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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'I'be undersigned understands that this perlit lay be subject to 'deed restrictions' "bieb lay be lOre restrictive than City
<br />regulations. !be undersigned assUles responsibility for CCIIpliance "ith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake IfOrk, 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 laY be
<br />cited for a lisdeleallOr violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireleDts laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (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 applicatioo for wbieb they will be resporl8ible. If JOU, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor wishes you to sign
<br />as contractor that laY be an indication that he is not properly licensed and is not entitled to peraitting privileges in the
<br />City of Zepbyrbills.
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<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 - ImeoImer's Protection
<br />Guidell prepared by the Florida Departlent of Agriculture and Conslller Affairs. If the applicant is 8OIeOI1e other than the
<br />'owner', I certify that I have obtained a copy of the above described docUIent and prlllise in good faith to deliver it to the
<br />lIownerll prior to COIIeDC8leDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infonation in this application is accurate and that all wort "ill be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developleDt.
<br />
<br />Application is hereby Jade to obtain a perlit to do wort and installation as indicated. I certify that no work or
<br />installation has CDleDced prior to issuance of a perlit and that all IIOrk will be perfol'led to leet staDdards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gOYl!IDIeDtal agenCies laY apply to the intended wort, and that it is
<br />If responsibility to identify "bat actions I lUst tue to be in COIpliance. SUeb agencies include but are not lilited to:
<br />t Departlent of EnvirODleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDleDtally Sensitive Lands,
<br />Water /Wastewater 'I'real:lent
<br />I Southwest Florida Water Jlanagelellt District - Wells, Cypress Bayhea4s, Wetland Areas, Altering Watercourses
<br />I AllY Corps of Engineers - Sea"alls, Docts, Kavigable Watervays
<br />I DepartJent of Health' Rehabilitative Services, EnvirOJlleDtal Health Unit - Wells, Wastewater 'I'reatlent, Septic lants
<br />I US EnviroDleDtal Protection Agency - Asbestos abat8leDt
<br />I also certify that, if fIll laterial is to be used in Flood Zone IIA' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpeD8ating volUle' will be saitted whieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued sball he construed to be a license to proceed "ith the wort and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perait issued shaH beCCIIe invalid
<br />unless the wort authoriled by sueb perlit is COIIeJ1ced "ithin sillOlltbs of issuance, or if wort authoriled by the perlit is
<br />suspended or abandoned for a period of sillODtbs after the tile the wort is CDleDced. One 90 day eJtension of tile, laY be
<br />allOlfed for the perlit with fee charge of $15.00. !be eJtension sball be requested in writing to the Building Official. In
<br />approved inspection lUSt be logged during eaeb sil IODth period, or the proj"ect will be considered abandoned.
<br />IImIKG 'l'O OIIDR: YOUR FAILURI 10 RECORD A KOIICE OF aJBICBIID! MAY BESOt'l' IK YOUR PAYIIfG filCE FOR DIPROVIIID'l'S 'l'O YOUR
<br />PROPBR'l'Y. IF YOU IIIBIID 'l'O OB'l'IIK FIIIDCIIG, CORSOt'l' WI'l'H YOOR LDDBR OR D 1!'l'ORIIY BBFORB RICORDIIG YOOR RO'l'ICE OF
<br />COJIIIEIfCEJlBR'l'. JOBS UHDIR. $2,500 II VAWI DO 101 mD fO RECORD UD POS'I' A -KOIICE OF aJIJIDCIIIIII'l'II.
<br />
<br />W~:K)
<br />SIGIIA: OR AGEJI'I
<br />
<br />, tV~~n_-
<br />
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<br />
<br />S'I'A'I'E OF F~
<br />COURfY OF p.. "5 Co
<br />The forego1ng instrument was ~c~owledged
<br />before me this.:::) LA" -€... ~ 0, 19 -U by
<br />
<br />lJl\uf\e ~~~~~,\J
<br />who is personall . to me or who has
<br />produced
<br />identifi
<br />ran at.
<br />
<br />S'I'A'I'E OF ~
<br />COURfY OF f\ <., UJ
<br />The forego1ng instrument was aC~OWled9ed
<br />before me this ~ l....\..fVl :::J.~ 19~ by
<br />
<br />W~.~~~d~
<br />who is all 1m me or who has
<br />produced
<br />as 'dentification and who did/did not
<br />ta e an 0 h.
<br />,.
<br />(Sign ure)
<br />
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