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<br />J
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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perlit JaY be subject to 'deed restrictions' wbieb JaY be lOre restrictive than City
<br />regulations. !be undersigned assUles responsibility for cmpliance with any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe owner bas bired a contractor or contractors to undertake work, tbey JaY be required to be licensed in accordance witb
<br />state and local regulations. If tbe contractor is not licensed as required by law, botb tbe owner and contractor laY be
<br />cited for a lisdeleanor violation under state law. If tbe owner or intended contractor are uncertain as to "bat licensing
<br />requireaents laY apply for tbe intended work, tbey are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
<br />788-6611. .
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<br />FurtberlOre, if tbe owner bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of tbe
<br />'Contractor Sections' of tbis application for wbieb tbey will be responsible. If you, as tbe owner sign as the contractor,
<br />you are indicating that you, ratber than tbe contractor, are responsible for tbe work. If tbe contractor "isbes you to sign
<br />as contractor that JaY be an indication that be is not properly licensed and is not entiUed to peraitting privileges in tbe
<br />City of Zepbyrbills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify tbat I, the applicant, bave been provided witb a copy of 'Florida's COnstruction Lien Law - JbIeotmer's Protection
<br />Guide' prepared by tbe Florida Departlent of Agriculture and Consuaer Affairs. If tbe applicant i8 BOIeORe other than the
<br />'owner', I certify that I bave obtained a copy of tbe above described docUleDt and prOlise in good faith to deliver it to tbe
<br />'owner' prior to COIIeDceaent.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application i8 accurate and that all work "ill be done in coapliance with all
<br />applicable laws regulating construction, loning, and land developaent.
<br />
<br />Application is herehy Jade to obtain a perlit to do work and installation as indicated. I certify that DO work or
<br />installation bas CDIeJ1ced prior to issuance of a perlit and that all work will be perfomed to .et standards of all laws
<br />regulating construction, City codes,. loning regulations, and land developaent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govermtental agencies laY apply to the intended IIOrt, and that it is
<br />If responsibility to identify what actions I lUst take to be in COIpliance. Sueb agencies include but are not liaited to:
<br />t Departlent of Envirol1lt!lltal Regulation - Cypress Baybeads, lIeUand Areas and BnviroDlentally Sensitive Lands,
<br />lIater/llaste"ater Ireatlent
<br />t Southwest Florida lIater Hanageaent District - lIells, Cypress Baybeads, Wetland Areas, Altering Kitercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, lIavigable Watenays
<br />t DepartJent of Health & Rehabilitative Services, EnvirODll!Jltal Health Unit - Wells, Wastewater rreatlent, Septic Tanks
<br />t US EnvirODlental Protection Agency - Asbestos abateaent
<br />I also certify that, if fill aaterial is to be used in Flood ZOne lA' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpeJI8ating volUll!' will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance. .
<br />
<br />A perait issued shall be construed to be a license to proceed "ith the wort and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a perIlt prevent the. Building Official flOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCCE invalid
<br />unless the work authorbed by sueb perlit is COIIIlJlced within slllOntbs of issuance, or if wort autboriled by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the IIOrk is co.enced. One 90 day atension of tile, laY be
<br />allowed for the perait with fee charge of $15.00. !be atension sball be requested in "riting to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sil IODth period, or the project will be considered abandoned.
<br />IfARJIIlfG !O omR: YOUR FAILURE !O RECORD A 1I0nCB OF aJlMDCEIIBI'f MAY RESUL! III YOUR PAYIlfG filCH FOR IIIPROVBIIBI'fS !O YOUR
<br />. f. . ..
<br />PROPER'lY. IF YOU IBEJID TO OBrAIJIFIlIAIICIIG,. COIfSULI IIlrH YOUR LEllDER OR U AnoRDY BEFORB RECORDIKG YOUR IIO'IICB OF
<br />COHHEIICBHIMI. JOBS UKDER $2,500 III VALUE DO 101 IlBED TO RlCORD AID POS! A 'II01ICB OF COIMEJICBIIBIII.
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<br />. ,...
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<br />SIGIlIIURE: COIIIJIAC!OR
<br />
<br />SIGJIA!URE: OIlIER OR AGEII
<br />
<br />STArE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19 by
<br />
<br />SUIB 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 Oif,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 />
<br />(Signature)
<br />
<br />(Rame Typed, Printed or Stamped)
<br />ROTARY PUBLIC
<br />
<br />(Rame Typed, Printed or Stamped)
<br />ROTARY PUBLIC
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