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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands tbat this perlit laY be subject to .deed restrictions" wbicb laY be lOre restrictive than City
<br />regulations. 'be undersigned assuaes 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 with
<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 lisd8leanor 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 tbe City of Zepbyrbills Building Departlent, (813)
<br />188-6611.
<br />
<br />FurtberlOre, if tbe OIfner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections. of this application for wbicb they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, ratber 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 113, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided witb a copy of .Florida's Construction Lien Law - BoIeoIoer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOl8ODe other than the
<br />.owner", I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to cOll8llceaent.
<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 bereby lade to obtain a perlit to do work and installation as indicated. I certify that DO work or
<br />installation bas COll8llced prior to issuance of a perlit and that all work will be perforled to .et staDdards of all laws
<br />regulating construction, City codes, loning regulations, and land developll!llt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of otber goveIDlental agenCies laY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in coapliance. Sucb agencies include but are not lilited to:
<br />t Departlent of Environaental Regulation - Cypress Baybeads, Wetland Areas and Environaentally Sensitive Lands,
<br />Vater/Vastewater 'reatlent
<br />t Soutbwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />t Deparllent of Health i Rehabilitative Services, Invironaental Health Unit - VeIls, Vastewater Treatlent, Septic Tanks
<br />t US Environaental Protection Agency - Asbestos abateaent
<br />I also certify that, if fill aaterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a .cOlpensating voluae. will be subaitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit 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 technical codes, nor sball issuance of a perlit prevent the Building Official frOl,thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall becoae invalid
<br />unless tbe work authoriled by such perlit is COIIBDCed within sil IOnths of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of sil IOntbs after the tile the work is COll8llCed. One 90 day 81tension of tile, lay be
<br />allowed for the perlit with fee cbarge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each sil IODth period, or the project will be considered abandoned.
<br />WARNING TO OIlIER: YOUR FAILURE TO RECORD A lOT ICE OF COHHEICEHBlfl HAY RESULT II YOUR PAYlIG !VICE FOR IHPROVIHDl'S TO YOUR
<br />PROPERTY. IF YOU IIITEW TO OBTAII FIIWfCIIG, COISULT WITH YOUR LBlDIlR OR 111 AnORlBY BIlFORE RECORDIIG YOUR IIOTICE OF
<br />COHHBICIHINT. JOBS OffDER $2,500 III VALUI 00 lOT HElD TO RECORD AIID POST A "IOTICE OF C<JtMBICBMlIIT".
<br />
<br />SIGIATURE: COITRACTOR
<br />
<br />SIGIATURE: OVNER OR AGIIIT
<br />
<br />STATI OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STATK 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 ~yped, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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