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CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS fhe undersigned understands that this peIlit laY be subject to Ideed restrictions" wbieb laY be lOre restrictive than City regulations. !be undersigned asSUles responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the owner bas hired a contractor or contractors to undertake work, they lay be required to be licensed In accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be cited for a lisd_anor violation under state law. If the owner or intended contractor are uncertaIn as to "bat llcensing requiretents laY apply for the Intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813) 788-6611. FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the IContractor Sections I of this application for wbieb they will be responsible. If you, as the owner sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor "isbes you to sign as contractor that laY be an indication that be is not properly llcensed and is not entitled to peraitting privileges in the City of Zepbyrbills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the appllcant, bave been provided with a copy of IPlorida's Construction Lien La" - lkIIeoImer's Protection Guide" prepared by the Florida Departlent of Agriculture and ConsUJeI Affairs. If the applicant is 8OIeODe other than the "owner", I certify that I bave obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the "owner" prior to COlleDCl!lellt. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infoIlation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, loning, and land developleDt. Application is bereby lade to obtain a peIlit to do work and installation as indicated. I certify that no IIOrt or installation bas c-.mced prior to issuance of a perlit and that allllOrk will be perfoIled to Jeet stanc1ards of all laws regulating construction, City codes, loning regulations, and land developll!llt regulations in the jurisdiction. I also certify that I understand that the regulations of other goveIlllelltal agencies laY apply to the Intended uk, and that it Is Ii responsibillty to identify wbat actions I lUSt take to be in cOlpllance. Sueb agencies include but are not IlJited to: * DepartleDt of EnvirODJeDtal RegulatIon - Cypress Baybeads, Wetland Areas and KnviroDleDtally Sensitive Lands, WaterjVastewater !reatleDt I Southwest Florida Water Hanagl!llent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses I AIIY Corps of Engineers - Seawalls, Docks, lavigable Waterways * Departlent of Health i Rehabilitative Services, KnvirODJeDtal Health Unit - Wells, Wastewater !reatleDt, Septic tanks I US InviIODlental ProtectiOn Agency - Asbestos abatetent I also certify that, if fill laterial is to be used in Flood ZOne IAI or "A,etc.l, it is understood that a drainage plan addressing a ICDpeIl8ating vol.1 will be sublitted wbieb is prepared by a professional engineer registered in the State of Florida prIor to peIllt Issuance. A peIlit issued sball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or set aside any provisions of the technical codes, nor sball issuance of a peIlit prevent the Building Official frOJ thereafter requiring a correction of errors in plans, construction, or violations of any code. Every perllt Issued aba11 becoIe invalid unless the work authoriled by sueb peIlit is COII8Jlced within sil IODtbs of issuance, or if work autboriled by the peIlit Is suspended or abandoned for a period of sil IODtbs after the tile the work is ~ced. One 90 day eltension of tile, lay be allowed for the perlit with fee ebarge of $15.00. !be eltenslon sball be requested in .riting to the Building OfficiaL' An approved inspection 8118t be logged during eaeb sil IODth period, or the project will be considered abandoned. IfARNllfG TO OIlIER: YOUR FAILURE !O RECORD A 1f000ICE OF C<IDIBICEllBII HlY RESUL! II YOUR PIYIIG DICE FOR lHPROVBHBIIS fO YOUR PROPERlY. IF YOU InDD fO 011111 PllWICIIG, CONSULf wlla YOUR LIIIDBJI OR II AnoRDY BEFORE RBCORDIIG YOUR DICE OF COHHIICEHBIf1'. JOBS UNDER '2,500 IN VILUB 00 101 DID fO RECORD AIfD POS! A 'IOIICE OF C(JUIDCBIIBIfII. SIGIfI!URE: COIlRAClOR SIGlArURI: OIlIER OR IGIII SfA!E OF FLORIDA coum OF The foregoing instrument was acknowledged before me this I 19____ by STAD: OF FLORIDA coum OF Tbe foregoing instrument was acknowledged before me this I 19_ by wbo is personally known to lie or wbo bas produced as identification and wbo did/did not take an o~tb. who is personally known to me or who bas produced as identification and who did/did not take an oatb. (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Signature) (Name Typed, Printed or St~ed) NOTARY PUBLIC