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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that tbis pemit lay be subject to "deed restrictions I wbich lily be lOre restrictive than City
<br />regulations. !be undersigned assuteS responsibility for capliance witb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OImer bas bired a contractor or contractors to undertake IIOrk, tbey lilY be required to be llcensed in accordance witb
<br />state and local regulations. If tbe contractor is not licensed as required by law, botb tbe owner and contractor lilY be
<br />cited for a lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireaents lilY apply for the intended work, they are advised to contact tbe City of Zepbyrbil1s Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtbeIlOre, if tbe OImer bas bired a contractor or contractors, he is advised to bave tbe contractor(s) sign portions of tbe
<br />"Contractor Sections" of this application for wbich tbey will be responsible. If you, as tbe OImer sign as the contractor,
<br />you are inc1icating that JOU, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign
<br />as contractor tbat lilY be an indication that be is not properly licensed and is not entitled to pertitting 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, tbe applicant, bave been provided witb a copy of "Florida's Construction Lien Law - lkIIeoImer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and CODSUEI' Affairs. If tbe applicant is 8CIIeOJIe other than the
<br />"owner", I certify tbat I bave obtained a copy of tbe above described dOCUleDt and pr<<aise in good faitb to deliver it to tbe
<br />DOImer" prior to COIIeDceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all tbe infoIliltion in tbis application is accurate and that allllOrk will be done in capliance witb all
<br />applicable laws regulating construction, zoning, and land developtent.
<br />
<br />Application is hereby tade to obtain a pertit to do IIOrk and installation as indicated. I certify that no IIOrk or
<br />installation bas C31eDced prior to issuance of a pertit and that allllOrk will be perf OIled to teet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developteDt regulations in the jurisdiction. I also
<br />certify tbat I understand that tbe regulations of other !JOYerDl8Dtal agencies lilY apply to tbe intenc1ec1work, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in cotpliance. Such agencies include but are not luited to:
<br />I DepartJent of Bnvil'Olllelltal Regulation - Cypress Bayheads, Wetland Areas and EnviroDJentally Sensitive Lands,
<br />Water IWastewater !reatlent
<br />I Southwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t Arty Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />I DepartJent of Healtb i Rehabilitative Services, EnvirODleDtal Healtb Unit - Wells, Wastewater !reatJent, Septic !ants
<br />I US BnviIODl8J1tal Protection Agency - Asbestos abateaent
<br />I also certify that, if fill laterial is to be used in Flood ZOne "A" or "A,etc. ", it is understood that a drainage plan
<br />addressing a "C08peD8ating volute I will be sublitted wbich is prepared by a professional engineer registered in tbe State of
<br />Florida prior to perlit issuance.
<br />
<br />A pertit issued sball be construed to be a license to proceed witb tbe IIOrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a pertit prevent the Building Official frot thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery pertit issued shall becoIe invalid
<br />unless tbe IIOrk authoriled by such pertit is co.enced witbin sillODtbs of issuance, or if work autboriled by the pertit is
<br />suspended or abandoned for a period of sillODtbs after tbe tite tbe work is co.enced. One 90 day 81tensioo of tite, JaY be
<br />allowed for tbe perlit witb fee charge of $15.00. !be 81tension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sil IODtb period, or tbe proj'ect will be considered abandoned.
<br />WmIffG TO (MIR: YOUR FAILURI TO RICORD A ffO'fICI OF ~ MAY RlSUL! IN YOUR PAYDlG !IIICI FORIIIPROVIIIIII'S !O YOOR
<br />PROPIRTY. IF YOU IIl'fIllD fO OBIlIN FIJWlCING, COlfSUL! WI'fH YOUR LIIIDBR OR 111 AnoRIIY BlFORI RICOBDIIG YOUR IOIICI OF
<br />allMDCIHIIft'. JOBS UlDIR U,SOO IN VALUI 00 10'1 IIUD TO RICORD 1110 POS! A -NOIICI OF aJIIIlfCIMIIfl.
<br />
<br />SIGlAtuIIB: (MIR OR AGIII!
<br />
<br />SIGlAtuIIB: COH!JIACTOR
<br />
<br />S!A!B OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19_ by
<br />
<br />S!AR 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 oc,.th.
<br />
<br />(Signature)
<br />(Rame Typed, Printed or Stamped)
<br />ROTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Rame Typed, Printed or Stamped)
<br />ROTARY PUBLIC
<br />
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