatioo for wbich they ,ill be responsible. If JOU, as the 0IIIleI sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for tbe IIOrt. If the cootractor .ilbes you to sign
<br />as contractor that tay be an indication that be is not properly licensed and Is not entitled to penitUng privileges 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 ,itb a copy of "'lorida's Construction Lien Law - lkIIeoImer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUIeI Affairs. If the applicant is sueone other than the
<br />"OIDer", I certify that I bave obtained a copy of the above described doc1ment and pIOlise in good faith to deliver it to the
<br />"owner" prior to COII8DCl!ll!llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIliltion in this application is accurate and that all IIOrt will be clone in co.pliance 11th all
<br />applicable laws regulating construction, zoning, and land developHDt.
<br />
<br />Application Is hereby tade to obtain a peIlit ~ clo IIOrt and installation as indicated. I certify that no IOrt or
<br />installation baa ~ced prior to issuance of a perlit and that all IIOrt will be perf ODed to .et atanc1arcla of all lau
<br />regulating construction, City codes, zoning regulations, and land developllent regulations in the jurisdiction. I also
<br />certify tbat I understand tbat the regulations of other goveruental agencies tay apply to the intendecJ 1IOI1, and that it is
<br />IY responsibility to identify wbat actions I lUst take to be in cotpliance. Such agencies include but are not lilited to:
<br />t Departlent of EnvirOJllelltal Regulation - Cypress Baybeads, Wetland Areas and Envirolllelltally Sensitive Lands,
<br />Water ,Wastewater !reatlent
<br />t Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY COIPS of Engineers - SeawallS, Docks, Kavigable WateI1lays
<br />t Departlent of Healtb , Rehabilitative Senices, EnvirODl8Dtal Health Unit - Wells, Wastewater !reatleDt, Septic tanks
<br />* US EnviIODl8l1tal Protection Agency - Asbestos abatell!llt
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "COIp8Il8ating volute" ,ill be saiUed wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A pertit issued &ball be construed to be a license to proceed with the IOrt and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a peIlit prevent the Building Official frOl thereafter
<br />requiring a correctioo of errors in plans, construction, or violations of any code. Ivery penit issued shall becaIe invalid
<br />unless the wort authoriled by such peIlit is COBeJlced lIithin sblOllths of issuance, or if IIOrt authoriled by the perlit is
<br />suspended or abancloned for a period of IiI IODtbs after the u.e the 1IOIk is COIIeDced. One 90 day eatension of tile, tay be
<br />allowed for the peIlit with fee charge of $15.00. fbe eatension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or tbe profect will be considered abandoned.
<br />WARNING fO OOIR: YOOR FAILURE ro RECORD A KOfICE OF aJlHDCEIIm MAY BESULf III YOUR PAYIIIG !VICE PUR DIPROVIIIIIIS ro YOUR
<br />PROPmY. IF YOU IID10} ro OBIIIJI ,FIIWICIIIG, COIfSUL! WIrS YOUR LBIIDBR OR AI IftORIIY BIFORE RICORDIIG fOOl JOIICI 0'
<br />C(JIMEIlCEHBII1'. JOBS OlDER '2,500 III VALUE DO 1101 IlEED 'f0 RECORD AND POSf A 'IIOfICB OF CCllllEllCBIIDI".
<br />
<br />~,V01A ~\?~r
<br />SIGJfA!URE: OIIDR OR AGBIII
<br />
<br />~'1IHm ~hhaA"t
<br />SIGIA : ~ COMIJIACIOR
<br />
<br />STATI OF FLORIDA
<br />coum OF
<br />The foregoing inst~ent was acknowledged
<br />before me this , 19____ by
<br />
<br />STAn: 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 oct.th.
<br />
<br />(Signature)
<br />
<br />(Na.e Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name 'J,'yped, Printed or Stamped)
<br />NOTARY 'PUBLIC
<br />
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