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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'!be undersigned understands that this pemit laY be subject to Ideed restrictions I wbich lilY be lOre restrictive than City
<br />regulations. tbe undersigned assUIeB respoJlSibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertake work, they lilY 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 lilY be
<br />cited for a .isdelle8JlOr violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />reguirelellts lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />IContractor Sections I 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 work. If the contractor wishes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to perJitting 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, have been provided with a copy of IFlorida's COnstruction Lien Law - lkIIeoImer's Protection
<br />Guide- prepared by the Florida DepartJent of Agriculture and ConsUle1' Affairs. If the applicant is 8OIl!OI1e other than the
<br />lownerl, I certify that I bave obtained a copy of the above described docuIent and pralise in good faith to deliver it to the
<br />lownerl prior to co.encell!llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infOrlation in this application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, zoning, and land developll!Jlt.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />inatallation bas CDIeIlced prior to issuance of a perlit and that all work will be perfomed to leet standards of all 1_
<br />regulating conatruction, City codes, loning regulationa, and land develOpll!llt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agencies lilY apply to the intended work, and that it is
<br />Jy responsibility to identify what actions I lUSt take to be in COIpliance. Such agencies include but are not lillited to:
<br />t Departlent of BnvirOllJelltal Regulation - Cypress Baybeads, Wetland Areas and BnvirOllJelltally Sensitive Lands,
<br />Water/Vastewater 'I'reatlent
<br />t Southwest Florida Water NanageJellt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t Aray Corps of Engineers - Seawalls, Docks, Xavigable Waterways
<br />t Departlent of Health' Rehabilitative Services, BnvirOJlll!Jltal Health Unit - Wells, Was_ter treatJent, Septic tanka
<br />t US BnviIODleJltal Protection Agency - Asbestos abateJellt
<br />I also certify that, if fill Iilterial is to be used in Flood Zone IAI or II,etc.l, it is understood that a drainage plan
<br />addressing a Icc:.pensating volUlleI will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued shall be conatrued 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 shall issuance of a perlit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perJit issued shall bec:oIe invalid '
<br />unless the work authorized by such perlit is co.enced .ithin sillODths of issuance, or if work authorized by the perIIit is
<br />suspended or abandoned for a period of sillODtbs after the tile the work is co.enced. One 90 clay eJtension of tile, lilY be
<br />allOlfed for the perlit with fee charge of $15.00. '!be eatension 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 />IWUfIRG '1'0 omR: YOUR FAILURI '1'0 RECORD A IfO'I'ICE OF ClJIMDCBIIII'l MAY RESUL'I' IX YOUR PAYIIG fiICE FOR DIPROVIIIIlI'I'S '1'0 YOUR
<br />PROPIR'I'Y. IF YOU II'fIJID '1'0 OB'IlIJf FIXUCIIG, COISOL'I' WI'I'H YOUR LlKDIR OR lK I'I"I'ORDY BlPOIIB RICORDIXG YOUR IIO'I'ICE OF
<br />_. .JlIlS _12.5G0 II YILIJIlIlllIOr 11III to IIItlIID ~;CI OP n'.
<br />
<br />
<br />
<br />SIGlllIOIII: OIIIIR 111- ~
<br />
<br />S'l'1'I'1 OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'I'A'I'I OF FLORIDA
<br />coum OF ~ I LL5Pi)(2{Ar>tf
<br />The foregoing inst~t was ac~owledged
<br />before lie this APIZIL 2D, 19~ by
<br />
<br />ILErn+- ~. S.WDPE..
<br />~o is ~personally known to m!)or who has
<br />produce<l
<br />as identification and who did/did not
<br />ta~~ ~J~;) Unl \ I l)4?Jd
<br />~ature) ~
<br />
<br />(Na.e Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />who is personally known to lie 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 />
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