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<br />CONDITIONS OF PERMIT AFFIDAVIT ~-- -,
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this pertit lay be subject to wdeed restrictionsw Ibich lay be lOre restrictive than Citi
<br />regulations. tbe undersigned assUles responsibility for cOlpliance lith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertale IOrk, 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 IlaY be
<br />cited for a lisdeJeaDor violation under state lal. If the owner or intended contractor are uncertain as to Ibat licensing
<br />requirelents laY apply for the intended IOrl, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, he is advised to bave tbe contractor(s) sign portions of tbe
<br />BContractor Sections. of this application for Ibich 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 IOrk. If the contractor lisbes 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 litb a copy of wFlorida's Construction Lien Law - BoIeoIner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is SOleOlU! other than the
<br />.0wnerB, I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />BownerB prior to cOll8nceJeDt.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all IOrk 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 no lork or
<br />installation has cOlleDced prior to issuance of a perlit and that all lork lill be perfoIJed to leet standards of all lals
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDlental agencies laY apply to tbe intended IOrl, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />. Departlent of HnviroDl8Dtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDleDtally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />· Soutbwest Florida Water Managelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />· ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />· Departlent of Health & Rebabilitative Services, HnvirOOl8Dtal Health Unit - Wells, Vastewater Treatlent, Septic 'anks
<br />· US HnvirODleDtal Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood ZOne WAW or "A,ete.B, it is understood that a drainage plan
<br />addressing a .cOlpensating VOlUleB will be subtitted wbicb 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 litb the IOrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of tbe technical codes, nor shall 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 petlit issued shall becoIe invalid
<br />unless the IOrk authoriled by such perlit is cOll8nced within sil IODthS of issuance, or if IOrk authorized by the perlit is
<br />suspended or abandoned for a period of sillOntbs after the tile the IOrl is cu.enced. One 90 day 81tension of tile, lay be
<br />allowed for the peIlit with fee charge of $15.00. Tbe 81tension sball be requested in Iriting to the Building Official. An
<br />approved inspection lUst be logged during each sillOnth period, or the project lill be considered abandoned.
<br />WARNING TO OVIHR: YOUR FAILURIl TO RiCORD A NOTICE OF COMMDCIIIINf MAY RiSUL' IN YOUR PAYING !VICK FOR IMPROVIMDl'S TO YOUR
<br />PROPERTY. IF YOU INfIND TO OBTAIN FIIlAlfCING, CONSULT VITH YOOR LINDHR OR AN AnoRIlY BIFORi RiCORDIHG YOUR HOTICI OF
<br />COMMlHCBMENf. JOBS UNDIR $2,500 IN VAWI DO lOT NEID TO RECORD AND POST A BNOTICE OF COMMDCEIIINf..
<br />
<br />
<br />~~rU?-
<br />'SIGNATU~IlR OR AGENT
<br />
<br />SIGNATURIl: CONTRACTOR
<br />
<br />STATIl OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 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 wbo did/did not
<br />take an oath.
<br />
<br />who is personally known to me or who bas
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Name 7yped, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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