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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit tay be subject to 'deed restrictions" wbieb lilY be lOre restrictive than City
<br />regulations. !be undersigned assUJes responsibility for COIIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the (MIer 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 O1IIler and contractor lay be
<br />cited for a lisd_anor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireJents lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
<br />788-6611.
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<br />FurtherlOre, 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 O1IIler 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 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 - lIoJeotmer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is SOIeon! other than the
<br />'owner', I certify that I bave obtained a copy of the above described dOCUJellt and prOJise in good faith to deliver it to the
<br />"owner' prior to COll8llCeJent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infOIliltion in this application is accurate and that all wort will be done in COJpliance with all
<br />applicable laws regulating construction, zoning, and land developent.
<br />
<br />Application is bereby Iilde to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas CDIeIlCed prior to issuance of a perli t and that all IOrk will be perfoIJeCl to leet stanc1ards of all laws
<br />regulating construction, City codes, zoning regulations, and land developJellt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governJel1tal agencies lilY apply to the intended IOrt, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in COJpliance. Sueb agencies include but are not lilited to:
<br />* Departlent of EnvirOl1l8lltal Regulation - Cypress Bayheads, Wetland Areas and Bnvirolllelltally Sensitive Lands,
<br />Water /Wastewater TreatJent
<br />* Southwest Florida Water ManageJent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />* AIIY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* Departlent of Health i Rebabilitative Services, BnvirODJeRtal Health Onit - Wells, Wastewater treatJent, Septic tanks
<br />* US BnvirODJental Protection Agency - Asbestos abateJent
<br />I also certify that, if fill Iilterial is to be used in Flood ZOne "A' or "A,etc.', it is understood that a drainage plan
<br />addressing a 'cOlpBDsating volUJe' 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 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 sball issuance of a perlit prevent the Building Official frOJ 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 sucb perlit is COIIIlIlCed within sil aonths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sil IOnths after the tile the IOrk is co.enced. One 90 day l!Itension of tile, lilY be
<br />allowed for the perlit with fee ebarge of $15.00. 'l'be l!Itension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillOllth period, or the project will be considered abandoned.
<br />WARRING 'l'O 0IflfIR: YOUR FAILURI 'l'O RlCORD A NO'l'ICI OF aIIMBRCIIIIH'l' MAY RlSUL'I' IN YOUR PAYING 'l'WICI FOR IMPROVIIIII!S TO YOUR
<br />PROPER'fY. IF YOU InBMD TO OB'l'AIH -tIIlUCIRG, COIISULt IlItH YOOR LIIIDER OR All AftORDY BBFORI RiCORDIHG YOUR HO'l'ICI OF
<br />COMMENCEMlM!. JOBS UlDER $2,500 IN VALUE 00 1I0'l' IlBED '1'0 RECORD AIID POS! A 'NO'l'ICI OF COMMBIfCBMBH'l".
<br />
<br />SIGIIA'l'URE: COM'l'RAC'l'OR
<br />
<br />SIGHA'IURI: OOER OR AGEIl'l'
<br />
<br />S'I'A!E OF FLORIDA
<br />COUN'l'Y OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'I'A'I'E OF FLORIDA
<br />COUN'l'Y 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 />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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