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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A _ NOTICE OF DEED RESTRICTIONS
<br />'l'be undersigned understands tbat this perlit laY be subject to Ideed restrictionsR wbieb lay be lOre restrictive than City
<br />regulations. !be undersigned assUIeB responsibility for coapliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIfIler bas bired a contractor or contractors to undertake 1fOrt, 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 mmer and contractor laY be
<br />cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!leDts laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtbeIlOre, if the OIner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of tbe
<br />RContractor Sections I of this application for wbieb they will be responsible. If you, as the OIfIler sign as the contractor,
<br />you are indicating that you, rather than 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 perlitting 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 - HCIIl!OIIJler's Protection
<br />GuideR prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is sOleOne other than the
<br />aOlfDer", I certify that I have obtained a copy of the above described dOCUleDt and prtmse in good faith to deliver it to the
<br />Rownera prior to COlleDCl!leDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in cDlpliance with all
<br />applicable laws regulating construction, Joning, and land developlent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas cOlleDced prior to issuance of a perlit and that all work will be perfoIJed to leet standards of all laws
<br />regulating construction, City codes, Joning regulations, and land developleRt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governJeDtal agenCies laY apply to the intended wort, and that it is
<br />Iy responsibility to identify wbat actions I lUSt take to be in CDlpliance. Sueb agencies include but are not lilited to:
<br />I Departlent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDleDtally Sensitive Lands,
<br />Water ,Wastewater 'I'reatJent
<br />I Southwest Florida Water HanageJent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t Arly Corps of Engineers - Seawalls, Docks, Havigable Waterways
<br />I Departlent of Health i Rebabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater 'I'reatlent, Septic 'l'anks
<br />I US BnvirODleDtal Protection Agency - Asbestos abateleDt
<br />I also certify that, if fill laterial is to be used in Flood ZOne "AI or "A,etc.l, it is understood that a drainage plan
<br />addressing a .cOJlpeD8ating vol.1 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 work and not as autbority 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 thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery peIlit issued shall beCOle invalid
<br />unless the work autborized by sueb peIlit is COIIeDced within sixlOnths of issuance, or if work autborized by the perlit is
<br />suspended or abandoned for a period of six IODtbs after the tile the 1fOrk is c~ced. One 90 day extension of tile, lay be
<br />allowed for the perlit with fee ebarge of $15.00. 'I'be extension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eaeb sillODth period, or the project will be considered abandoned.
<br />WARRING '1'0 omIl: YOUR FAILURE '1'0 RBCORD A HorlCE OF COtMDCBIIIR'I' MAY RlSUL'I' IH YOUR PAYING nICE FOR DIPROVIIIIIIS '1'0 YOUR
<br />PROPBR'I'Y. IF YOU IR'I'BMD '1'0 OB'l'AIH FIIWCIHG, COMSUL'I' WI'I'H YOUR LBMDER OR All AftOlIDY BBFORI RBCORDIRG YOUR JforlCB OF
<br />COMMBRCBMBR'I'. JOBS UNDER $2,500 1M VALUB 00 Nor HBED '1'0 RlCORD AND POS'I' A "NorICH OF C<IDlBRCBIIIR'I'A.
<br />
<br />SIGJIA'I'URE: OIOOlR OR AGBJI'I'
<br />
<br />SIGMA'I'URB: COR'I'RAC'I'OR
<br />
<br />srArE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'I'A'I'E 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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