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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'be undersigned understands that this pemit lilY be subject to Ideed restrictions I wbieb lilY be lOre restrictive than City
<br />regulations. Ibe undersigned 888UJe8 responsibility for allpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OlDer bas bired a contractor or contractors to undertake work, they lilY be required to he licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the DIIJ1el' and contractor lilY be
<br />cited for a lisdeIM!8Dor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />reguirelents lilY 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 owner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
<br />IContractor Sections I of this application for wbieb they will he responsible. If you, as the owner 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 lilY be an indication that be is not properly licensed and is not entitled to peIJitting 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 - ~er's Protection
<br />Guidel prepared by the Florida DepartJent of Agriculture and Consl1lel' Affairs. If the applicant i8 8OIl!OI1I other than the
<br />lowner', I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />lownerl prior to COlleDCel8Dt.
<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 cOlpliance with all
<br />applicable laws regulating construction, loning, and land developunt.
<br />
<br />Application is hereby Iilde to obtain a perlit to do work and insWlation as indicated. I certify that DO work or
<br />installation bas ~ced prior to iuuance of a pemit and that all work will be perfoIJed to Jeet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developieDt regulations in the juriscliction. I also
<br />certify that I understand that the regulations of other goveruental agencies lilY apply to the intended IIOlk, and that it is
<br />IY responsibility to identify wbat actions I lUst take to be in COIpliance. Sueb agencies include but are not liaited to:
<br />I DepartJent of EnvirODleDtal Regulation - Cypress Baybeads, Wetland Areas and EnvirollleDtally Sensitive Lands,
<br />Water/Wastewater 'l'reatJent
<br />I Southwest Florida Water lIanagell!llt District - lIells, Cypress Baybea4s, Wetland Areas, Altering lfatercourses
<br />I AIIY Corps of Engineers - Seawalls, Docks, lIavigable Watenays
<br />I Departlent of Health' Rebabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater 'l'reatJent, Septic 'l'anks
<br />I US BnviIODleDtal Protection Agency - I8bestos abatl!ll!llt
<br />I also certify that, if fill Iilterial is to be used in Flood Zone IAI or IA,etc.l, it is understood that a drainage plan
<br />addressing a lCOIpeD8ating vol_I will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to pemit issuance.
<br />
<br />A pemit issued shall 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 tecbnical codes, nor sball iUuaDce of a perlit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perUt i88Ued sball beCOll! invalid
<br />unless tbe work autboriled by sueb pemit is COII8Jlced within sillODtbs of i88uance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after the tiae the IIOlk Is ~ced. One 90 day utension of tiae, lilY be
<br />allowed for the pmit with fee ebarge of $15.00. fbe utension sball be requested in writing to the Building Official. An
<br />approved inspection at be logged during eaeb sillODth period, or the project will be considered abandoned.
<br />IIAlU1IffG YO OIfIfO: YOUR FAILURE fO RICORD A ffOl'ICE OF <DIIIDCBIIBIff MAY RESULt' Iff YOUR PAYIIfG DICE FOR DIPROVIIIBIl'S fO YOUR
<br />PROPERTY. IF YOU umo '1'0 OBIlIJI FIJlUCIIfG, COISOL'I' Ium YOUR LIIfDIR OR 11 InoRIIY BlPORE RICORDIJIG YOUR DICE OF
<br />aJlMBNCIMBIIf. JOBS UNDO $2,500 IN VALUB DO NOl' IIBID YO RECORD AIfD POSf A 1II000ICE OF aJIIIBIICBIlBN'l.
<br />
<br />SIGNA'l'URB: 0IfIIIR OR IGBNI
<br />
<br />SIGNA'l'URI: COJIJRAC'l'OR
<br />
<br />SrATE OF FLORIDA
<br />COUN!Y OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'l'AR OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19_ by
<br />
<br />who is personally known to lie or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />who is personally known to 118 or who has
<br />produced
<br />as identification and who did/did not
<br />take an oct.th.
<br />
<br />(Signature)
<br />
<br />(Naae Typed, Printed or Sta.ped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />(NiUIt!. Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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