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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'he undersigned understands that this perlit JaY be subject to .deed restrictions. which JaY be lOre restrictive than City
<br />regulations. rhe undersigned assues respoosibility for COIpliance with any applicable deed restrictia.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a contractor or contractor.. to undertake work, they lay be required. to be licell8ed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the ~ and contractor JaY be
<br />cited for a lisdel8allOr violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!l8llts JaY apply for the intended wort, they are advised to contact the City of Zepbyrbills Building Departlent, (BI3)
<br />7BB-6611.
<br />
<br />Furthenore, if the owner has hired a contractor or contractors, be is advised to have the contractor(s) sign portia of the
<br />.Contractor Sectia. of this application for wbich they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the wort. If the contractor wishes you to sign
<br />as contractor that JaY be an indication that be is not properly licensed and is not entitled to penitting privileges in the
<br />City of Jepbyrbills.
<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, have been provided with a copy of .Plorida's COnstruction Lien Law - lDeoImer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsWI8I Iffairs. If the applicant is lUl!OIle other than the
<br />.owner-, I certify that I have obtained a copy of the above described docUlent and premse in good faith to deliver it to the
<br />.owner. prior to co.enCl!l8llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infonation in this application is .accurate and that all wort will be done in CCJlpliance with all
<br />applicable laws regulating construction, loning, and land develoPElt.
<br />
<br />Application is hereby lade to obtain a perlit to do wort and installation as indicated. I certify that no wort or
<br />installation bas CDIl!Dced prior to issuance of a perlit and that all wort will be perfoIlelJ to _t staDdarl1s of all IDs
<br />regulating construction, City codes, loning regulations, and land developl8Jlt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDl8l1tal agencies JaY apply to the intended vort, and that it is
<br />IY responsibility to identify wbat actions I lUSt take to be in COIpliance. Such agencies include but are not Iilited to:
<br />t Departlent of Invirollll8lltal Regulation- Cypress Baybeads, Wetland Areas and InviroDlenta11r Sensitive Lands,
<br />Water/Wastewater rreatlent
<br />t Southwest Florida Water Managl!l8llt District - Wells, Cypress Baybea4s, Wetland Areas, Altering Watercourses
<br />t lIlY Corps of Engineers - Seawalls, Docks, Ravigable Waterways
<br />t Departlent of Health' Rebabilitative Services, EnvirODl8J1tal Health Unit - Wells, Wastewater !reatlent, Septic 'Ianb
<br />t US BnvirODl8J1tal Protection Igency - Asbestos abatl!l8llt
<br />I also certify that, if fill Jaterial is to be used in Flood ZOne .1. or .1, etc. ., it is understood that a draiDage plan
<br />addressing a .COIpIlD8ating volUle. will be saitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance. . .
<br />
<br />I PeIlit issued shall be construed to be a license to proceed with the IIOrt and not as authority to violate, cancel alter, or
<br />Bet aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official fl'Ol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery penit issued shall hecme invalid
<br />unless the IIOrt authoriled by such perlit is co.enced within sillODtbs of issuance, or if IIOrt autboriled by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after. the tile the wort is co.enced. One 90 day atension of tile, Ja' be
<br />allowed for the perlit with fee charge of $15.00. !be atension shall be requested in writing to the Building Official. In
<br />approved inspection lUSt be logged during each sillODth PeriOd, or the project will be considered abandoned.
<br />WIRIfIRG '1'0 (MIBR: YOUR PIILURI '1'0 RECORD A. ROrICE OF C<IIMDCBIIDf lilY RESUL! U YOUR PIYUG 'l'IIICE POI DIPROVIIIII'IS '10 YOUR
<br />. .. . ." .
<br />PROPER'l'Y. IF YOU IIIIDD ro OBfIIRPIlIDCIllGi. COIISUL! WlrB YOUR LBIIDIR OR II 1'l'IORIIY BEPOBB RICORDIRG YOUR JOIlCE OF
<br />C(JUfIRCBIIBN'I'. - JOBS OlDER $2,500 IR VALUE DO ROIIfBBD '1'0 RECORD lID POSr I 'ROIICH OP COlIIDCBIIBN'I".
<br />
<br />.;;~
<br />
<br />SIGlArURB: OIOIIR OR AGD'I'
<br />
<br />SIGII'I'URI: COI'I'IIIC'I'OR
<br />
<br />STA'I'I OP PLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'I'I'I'I OF FLORIDA
<br />coum 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 o~th.
<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 />(Bame Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Baas Typed, Printed or Stamped)
<br />BOTARY PUBLIC
<br />
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