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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit laY be subject to "deed restrictions" which laY be lOre restrictive than City'
<br />regulations. Tbe undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they lay be required to be licensed in accordance witb
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor laY be
<br />cited for a lisdl!lleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtberlOre, if the owner bas hired a contractor or contractors, he is advised to bave tbe contractor(s) sign portions of tbe
<br />"Contractor Sections" of this application for whicb tbey will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather tban the contractor, are responsible for the work. If the contractor wisbes you to sign
<br />as contractor that laY be an indication that he 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 113, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of 'Florida's Construction Lien Law - BOIeOMDer's Protection
<br />Guide" prepared by tbe Florida DepartJent of Agriculture and ConsUJer Affairs. If tbe applicant is sOlH!Olle otber than the
<br />"owner", I certify that I have obtained a copy of the above described docUJent and prOllise in good faith to deliver it to the
<br />"owner" prior to cOlleDce.ent.
<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 developlent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation has cOlleDced prior to issuance of a perlit and that all work will be perfoIled to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land develoPEDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governlental agencies aay apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />A Departlent of Envirou.ental Regulation - Cypress Baybeads, Vetland Areas and Envirou.entally Sensitive Lands,
<br />Vater/Vastewater TreatleRt
<br />A Southwest Florida Vater Hanage.ent District - VeIls, Cypress Baybeads, Vetland Areas, Altering Vatercourses
<br />A ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />A Departlent of Health' Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater TreatleRt, Septic Tanks
<br />A US EnvirODl!Dtal Protection Agency - Asbestos abate.ent
<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 'cOlpensating volUle" will be subtitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued sball be construed to be a license to proceed witb tbe work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frUl,tbereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued &ball beCOlB invalid
<br />unless the work authorized by such perlit is COll8llced within sillOntbs of issuance, or if work autboriled by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work is ~enced. One 90 day l!Itension of tile, aay be
<br />allowed for tbe perlit with fee charge of $15.00. The extension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COHHBICKIIKHI MAY RESULT IN YOUR PAYING TIIICB FOR IHPROVBHKII1'S TO YOUR
<br />PROPERTY. IF YOU III1'BW TO OBTAIN FIJlAHCING, CONSULT WITH YOUR LDDIR OR AN AnORIBY BIFORE RECORDING YOUR NOTICE OF
<br />COMHKNCKHBNT. JOBS UNDER $2,500 IN VALUE DO NOT NEED '1'0 RECORD AND POST A "NOTlCE OF COIIHKNCKHKJII".
<br />
<br />SIGNAtURE: OWNER OR AGEIIT
<br />
<br />SIGNATURE: COIITRACTOR
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />before me this I 19____ by
<br />
<br />STATE OF FLORIDA
<br />COUNTY 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 1yped, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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