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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS .
<br />The undersigned understands that tbis peIlit lilY be subject to 'deed restrictions' wbieb lilY be IIJre restrictive than City
<br />regulations. rbe undersigned assUIeB responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES,"
<br />If the owner bas hired a contractor or contractors to undertate wort, they .y 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, MY be
<br />cited for a lisd_anor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />reguiretents lilY apply for the intended wort, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611. .
<br />
<br />FurtherlOre, if the OIner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />'Contractor Sections' ,of this application' for whicb 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 MY be an indication that he is not properly licensed and is not entitled to perlitting pr,ivileges 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 -1IoIeoImer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is 8OIBOIle other than the
<br />'owner", I certify that I bave obtained a copy of the above described docUlBDt and prOlise in good faith to deliver it to the
<br />"owner" prior to COII8I1Cl!lBDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforJition in this application is accurate and that all wort will be done in eotpliance with all
<br />applicable laws regulating construction, loning, and land developleDt.
<br />
<br />Application is bereby Iilde to obtain a peIlit to do work and installation as indicated. I certify that DO wort or
<br />installation bas COIIeDced prior to issuance of a peIlit and that all work will be perfoaed to _t stam1arda of a11liIIIB
<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 goveIDIBDtal agencies By apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lust take to be in COIpliance. Sueb agencies include but are not liaited to:
<br />t Departlent of EnvirOllleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlBDtally Sensitive Lands,
<br />Vater/Wastewater Treatlent
<br />t Southwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AllY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />t Departlent of Health , Rehabilitative Services, InvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic ranks
<br />t US IlnvirODlBDtal Protection Agency - Asbestos ahatelent
<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 'COIpeIlsating volUle' will be subJIitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance. '
<br />
<br />A peIlit 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 perlit prevent the Building Official frol,~eafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every pertit issuedshall beCCIIe invalid
<br />unless the work authoriled by sueb perlit is COII8IlCed within slllODtbs of issuance, or if work authoriled bJ the perlit is
<br />suspended or abandoned for a period of slllODtbs after the tile the work is cc.enced. One 90 day 81tension of tile, lily be
<br />allowed for the perIIit with fee ebarge of $15.00. Tbe 81tension shall be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eaeb sil IOI1th period, or the project will be considered abandoned.
<br />WARNING TO OIlIER: YOUR FAILURI TO RECORD A IOTICE OF COIMDCBIIIII MAY RESULT II YOOR PAYING nICE FOR IIIPROVIIIII!S TO YOOR
<br />PROPERTY. IF YOU IJIDID TO OBTAII F1WCIIG, CONSULr WIm YOOR LBIDIJI OR AI AnomY BEFORE RECORDIIG YOOR JOrICI OF
<br />C(JtMEICIlMENI. JOBS UNDER $2,500 II VALUE DO lOT lIED TO RECORD AID POST A -IOTICE OF ClIUIEICIIIEIIl".
<br />
<br />
<br />SIGlATURIl: CONIRACTOR
<br />
<br />STATE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STAn: 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 />,
<br />produced l J '
<br />as identification and wbo did/did not
<br />take an oatb.
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY.PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Sta.ped)
<br />NOTARY PUBLIC
<br />
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