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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />fhe undersigned understands that this penit JaY be subject to 'deed restrictions' which JaY be lOre restrictive than City
<br />regulations. fbe undersigned assUJes 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 lay 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 JaY be
<br />cited for a lisdeteallor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelenta lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for which 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 wishes you to sign
<br />as contractor that JaY be an indication that be is not properly licensed and is not entitled to penitting 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, have been provided with a copy of 'Florida's Construction Lien Law - lbIeoImer's Protection
<br />Guidell prepared by the Florida Departlent of Agriculture and COnsUller Affairs. If the applicant is SOHODe other than the
<br />'owner", I certify that I have obtained a copy of the above described dOCUleDt and prCllise in good faith to deliver it to the
<br />"ownerll prior to COlleDCl!IIeDt.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforJation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulatinq construction, Joning, and land developleDt.
<br />
<br />Application is hereby lade to obtain a pmit to do work and installation as indicated. I certify that no work or
<br />installation bas ~ced prior to issuance of a peni t and that all work will be perf ODed to .et standards of all laws
<br />regulating construction, City codes, Joning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIJlleDtal agencies JaY apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in eotpliance. Such agencies include but are not lilited to:
<br />t Departlent of EnvirODleDtal Regulation - Cypress Baybeads, Wetland Areas and Envirollll!Dtally Sensitive Lands,
<br />Water/Wastewater freatlent
<br />I Southwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docts, lavigable Waterways
<br />t Departlent of Health & Rehabilitative Senices, EnvirODleDtal Health Unit - Wells, Wastewater freatlent, Septic fants
<br />t US EnvirODleDtal Protection Agency - Asbestos abatl!lleDt
<br />I also certify that, if fill Jaterial is to be used in Flood Zone 'A' or IIA,etc.', it is understood that a drainage plan
<br />addressing a 'COIpeIlsating volute' will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to pertit issuance.
<br />
<br />A pmit issued shall 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 petlit prevent the Building Official fIOl thereafter
<br />requirinq a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCClll! invalid
<br />unless the work authorized by such pertit is COlleDCed ,dthin sillODths of issuance, or if work authorized by the pertit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work is cc.ll!Dced. One 90 day l!Itension of tile, JaY be
<br />allowed for the penit with fee charge of $15.00. !be l!Itension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sil IODth period, or the project will be considered abandoned.
<br />WARMING TO OVKER: YOUR FAILURE 'to RECORD A IO!ICB OF C(JIMIICBIIIKf MAY RESULf II YOUR PAYIIG !IIICB FOR IMPROVEIIDl'S fO YOUR
<br />PROPER'lY. IF YOU IJIUKD 'to OBtAIJI FlMAJlCllG, COISULf Ium YOOR LIKDBR OR IK AnoRRIY BEfORE RECORDIHG YOUR IO'I'ICB OF
<br />COMMEIC JOBS OlDER '2,500 II VALUE 00 IO! KIlO fO RECORD AND POS A 'IO!ICB OF aJlMEKCBIIIKI'.
<br />
<br />
<br />
<br />SfAfE OF FLORI~
<br />coum OF ~~LO
<br />The foregoing instrument was acknowledged
<br />before me this Cl'\~ , 19 q~ by
<br />
<br />~""'{'. -:;\0.0.~ ~~
<br />who is personally known to me ?r who has
<br />produced \)~ ~~ ~ ~
<br />as identification and who did . o~
<br />take an oath.
<br />~\~~
<br />(Signa ure)
<br />~.Q.\"-....'v'-. -S L\;~:~~
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />SfAfE OF FLORIDA
<br />comm OF \l ~"-, ( 0
<br />The foregoing instrument was acknowledged
<br />before me this dL\~ , 19~ by
<br />
<br />~""'0- ~ \C)...V\. ~\.--.... A \(,\:~'N-A(
<br />who is personally known to me or who has
<br />produced \1~ \-\'" Vv.-v--e'~ ~ .
<br />as identification and who did/did not
<br />tak~ an o~tb.
<br />} . '\ ~
<br />(Si~)
<br />~ 0 '}'^- "S, c... \ ~"::.~
<br />(Naae Typed, Printed or Sta.ped)
<br />NOTARY PUBLIC
<br />
<br />f\C
<br />
<br />My CA.
<br />
<br />\,. ~ Iii", ~~ ':. v
<br />
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