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CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS . Tbe undersigned understands that this pellit lay be subject to 'deed restrictions" wbieb lay be IDre restrictive than City regulations. !be undersigned assUles responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIB~~ITIES If the owner bas bired 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 lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requiretents tay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departtent, (813) 788-6611. FurtberlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the "Contractor Sections' 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 wisbes you to sign as contractor that tay be an indication that be is not properly licensed and is not entitled to peuitting 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 applicant, bave been provided with a copy of 'Florida's Construction Lien Law - Hoteowner's Protection Guide" prepared by the Florida Departtent of Agriculture and COOSUHr Affairs. If the applicant is SOHone other than the 'owner", I certify that I bave obtained a copy of the above described docUleDt and prOtise in good faith to deliver it to the "owner' prior to COlleDcetent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the inforaation in this application is accurate and that all work will be done in cotpliance with all applicable laws regulating construction, loning, and land developlent. Application is hereby lade to obtain a pellit to do work and installation as indicated. I certify that no work or installation bas cOllenced prior to issuance of a pellit and that all work will be perfoited to teet standards of all laws regulating construction, City codes, loning regulations, and land developteDt regulations in the jurisdiction. I also certif! that I understand that the regulations of other goveruental agencies tay apply to the intended work, and that it is IY responsibility to identify wbat actions I lust take to be in COIpliance. Sucb agencies include but are not liaited to: t Departlent of Bnvirollll!l1tal Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands, Water/Wastewater !reatlent t Southwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t AllY Corps of Engineers - Seawalls, Docks, Navigable Watenays t Departlent of Health rr Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater !reattent, Septic ranks t US BnvirODlental Protection Agency - Asbestos abatetent 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 addressing a 'cOtpensating volUte' will be subtitted wbieb is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. A perlit 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 pellit prevent the Building Official frOt thereafter requiring a correction of errors in plans, construction, or violations of any code. Every persit issued sball beCOle invalid unless tbe work authoriled by sueb pellit is COII8IlCed within slllODtba of issuance, or if work authoriled by the pellit is suspended or abandoned for a period of slllOntba after the tHe the work is c_enced. One 90 day eltension of tile, tay be allowed for the pellit with fee ebarge of $15.00. Tbe eltension sball be requested in writing to the Building Official. An approved inspection lUst be logged during eaeb sil IDnth period, or the project will be considered abandoned. WAIUUNG TO OtUfBR: YOUR FAILURE TO RECORD A NOTICE OF COIlMBNCBMm MAY RESULT IN YOUR PAYING nICB FOR IMPROVEMmS TO YOUR PROPBRTY. IF YOU IIIfBHD TO OBTAIN FIIWICIHG, COHSULT WITH YOUR LEIIDBR OR 111 AffORIEY BEFORE RECORDIHG YOUR HO'rICE OF COIlMBNCEHBNt'. JOBS UNDER $2,500 IN VALUE 00 NOT NBED TO RECORD lIID POST A 'NOTICB OF CCiuIBIICBMBIIT". SIGNAtURE: OIOIBR OR AGm SIGNA!URE: COIlfRACfOR STATE OF FWRIDA coum OF The foregoing instrument was acknowledged before me this 1 19____ by STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged befQre me this ' . ; 19 by who is personally known to me or who has produced as identification and who did/did not take an oath. who is personally known to me or who has produced as identification and who did/did not take an oath. (Signature) (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC (Nam~ Typed, Printed or Stamped) NOTARY PUBLIC