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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perlit lay be subject to "deed restrictions" wbieb laY be lOre restrictive than City
<br />regulations. Tbe undersigned assUleS responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe owner has bired a contractor or contractors to undertake IIOrk, they oy be required to be licensed in accordance witb
<br />state and local regulations. If the contractor is not licensed as required by law, both the mmer and contractor IiY be
<br />cited for a lisdelH!anor violation under state law. If the mmer or intended contractor are uncertain as to what licensing
<br />requirelents laY apply for the intended IIOrt, they are advised to contact the City of Zepbyrbills Building DepartleRt, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of tbe
<br />"Contractor Sections" of this application for wbicb they will be responsible. If you, as the mmer sign as the contractor,
<br />you are indicating that you, rather than tbe contractor, are responsible for the work. If the contractor wisbes you to sign
<br />as contractor that oy 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 with a copy of "Florida's Construction Lien Law - BOJeOIDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUIBI Affairs. If the applicant is sOlBODe other than the
<br />. "owner", I certify that I bave obtained a copy of the above described dOCUll!llt and premise in good faith to deliver it to the
<br />"mmer" prior to cOllBDcelH!nt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforotion in tbis application is accurate and that all IIOrk 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 work or
<br />installation bas cOllenced prior to issuance of a perlit and that all work will be perfoIJed to leet standards of all laws
<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 goverDJeDtal agencies laY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />t Departlent of EnviroDlBRtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDJeRtally Sensitive Lands,
<br />Water/Wastewater TreatleRt
<br />t Southwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health i Rebabilitative Services, EnvirORJental Health Unit - Wells, Wastewater TreatleRt, Septic lanks
<br />t US EnvirODlental Protection Agency - Asbestos abatetent
<br />I also certify that, if fill oterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "cOJPBDSating volUle" will be sublitted wbieb is prepared by a professional engineer registered in the St~te of
<br />Florida prior to perlit issuance.
<br />
<br />A pe~it issued sball be construed to be a license to proceed with the IIOrk 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 />requiring a correction of errors in plans, construction, or violations of any code. Ivery peIlit issued shall becoJe invalid
<br />unless the work authoriled by such peIlit is COJJellced within sillOnths of issuance, or if IIOrt authoriled by the perlit is
<br />suspended or abandoned for a period of sil IOnths after the tile the work is co.enced. One 90 day eztension of tile, IiY be
<br />allowed for the perlit with fee ebarge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lust be logged during eaeb sillOnth period, or the project will be considered abandoned.
<br />WARKING TO OIINER: YOUR FAILURE TO RECORD A NOt'ICE OF C(JIIINCBIID1' lilY RESULT IN YOUR PAYING "'ICE FOR IMPROVBIIBI1'S TO YOUR
<br />PROPBRTY. IF YOU IJl'fBIfD TO OBTAIN FIWCING, CONSULT WITH YOUR LBIDIR OR AI AnORRBY BBFORE RBCORDING YOUR JlarICE OF
<br />COHHBlfCBllBHT. JOBS UNDBR $2,500 IN VALUE DO NOt' MBlD fa RICaRD AID POST A 'NOt'ICE OF C(JUIINCBItBJI'f".
<br />
<br />SIGNATURE: OIfHIR OR AGEJI'f
<br />
<br />SIGHATURB: CONTRAC'fOR
<br />
<br />STATE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STATE 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 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 />(Naae Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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