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<br />CONDITIONS OF PERMIT AFFlDAVI'r
<br />A. NO'l'lCE OF' DEED RES'I'RICTIONS
<br />'1'he undersigned understands that tlli::> penni t may be
<br />UlClY l>e more restrictivo::: thCln CitYL.egulations. The
<br />compliClnce vJith any applicabl e deed l:estrictions.
<br />B. IJNLlCE:NSED CPj-JTRAC'l'ORS AND CONTRACTOR RESPONSIBILI'l'IES
<br />I f the oHner lIas hired a contractor 01' contractors to undertake work, they may be l'equir.;:d
<br />to be licensed in accor.dance with state and local regulations. If the contractor is not
<br />licensed a.:i required by lav.l, both the ovmer and contractor may be cited for a misdelHecHlor
<br />violation under state law. If the owner or intended contractor are unco:::rtain as to wllat
<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 />Furtllermore, if the owner 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 which they
<br />will be responsible. If you, as the owner signs as the contractor, you are indicating that
<br />you, rather than the conti'actor, are responsible for the Hork. If the contractoJ.: Hisht::s
<br />you to sign as contractor that may be an indication that he is not properly licellsed and is
<br />not entitled to permitting privileges in the City of ~ephyrhi.lls.
<br />C. 'l'RANSPOR'1'A'I'ION H1PAC'l' fEES AND UTILITY CONNEC'I'ION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAP'rER 713, FLORIDA STNrUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction
<br />lien LCiH - Homeowner's Protection Guide" prepared by the Iflorida Department of Agriculture
<br />and Conl:iumer Affairs. If the applicant is someone other that the "ovmer", I cl:lrifythat r
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner-" prior to conunencement.
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify tllat all the information in this application is accurate and that all work will
<br />be done in compliance ~dth Cill applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permit to do work and installation as indicated. I
<br />certify that no work or inl:itallation has conmenced prior to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regulating construction, City
<br />codes, zoning regulations, and land development regulations in the juril:idiction. ] also
<br />cE::rtify that I understand that the regulations of other governmental agencies may apply to
<br />the intended ~JOrk, and that it is my responsibility to identify what actions I must Lak!:: to
<br />be in compliance. Such agencies include but are not limited to: ".Department of
<br />J1:nvironmental Regulation-Cypress Bayhead,:;, Wetland Area,:; and Environmentc:illy Sensitive
<br />Land::;, Wclter/Waste~~ateJ.: 'rreal:ment
<br />*Soutllwest florida Water Management District-Wells, Cypre,:;s Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Anny Cor'ps of Engineerl:i-SeaHalls, DOCks, Navigable Waterways
<br />*Departm~nt of Health & Rehabilitative ServiceM, Environmental Health Unit-Wells,
<br />Wa,:;tewater Treatment, Septic Tanks
<br />."U. s. Environmental Protection Agency-Asbestos abatement
<br />I 0.1::;0 certify that, if fill material is to be used ill Flood Zone "A" or "A,etc.", it is
<br />understood l:hat a dl:ainage plan addressing a "compensating volume" Hill be submitted which
<br />i.:> pn:pared l>y a professional engineer J.:egistered in the State of B'lorida pl'i.ox: to permit
<br />is::;l1ance.
<br />A permit i,:;suo:d shall bE::: construed to be a license to proceed Hith the Hark i'lnd not as
<br />authority to violate, cancel, alter, or set aside any provisions of tile technical codel:l,
<br />nor shall issuance of a permit prevent the Building Official from thereafter requiring a
<br />correction of errors in plans, construct~on, or violations of any code. Every permit
<br />il:isued shall become invalid unless the work authorized by such permit is cOllmenced wi.thin
<br />six montlls of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />period ot si.x month::! after the time the work i,:; conunenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall l>e requested
<br />in v/riting to the Building Official. An approved inspection mu,:;t be Jogged during each si..
<br />month period, or the project Hill be considered abandoned.
<br />WARNING 'ro OWNER: YOUR E'AILURE TO RECORD A NO'l'ICE OF COlvJMENCEMENT MAY RESUI.'J' lH YOUR
<br />PAYING TWICE FOR IMPROVEMEN'l'S '1'0 YOUR PROPERTY. IE' YOU IN'l'END '1'0 OB'11AIN FINANCING, CONSUL'!'
<br />WITH YOUR LENDER OR AN AT'l'ORl-.JEY BEfORE RECORDING YOUR NOTICE Of COMMENCEMENT. ,TOBS UNDER
<br />$2,500 IN VALUE DO NO'I' NEED '1'0 RECORD AND POST A "NO'l'ICE OF COMMENCEMEN'r".
<br />
<br />
<br />
<br />SIG"A"~AGEN;;. SI~ ~~;:"'OR
<br />
<br />subject to "deed restrictions" wid ell
<br />undersigned assumes re::;pomdbi lity for
<br />
<br />S'IIATE OF FLORI DA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this ___ day of
<br />by
<br />
<br />acknovrledged
<br />, 19_
<br />
<br />STA'l'E OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _day of
<br />by
<br />
<br />acknowledged
<br />19
<br />
<br />(name of person acknowledged)
<br />o who is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />OJho is personally known to me, or
<br />
<br />o VJho has produced
<br />(type
<br />and \'~hoD did Ddid not
<br />
<br />of identification)
<br />take an oatil.
<br />
<br />Dwho has produced
<br />(type of identificatiou)
<br />and Hho Ddid []:lid not take an oath
<br />
<br />Signature of person taking acknowledgement
<br />
<br />Signature of person taki.ng aclmowledgment
<br />
<br />Name typed, printed Oi stamped
<br />
<br />Name typed, printed or stamped
<br />
<br /># 'fOD 7)() y- [ .;.Ir 0
<br />
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