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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perlit JaY be subject to 'deed restrictions' wbich lilY be lOre restrictive than City-
<br />regulations. !be undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they JaY be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lilY be
<br />cited for a lisdl!leallor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!lents lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Deparblent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections' of this application for wbich they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign
<br />as contractor that JaY be an indication that be is not properly licensed and is not entitled to perlitting privileges in the
<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 with a copy of 'Plorida's Construction Lien Law - lReowner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is soeone other than the
<br />'owner", I certify that I bave obtained a copy of the above described docUleDt and pro.ise in good faith to deliver it to the
<br />"owner" prior to COlleDCl!ll!llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, zoning, and land developllent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas CDleDced prior to issuance of a perlit and that all work will be perfoIled to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developleRt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governJelltal agencies lilY apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not luited to:
<br />· Departlent of EnvirollJelltal Regulation - Cypress Baybeads, Wetland Areas and Envirouentally Sensitive Lands,
<br />Water/Wastewater lreablent
<br />* Southwest Plorida Water Managl!l8llt District - Wells, Cypress Baybeacls, Wetland Areas, Altering Watercourses
<br />* ArQ Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />* Departlent of Health i Rehabilitative Services, Envirouental Health Unit - Wells, Wastewater Ireablent, Septic lanks
<br />* US BnviroDleDtal Protection Agency - Asbestos abatl!lent
<br />I also certify that, if fill Iilterial is to be used in Plood Zone "A" or "A,etc.', it is understood that a drainage plan
<br />addressing a 'cOlpeDsating vol.' will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued sball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOle invalid
<br />unless the work authoriled by such perlit is COIIeDced within sillOntbs of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work is co.enced. One 90 day I!Itension of tile, lilY be
<br />allowed for the perlit with fee charge of $15.00. lbe I!Itension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned.
<br />WARMIIfG TO owm: YOUR FAILURE 10 RECORD A NOIICE OF COIDIDCBIIIN! MAY RESULI IN YOUR PAYING ftlCE FOR DIPROVBMElITS 10 YOUR
<br />PROPERlY. IF YOU IIIEND TO OBlIII PlMAKCIIIG, COIISULI WIIH YOUR LBKDER OR All AnomY BIFORE RECORDIIG YOUR DICE OF
<br />COOIEIICEMEII. JOBS OlDER '2,500 II VALUE 00 NOI IfIED TO RECORD DD POSI A -NOIICE OF COOIDCEIIEMfI.
<br />
<br />SIGXAfURB: 0IflIER OR AGm
<br />
<br />SIGlIAfURE: COlI!IIACfOR
<br />
<br />STAlE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SIAfE OF FLORIDA
<br />coum OP
<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 oath.
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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