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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perlit .ay be subject to Ideed restrictions I wbich laY be lOre restrictive than City
<br />regulations. !be undersigned assUles responsibility for coapliance 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 owner and contractor laY be
<br />cited for a .isdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireaents 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 OIfIler bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections I of this application for wbicb they will be responsible. If fOU, as the OIOler sign as the contractor,
<br />you are indicating that JOU, ratber tban the contractor, are responsible 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 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, the applicant, bave been provided with a copy of IFlorida's construction Lien Law - lkIIeoImer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsuteI Affairs. If the applicant is SOIeOD8 other than the
<br />'owner', I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to cOlleDceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land developaent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas ~ced prior to issuance of a perIIit and that all work will be perfoIJed to .et stanc1ards of all law8
<br />regulating construction, City codes, loning regulations, and land developll8llt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govemtental agencies laY 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 />t Departlent of EnvirOllll8lltal Regulation - Cypress Baybeads, Wetland Areas and Invirolll8lltally Sensitive Lands,
<br />Water/Wastewater Ireatlent
<br />t Southwest Florida Water Hanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health i Rebabilitative Services, Bnvironaental Health Unit - Wells, Wastewater Ireatlent, Septic lants
<br />t US EnvirODlelltal Protectiim Agency - Asbestos abateaent
<br />I also certify that, if fill laterial is to he used in Flood Zone IAI or 'A,etc.l, it is understood that a drainage plan
<br />addressing a lCOIp8D8ating volute' will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it issuance.
<br />
<br />A per.it issued sball be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a peIlit prevent the Building Official frot thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued shall becote invalid
<br />unless tbe work authoriled by such perlit is cOB8Ilced within slllODtbs of issuance, or if work authoriled by the perllt is
<br />suspended or abandoned for a period of sil IOntbs after the tile the work is co.enced. One 90 day 81tension of tile, laY be
<br />allowed for the perllt with fee cbarge of $15.00. fbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sil IODth period, or the project will be considered abandoned.
<br />WARKING 10 OIlIER: YOUR FAILURE 10 RECORD A NOfICK OF C<HfDCEMBR1' HAY RESULT IN YOUR PAYING DICK FOR lHPROVIIIDIS 10 YOUR
<br />PROPERlY. IF YOU IIlIBIID 10 OBIIIN FIUlCING, COIISULI WID YOUR LIIfDIR OR AI AnORm' BIFORE RECORDIBG YOUR BOUCK OF
<br />COMMENCEHBNf. JOBS UKDBR $2,500 IN VALUE 00 NOf HED fO RECORD AID POSf A 'NOfICI OF COMMEIfCBllElll'.
<br />
<br />7:!::.~tJ{ !~~
<br />SIGJlA!URB: OIOIER OR AGm
<br />
<br />SIGIfITURIl: COIllRAClOR
<br />
<br />STAfl OF FLORIDA
<br />COUIlIY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SIAD 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 bas
<br />produced
<br />as identification and wbo 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 StilllPed)
<br />NOTARY PUBLIC
<br />
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