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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perait lay be subject to "deed restrictions" wbich laY be lOre restrictive than City
<br />regulations. the undersigned asSUl88 responsibility for COIpliance 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 wort, 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 lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />reguirelents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />Furtheraore, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />DContractor Sections I of this application for which they will be responsible. If fOU, as the owner sign as the contractor,
<br />you are indicating that fOU, rather than the contractor, are responsible for the work. If the contractor wishes you to sign
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to pertitting 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 IPlorida's Construction Lien Law - lIoIeowner's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUlleI' Affairs. If the applicant is sOftOne other than the
<br />lowner", I certify that I bave obtained a copy of the above described docuaent and prOtise in good faith to deliver it to the
<br />"owner" prior to cOlleDceaent.
<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 cDlpliance 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 no work or
<br />installation bas CDIIeDced prior to issuance of a pertit and that all work will be perfoIled to teet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govemaental agencies uy apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in coapliance. Such agencies include but are not lilited to:
<br />* Departlent of Environaental Regulation - Cypress Baybeads, IIetland Areas and Invironaentally Sensitive Lands,
<br />IIater /IIastewater Treablent
<br />* Southwest Florida Water Manageaent District - IIells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />* Aray Corps of Engineers - Seawalls, Docks, Mavigable Waterways
<br />* Departlent of Health , Rebabilitative Services, EnvirODleDtal Health Unit - IIells, IIastewater Treatlent, Septic Tanks
<br />* US EnviI'ODlll!Dtal Protection Agency - Asbestos abatl!lent
<br />I also certify that, if fill laterial is to be used in Flood ZOne "AI or DA,etc.", it is understood that a drainage plan
<br />addressing a uCOIpeDsating voluteD will be subtitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perait issuance.
<br />
<br />A pertit 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 perlit prevent the Building Official frOl thereafter
<br />reguiring a correction of errors in plans, construction, or violations of any code. Bvery perlit issued shall beCOle invalid
<br />unless the work authorized by such perait is COll8llced within sillOntbs of issuance, or if wort authoriled by the perlit is
<br />suspended or abandoned for a period of six IOntbs after the tile the wort is ~ced. One 90 day extension of tile, uy be
<br />allowed for the 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 sillODth period, or the project will be considered abandoned.
<br />WARMIHG TO OWNER: YOUR FAILURE TO RECORD A MOTICE OF COMMEMCEIlIIft' MAY RESULT 1M YOUR PAYIMG 'NICE FOR IMPROVEMEIft'S TO YOUR
<br />PHOPKRn. IF YOU IIIJEHD TO OBrAIK FIIWCIMG, COISULT 111m YOUR LINDER OR All AnORm BEFORE RECORDIIG YOUR HorlCE OF
<br />COMHBMCBMBIft'. JOBS UMDER $2,500 1M VALUE DO Mor MEED TO RECORD AIID POST A "MOTICE OF COMMEKCEMEIft'".
<br />
<br />~..:. ~~ ~ ~ tf~~ ~
<br />SIGlAfURE: OIIJIR AS " SIGNATURE: COlifRACrOR
<br />
<br />STATE OF FLORIDA
<br />coum OF .
<br />The foregoing instrument was aCknowledged
<br />before me this , 19____ by
<br />
<br />STArK OF FLORIDA
<br />COUIft'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 />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Namt! Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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