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CONDITIONS OF PERMIT AFFIDAVIT A. NOTICE OF DEED RESTRICTIONS 'fbe undersigned understands that this pertit JaY be subject to "deed restrictions" which Jay 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 OIfller bas hired a contractor or contractors to undertake work, they JaY be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the OIlIer and contractOr JaY be cited for a .isdeleanOr violation under state law. If the owner or intended contractor are uncertain as to what licensing requirelellts JaY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813) 788-6611. FurtherlOre, if the OIfller bas bired a Contractor or contractors, be is advised to bave the contractor(s) sign portions of the "Contractor Sections' of this applicatioo for which they will be responsible. If fOU, as the OIIDer sign as the contractor, you are indicating that fOU, rather than the contractor, are responsible for the IOrk. If the contractor wishes you to sign as contractor that JaY 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, have been provided with a copy of 'Florida's COnstruction Lien Law - BoIeoImer's Protection Guide' prepared by the Florida Departlent of Agriculture and COnsUler Affairs. If the applicant is 8OIeOIUl other than the "OIfI1er", I certify that I have obtained a copy of the above described dOCUJl!llt and pIOlise in good faith to deliver it to the 'owner" prior to co.enCelellt. E. CONTRACTOR'S/OWNER'S AFFIDAVIT I certify that all the infoI'liltion in this application is accurate and that alllOrk will be done in COIpliance with all applicable laws regulating construction, lOlling, and land develoJll8llt. Application is hereby Jade to obtain a perlit to do IOrt and installation as indicated. I certify that no IOrk or installation bas CDlencec1 prior to issuance of a perlit and that all work will be perforJed to I88t standards of all laws regulating construction, City codes, loning regulations, and land developElt regulations in the jurisdictioo. I also certify that I understand that the regulations of other goverDlental agencies laY apply to the intended work, and that it is If responsibility to identify what actions I lUSt take to be in COIpliance. Such agencies include but are not lilited to: I Departlent of Envirouental Regulation - Cypress Bayhead8, Metland Areas and Envirollllentally Sensitive Lands, WaterjVastewater 'Ireatlent I Southwest Florida Water Managel8llt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses I IrIy Corps of Engineers - Seawalls, Docks, Ravigable Waterways I Departlent of Health i Rehabilitative Senices, InvirOJll8l1tal Health Unit - Wells, Wastewater 'Ireatlent, Septic 'Iants I US Invirouental Protection Agency - Asbestos abatelellt 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 '~ating volUle" will be subaitted wbich is prepared by a professional engineer registered in the State of Florida prior to pellit issuance. ( ( e Typed, Printed or Stamped) HOTARY PUBLIC "A' ADMEAU LOIS ANN \:11'>1...1\"" MY COMMISSION' CC 307950 EXPIRES: August 28. 1991 IlOl\d8d Thill NotIIIY PublIC Unde\WlltOl1 (Hue Typed, Printed or Stamped) HOTARY PUBLIC "'~-:;'~:ftJ"" LOIS ANN GALARNEAU Lf' '1'4 MY COMMISSION' CC 307950 , - EXPIRES: August 28, 1997 ,.,- Bonded Thill NolaJy Public Und8rM1t8l1 ".