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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS ,
<br />Tbe undersigned understands that this peI'lit tay be subject to -deed restrictions' wbieb aay be lOre restrictive than City
<br />regulations. Ihe undersigned assUleS responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they tay 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 tay be
<br />cited for a lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to "bat licensing
<br />reguireIeDts aay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheI'lOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbieb 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 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 'Florida's Construction Lien Law - HoIeoImer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and COnsUlef Affairs. If the applicant is SQIeOne other than the
<br />IImmer", I certify that I bave obtained a copy of the above described docUlent and pro.ise in good faitb to deliver it to the
<br />"mmer" prior to COlleDCl!lellt.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developllent.
<br />
<br />Application is hereby lade to obtain a peI'lit to do work and installation as indicated. I certify that no work or
<br />installation bas C08enced prior to issuance of a perlit and that all work will be perfoIJed to lIl!et standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developllent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agencies laY apply to the intended wort, and that it is
<br />IY responsibility to identify wbat actions I lUst take to be in cOlpliance. Sueb agencies include but are not lilited to:
<br />I Departlent of Envirolllll!Jltal Regulation - Cypress Baybeads, Wetland Areas and Envirolllll!Jltally Sensitive Lands,
<br />Water/Wastewater Ireatlent
<br />i Southwest Florida Water HanageleDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />I Arl)' Corps of Engineers - Seawalls, Docks, Ifavigable Waterways
<br />t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Ireatlent, Septic lants
<br />t US EnvirODlll!Dtal Protection Agency - Asbestos abatl!lellt
<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 'cD.lpel1Sating volUlll!" will be sublitted "bieb is prepared by a professional engineer registered in the State of
<br />Florida prior to peI'lit issuance.
<br />
<br />A perlit 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 shall issuance of a peI'lit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCOle invalid
<br />unless the work authorized by sueb peI'lit is COIIeIlced within six IODtbs of issuance, or if work authorized by the peI'lit is
<br />suspended or abandoned for a period of slllOlltbs after the tile the wort is cogenced. One 90 day l!Jtension of tile, lilY be
<br />allowed for the peI'lit with fee charge of $15.00. the l!Jtension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillOnth period, or the project will be considered abandoned.
<br />WARlfING TO (lIfER: YOUR FAILURE TO RECORD A 1f0000ICE OF C<IlMDClllBIII MAY RESULt IN YOUR PAYllfG !WICE FOR IMPROVIIIEIft'S 10 YOUR
<br />PROPERTY. IF YOU IJI!BID 10 OBIAIK FIIlAlfCING, COIfSULI WITH YOUR LBMDER OR AM AnomY BEFORE RECORDIIfG YOUR NO'I'ICE OF
<br />COHMEIfCEMm. JOBS UffDER $2,500 IIf VALUE 00 If 0'1' IfEED 10 RECORD AIfD POSt A "IfO'l'ICE OF COHMEIfCEHEIII".
<br />
<br />SIGllAlURE: omR OR AGEIf!
<br />
<br />SIGII1IURE: COIllIlAClOR
<br />
<br />S!A'rE OF FLORIDA
<br />COUIf'fY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SIAIE OF FLORIDA
<br />COUIf'fY 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 />(Nam~ 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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