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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />file undersigned understands that this pemit lay be subject to 'deed restrictions" wbich 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 the owner bas bired a contractor or contractors to undertake wort, 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 laY be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!leDts laY apply for the intended wort, 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, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' 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 wisbes you to sign
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to pem1tting 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 - HoIeoJmer's Protection
<br />Guide' prepared by the Plorida Departlent of Agriculture and COnsUller Affairs. If the applicant is 8OIIeOI1e other than the
<br />'owner', I certify that I bave obtained a copy of the above described docUIent and pnmse in good faith to deliver it to the
<br />"owner" prior to co.enCeJIeDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infomtion in this application is accurate and that all wort will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developient.
<br />
<br />Application is hereby Jade to obtain a pemit to do wort and installation as indicated. I certify that no wort or
<br />installation bas CDlenced prior to issuance of a perlit and that all wort will be perfoIJed to aeet standards of all laws
<br />regulating construction, City codes, loning regulations, and land develOpleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agencies laY apply to the intended worl, and that it is
<br />If responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not lilited to:
<br />t Departlent of EnvirOllleDtal Requlation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater treatlent
<br />t Southwest Plorida Water Hanagl!leDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t Ally Corps of Engineers - Seawalls, Docts, Kavigable Waterways
<br />t Departlent of Health i Rehabilitative Services, EnvirOJllental Health Unit - Wells, Wastewater treatlent, Septic tants
<br />t US EnvirODllelltal Protection Agency - Asbestos abatl!leDt
<br />I also certify that, if fill aaterial is to be used in Plood Zone 'A' or II,etc.", it is understood that a drainage plan
<br />addressing a 'COIpen.Bating volUJe' will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A P81lit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official f1'Ol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued sball beCCIIe invalid
<br />unless the wort authorized by such pemit is ~ced within sillODths of issuance, or if wort authoriled by the perlit is
<br />suspended or abandoned for a period of sil IODths after the tile the wort is ccamced. One 90 day l!Itension of tile, laY be
<br />allowed for the perlit with fee charge of $15.00. file l!Itension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned.
<br />WARKING !O omR: YOUR PAILURB !O RECORD A KOlICH OF COIMDCDIDl' HAY RESULt IK YOUR PAYIKG flfICH FOR DIPROVBIIBI1'S !O YOUR
<br />PROPERlY. IF YOU ImIfD !O OB'IAIB PIWCIHG, COHSOLt WID YOUR LlllDIR OR All AftORDY BIPORE RECORDIKG YOUR DICH OF
<br />COHHDCIHEHf. JOBS UlfDER $2,500 Ilf VILUE DO KOf NKED to RECORD AIID POSt A "KOlICH OP COHHDCBIIIIif".
<br />
<br />--~~
<br />(
<br />SIGlAtURB:. OR AGBJI1'
<br />
<br />SIGIfA'I'URB: COlf'I'IIAC'I'OR
<br />
<br />S'I'AtE OF PLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'I'A'I'E 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 />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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