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CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS Tbe undersigned understands that this peClit laY be subject to .deed restrictions. whieb lay be lOre restrictive than City regulations. 'he undersigned assUleS responsibility for COIpliance with any applicable deed restrictions. B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES If the ~ner bas hired a contractor or contractors to undertake work, they .ay be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the mmer and contractor .y be cited for a lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing requirelents .ay apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813) 788-6611. FurtberlOre, if the mmer bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the "Contractor Sections. of this application for wbicb tbey will be responsible. If you, as the mmer sign as the contractor, you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes you to sign as contractor that laY be an indication that be is not properly licensed and is not entitled to perlitting privileges in the City of Zepbyrbills. C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) I certify that I, the applicant, bave been provided with a copy of .Florida's COnstruction Lien Law - HOIeONDer's Protection Guide" prepared by the Florida DepartJent of Agriculture and Consl1ller Affairs. If the applicant is SOIH!One other than the "mmer", I certify that I have obtained a copy of the above described docUIIeDt and prOlise in good faith to deliver it to the "owner" prior to cOlleDcelent. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that. all the inforaation in this application is accurate and that all work will be done in cOlpliance with all applicable laws regulating construction, loning, and land developaent. Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no IOrl or installation bas cOlleDced prior to issuance of a perlit and that all work will be perfoCJed to leet standards of all laws regulating construction, City codes, loning regulations, and land developaent regulations in the jurisdiction. I also certify that I understand that the regulations of other governtental agencies laY apply to the intended work, and that it is .y responsibility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not litited to: t DepartJent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDleDtally Sensitive Lands, Water/Wastewater Treattent . t Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways t DepartJent of Health' Rebabilitative Services, Environtental Health Unit - Wells, Wastewater 'reattent, Septic ranks t US EnvirODleDtal Protection Agency - Asbestos abatl!lent I also certify that, if fill laterial is to be used in Flood Zone .A. or .A,etc.., it is understood that a drainage plan addressing a .cOlpensating volute. will be sublitted whieb is prepared by a professional engineer registered in the State of Florida prior to perlit issuance. STATK OF FLORIDA COUITI OF PASC!-O The foregoing instrument was acknowledged before me this /d. - ~ , 191f. by .:bo/.J~~"D W I &IU~,.~vJ who is personally known to me or who has produced F).oR..Jl>i" '])/<., V~ J..J~E.P :!it: as identification and who did/did not ta~o~h~c?~ (Signature) /) MtJl2A ). I '- LA,€/<.. (Name Typed, Printed or Stamped) NOTARy'PUBLIC ~ LAURA L. CLARK . My Comm (xp, 3/2!i/97 .. . ...' . l~' Bonded By SeMce In. S . . o~. No, CC77t823 6, ,-.; I ) Per.....,KnlIIn. ~..l. .. ~woo-Jq9-"Iq -;l.{pl-O STATK OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this , 19_____ by who is personally known to me or who has produced as identification and who did/did not take an oiJth. (Signature) (Name Typed, Printed or Stamped) NOTARY PUBLIC