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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'fbe undersigned understands that this pentt lilY be subject to "deed restrictions" wbieb lilY be lOre restrictive than City
<br />regulations. !be undersigned assUJes responsibility for CCIIpliance 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 0IIJI8I and contractor lilY be
<br />cited for a lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to "bat licensing
<br />requireJellts lilY apply for the intended work, they are advi~ to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611. .
<br />
<br />FurtberlOre, 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 wbieb 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 wort. If the contractor wisbes you to sign
<br />as contractor that lilY 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, bave been provided with a copy of "Florida's Construction Lien Law - lkIIeowner's Protection
<br />Guidell prepared by the Florida Departlent of Agriculture and ConsUll!I Affairs. If the applicant is SOJeODe other than the
<br />"ownerll, I certify that I bave obtained a copy of the above described dOCUJent and pIWise in good faith to deliver it to the
<br />lIowner" prior to COIIl!IlCl!lellt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIliltion in this application is accurate and that all wort "ill be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land developJeJlt.
<br />
<br />Application is hereby lade to obtain a perlit to do wort and installation as indicated. I certify that no work or
<br />installation bas CDIeIlced prior to issuance of a perlit and that all work will be perfoIled to .et standards of all 1_
<br />regulating construction, City codes, loning regulations, and land developleJlt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveI1llelital agencies lilY apply to the intended wort, and that it is
<br />I}' responsibility to identify what actions I lUst take to be in COIpliance. Sueb agencies include but are not liltted to:
<br />t Departlent of EnvirOlllel1tal Regulation - Cypress Baybeads, Wetland Areas and Envirolllellta11y Sensitive Lands,
<br />Water/Wastewater 'freatlent
<br />t Southwest Florida Water HanageJellt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t Arty Corps of Bnqineers - Seawalls, Docks, lavigable Watenays
<br />t Departlent of Health i Rehabilitative Services, InvirOlllental Health Unit - Wells, Wastewater 'freattent, Septic 'fws
<br />t US InviIOl1lental Protection Agency - Asbestos abatl!lellt
<br />I also certify that, if fill laterial is to be used in Flood ZOne "A" or IIA,etc.", it is understood that a drainage plan
<br />addressing a "~ating volue" will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with 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 fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perait issued sba11 becme invalid
<br />unless the work authorized by sueb perlit is COII8Ilced within sillODthe of issuance, or if work authoriled 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 81tension of tile, lily be
<br />allowed for the perlit with fee charge of $15.00. 'fbe 81tension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillODth period, or the proj'ect will be considered abancJoned.
<br />IIAJUfIIfG TO onBR: YOUR FAILURE TO RECORD A lorICE OF aJIMDCEIIBM! lilY RlSULf IIf YOUR PAYING niCE FOR DIPROVIIIII!S TO YOOft
<br />PROPER'fY. IF YOU 10110 TO osrm FIDlCIIfG, COIfSOL'f WI'fH YOUR LIIfDIR OR AI Af'l'ORDY BlFORI RICOIDIIG YOUR IfO'fICE OF
<br />aJlMDCEMBIft'. JOBS ORDER '2,500 II VALUI 00 KO'f lIED TO RECORD lID POSf A 'lorICE OF aJIIDCllllM'fI.
<br />
<br />SIGlAfURI: (IllER OR AGII'f
<br />
<br />SIGIA'fURI: COIf'fRACTOR
<br />
<br />S'fAfE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'fAn: 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 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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