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<br />CONDIT IONS OF PERMIT AF'FIDAVr'r
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'he undersigned understands that this p€;l:mit !nay be subject to "deed restrictions" wid ell
<br />Utay iJe mord rest.rj,clive than City ['dgulations. The undersigned a:>sUInes responsibility for
<br />compliance vdth any applicabl e deed restrictions.
<br />B. UNLICE:NSED COi<lTRACTORS AND C:ONTAAC'rOR RESPONSIBILI'l'IES
<br />1 f the ovwer bas hir"ed a contractor or contractor:> to undertake work, they may be required
<br />to be licensed in accordance with state and local regulations. If the contractor is not
<br />licensed as r.;guired by lavl, both the ovmer and contractor may be cited for' a misdelllt::clllor
<br />violation undf:r :>tate lavl. If the ovmer or intended contl:actor are uncertain as to what
<br />licensing requirements may apply for the intended work, they are advised to contact tIle
<br />City of Zephydlill::> Building Department, 813-788-6611.
<br />Furthermore, if the ovmer has hin-ld 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 Hork. If the cont.cactor wishes
<br />you to sign as contractor that may be an indication that he is not properly liccllsed and is
<br />not entitled to permitting privileges in the City of l.ephyrhi,lls,
<br />C. 'l'RANSPOR'l'A'rlON H1PAC'l' fEES AND UTILITY CONNECTION FEES
<br />D. CONSTRUCTUION LIEN LAW (CHAP'rER 713, FLORIDA 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 Pr'otection Gl!ide" prepared by the Florida Department of Agricul.ture
<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 "ovmer" prior' to corrunencement.
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVIT
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />devel.opment.
<br />Application is hereby made to obtain a permi t to do \lOrk and installation as indicated. I
<br />cerU ty that no work or installation has cOllunenced prior to issuance at a permit aud that
<br />all work will be performed to meet standards of all laws regulating constructioll, City
<br />codes, zoninv reyulations, and land development regulations in the jurisdi,ction. 1 also
<br />ce:rtify that I understand that the n:gulations of other governmental agencies may apply to
<br />the intended vwrk, and that it is my responsibility to i.dentify what action.:> I must take to
<br />be in compliance. Such agencies include but are not limited to: -A'Depar'tment of
<br />Environmental Regulation-Cypre::>s Bayheads, Wetland Areas and Environmentally Sen.sitive
<br />Lands, Water-/WasteVlater Treatment
<br />*Southwest ~lorida Water Management District-Well::>, Cypress Bayheads, Wetland Areas,
<br />Altering Watercourses
<br />*Anay Corps of Engineers-SeaHalls, Docks, Navigable Waterway::;
<br />*Department of Health & Rehabilitative Service.:;, Environmental Health Unit-Wells,
<br />Wa.stewater Treatment, Septic Tanks
<br />''''U. S. I::nviromnental Protection Agency-Asbestos abatement
<br />I also certify thal, if fill material is to be used in Flood Zone "A" or "A,etc.", it is
<br />understood that a dr'ainage plan addressing a "compensating volume" vJill be submitted which
<br />is prepared by a professional engineer registered in the state of Florida prior to permit
<br />issuance.
<br />A permit issued shall be: construf:d to be a license to proceed with thf: work and not as
<br />authority to violate, cancel, alter, or set aside any provision.:> of tbe technical code.:>,
<br />nor: shall i.:>suance of a permit prevent the Bui.lding Offlcial from thereaftf:r reqlliring a
<br />correction of errors in plans, construct!on, or violations of any code. Every permit
<br />issued shall become invalid unless the work authorized by such permit is commenced within
<br />six 1II0ntbs of issuance, or if work authorized by the permit is suspended or abandoned for a
<br />pf:riod of six months after the time the work is conunenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extension shall be reque:.sted
<br />in ~niting to the Building Official. An approved inspection must be logged during each si"
<br />month period, or the project will be considered abandoned.
<br />WARNING 'ro OWNER: YOUR E'AILURE TO RECORD A NonCE OF COMMENCEMENT MAY RESUI.'I' IN YOUR
<br />PAYING TWICE FOR IMPROVEMEN'1'S '1'0 YOUR PROPERTY. IF' YOU IN'l'END 'L'O OB'I'AIN !!'INANCING, CONSUL'!'
<br />WITH YOUR LENDER OR AN AT'l'ORNEY BEfORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. ,JOBS UNDER
<br />$2,500 IN VALUE DO NO'1' NEED '1'0 RECORD AND POST A "NO'rJCE OF COMMENCEMEN'r".
<br />
<br />
<br />SIG~T:R:~ OR AGENT (-;,~t:~, CONTRACTOR
<br />
<br />STATE OE' FLORI DA
<br />COUNTY OF
<br />The foregoing instrument was
<br />Before me this _ day of
<br />by
<br />
<br />STA'rE OF FLORIDA
<br />COUNTY OE'
<br />The foregoing instrument Has
<br />Before me this _day of
<br />by
<br />
<br />a cknovll edged
<br />19_
<br />
<br />acknowledged
<br />19
<br />
<br />(name of person acknowledged)
<br />o wbo is personally known to me, or
<br />
<br />(name of person acknowledged)
<br />O/ho is personally known to me, or
<br />
<br />o ~/ho has produced
<br />( type
<br />and whoD did 0 did no t
<br />
<br />Dwho has produced
<br />(type of identification)
<br />and vlho Odid [}jid not take an oatl!
<br />
<br />of identification)
<br />take: an oath.
<br />
<br />Sj,gnature of person taking acknowledgement
<br />
<br />Signature of person taking acknowledgment
<br />
<br />Name typed, printed or stamped
<br />
<br />Name typed, printed or stamped
<br />
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