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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'be undersigned understands that this peIlit JaY be subject to 'deed restrictions' wbich lilY be lOre restrictive than City
<br />regulations. !be undersigned assUJeS responsibility for COIpliance with any applicable deed reBtrictions.
<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 />Btate and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be
<br />cited for a liscll!leallor violation under Btate law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirlllents JaY apply for the intended work, they are advised to contact the City of ZepbyrbillB Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, be is adviBed to have the contractor(s) sign portions of the
<br />'Contractor Sections' of this applicaticm 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 reBponsible for the work. If the contractor wisbes you to sign
<br />as contractor that laY be an indication that be is not properly licensed and is not entitled to peraitting 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 />Guide' prepared by the Florida Departlent of Agriculture and ConBUIer Affairs. If the applicant is BOIl!ODIl other than the
<br />'owner", I certify that I have obtained a copy of the above described dOCUleDt and pn.ise in good faith to deliver it to the
<br />"owner' prior to COIIeDCeleDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land developent.
<br />
<br />Application is bereby lade to obtain a peIlit to do work and inBtallation as indicated. I certify that no work or
<br />inBtallation bas ~ced prior to issuance of a perlit and that all work will be perfoIJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developllent regulations in the jurisclictioo. I also
<br />certify that I understand that the regulations of other goverDlleJltal agencies JaY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not lilited to:
<br />II Departlent of BnvirOllleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water /Wastewater !reatlent
<br />II Southwest Florida Water ManageleDt DiBtrict - WellB, CypresB BaybeadB, Wetland AreaB, Altering WatercourBes
<br />II AIly Corps of BngineerB - Seawalls, Docks, Navigable Waterways
<br />II Departlent of Health & Rehabilitative Services, Bnvil'Ollllelltal Health Unit - Wells, Wastewater !reatlent, Septic !mB
<br />II US BnvirODJental Protection Agency - Asbestos abatllleDt
<br />I also certify that, if fill laterial is to be used in Flood Zone 'A' or 'A,etc.', it is underBtood that a drainage plan
<br />addressing a 'COIpeDSating vol_' will be sublitted wbich is prepared by a profesBional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A PeIlit iBsued 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 proviBions of the technical codes, nor sball iBsuance of a peIlit prevent the Building Official fIOl thereafter
<br />requiring a correctioo of errors in plans, construction, or violations of any code. Every perlit iSBued shall becme invalid
<br />unless the work aUthoriled by such peIlit is COIIeDCed within sillODthe of issuance, or if work autboriled 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 eltension of tile, laY be
<br />allowed for the perlit with fee charge of $15.00. !be eltension 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 />WWIIG TO omR: YOUR FAILURE TO RECORD A NOTICE OF aJIIIBICDIIIT MAY RESULT II YOUR PAYIIG fiICE FOR IMPROVIIIIITS 'l'O YOUR
<br />PROPBRTY. IF YOU IJIfDD 'l'O OBTAIN FIIlAlCING, CONSUL! IUft YOUR LDDIR OR II AT'l'ORDY BEFORE RECORDING YOUR DICE OF
<br />C(IOlBNCBMBN'l'. JOBS UtmBR $2,500 IN VALUE 00 NOT tIlED fO RECORD AID POST A lINO'fICE OF C<IUIBHCBIIII'lI.
<br />
<br />SIGllATURE: COIft'RAC'l'OR
<br />
<br />SIGlATURE: (JIIIR OR AGm
<br />
<br />SfA!E OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SfAfE OF FLORIDA
<br />coum OF
<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 o~th.
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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