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<br />CONDITIONS OF PERl>1IT AFFIDAVI'I'
<br />A, NO/l'lCE OF' DEED RES'l'RICTIONS
<br />'rhe under~igned understands that thi::; peuni t may be subject to "deed restrictions" whi ch"
<br />way Le: mort! restrictive than City regulations. 'I'he undel:sign.;d a::>::;UIlles re::>ponsi.Li.l.i.ty for
<br />compliance with any applicable deed restrictions.
<br />B. UNLICENSED CPNTRAC'l'ORS AND CONTRAcrOR RESPONSIBILI'I'IES
<br />I f the OH1HH has hired a contractor or contractor::! to undertake Hork, they may be r'equired
<br />to be licensed in accordance witll state and local regulations, If the contractor is not
<br />licensed a:; required by law, both the OHner and contractOl: may be cited for a misdemeanol:
<br />violation und.;r state law, If the owner or intended contractor are uncertain as to what
<br />licensing requirements may apply for the intended work, they are advised to contact tIle
<br />City of Zephydlills Building Department, 813-788-6611.
<br />Furthermore, if the OHner has hired a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application for whicll they
<br />will be responsible, If you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the contractor, are responsible for the work, If the contractor wishes
<br />you to sign as contractor that may be an indication that he is not properly licensed and is
<br />not entitled to permitting privileges in the City of Zephyrh.i.lls,
<br />C, 'I'RANSPOR'fA'rlON Il>1PACT fEES AND UTILI'!'Y CONNECTION FEES
<br />D, CONSTRUCTUION LIEN LAW (CHAP'rER 713, InORIDA S'I'A'rUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien LaH - Homeowner's Protection Guide" prepared by the Inorida Department of Agri clllture
<br />and Consumer Affairs, If the applicant is someone other that the "owner", I cerify that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to commencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI'r
<br />I certify that all the information in this application 105 accurate and that all Hork will
<br />be done in compliance Hith all applicable laws regulating construction, zoning, and land
<br />development,
<br />Application is hereby made to obtain a permit to do Hork and installation as lndicated. I
<br />certify that no Hork or installation has co~nenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laHs regulating construction, City
<br />codes, zoning regulations, and land development regulations in tIle jurisdiction. 1 also
<br />certify that I understand that the regulations of other governmt::ntal agencies may apply to
<br />the intended ~lOrk, and that it is my responsibility to identify what actions I must ti:ike to
<br />be in compliance, Such agencies include but are not limited to: *'Depat-tment of
<br />t:nvironmental Regulation-Cypress Bayheads, Wetland Areas and Envir'omn.mtally St;:nsiti.ve
<br />Lands, Wi:lter/Waste~Jater 'rreatment
<br />.Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-SeaHalls, Docks, Navigable Waterways
<br />;'-Department of Health /< Rehabilitative Services, Environmental Health Unit-Wells,
<br />WasteHater Treatment, Septic Tanks
<br />'kU,::;. Environmental Protection Agency-Asbestos abatement
<br />I also certify that, if fill material is to be used ill Flood Zone "A" or "A,etc,", it i~
<br />understood that a drainage plan addressing a "compensating volume" Hill be submil:Led Hhich
<br />is prepared by a professional engineer registered in the state of Florida prior to permit
<br />issuance,
<br />A permit issued shall be construed to be a license to proceed Hith the work and not as
<br />authority to violate, cancel, alter, or set aside any provisions of tIle technical codes,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construction, or violations of any code. Every permit
<br />issued shall become invalid unless the worK authorized by such permit is cOllunenced Hi thin
<br />six montlls of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />period of six months after the time the work is conunenced, One 90 day extension of time
<br />may be alloHed tor the permit with fee charge of $15,00, 'I'he extension shall be requested
<br />in ~niting to the Building Official. An approved inspection must be ] ogged dlll-ing each six
<br />month period, or the pi'oject Hill be considered abandoned,
<br />WARNING '1'0 OWNER: YOUR E'AILURE TO RECORD A NO'I'ICE OF COI'1MENCEMENT MAY RESUW' IN YOUR
<br />PAYING TWICE FOR IMPROVEMEN'l'S 'fO YOUR PROPERTY, IE' YOU INTEND TO OB'l'AIN b'INAlJCING, CONSULT
<br />WITH YOUR LENDER OR AN ATTORl~EY BEb'ORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOBS UNDER
<br />$2,500 IN VALlIE DO NO'!' NEED TO RECORD AND POST A "NOnCE OF COMMENCEMEN'r",
<br />
<br />SIGNATURE: OWNER OR AGEN'I'
<br />
<br />SIGNATURE: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUN'l'Y OE'
<br />Tht! foregoing instrument was
<br />Before me this __ day of
<br />by
<br />
<br />acknovlledged
<br />19_
<br />
<br />STA'l'E OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this ----..Jlay of
<br />by
<br />
<br />acknowledged
<br />19
<br />
<br />(name of person acknowledged)
<br />o Hho is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />[1ho is personally known to me, or
<br />
<br />o who has produced
<br />(type
<br />and vJhoD did Ddid not
<br />
<br />of identification)
<br />take an oath.
<br />
<br />DHho has produced
<br />(type of identification)
<br />and vJho Ddid [):ji d not take an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taking acknovJ1edgrnent
<br />
<br />-
<br />Name typed, printed or stamped
<br />
<br />Name typed, pri nted OJ: stamped
<br />
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