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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS #..
<br />The undersigned understands that this perlit lay be subject to Ideed restrictions" wbicb laY be lOre restrictive than City
<br />regulations. The 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 work, they .ay 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 lisdl!leanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />reguireleDts laY apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner has hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections I of this application for which 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 tbe work. If the contractor wishes you to sign
<br />as contractor that laY 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 IFlorida's Construction Lien Law - no.eowner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is SOIeODe other than the
<br />lowner", I certify that I bave obtained a copy of the above described dOCUl8Dt and prOlise in good faith to deliver it to the
<br />.owner" prior to COlleDCeleDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in tbis application is accurate and that all work 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 C08eJ1ced prior to issuance of a perlit and that all work will be perfoIled to _t standards of all lalls
<br />regulating construction, City codes, loning regulations, and land develo(llent regulations in the jurisdiction. I also
<br />certify tbat I understand that the regulations of other goveIDlK!lltal agencies laY apply to the intended work, and that it is
<br />.y responsibility to identify what actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />t Departlent of BnviroDlental Regulation - Cypress Baybeads, Wetland Areas and BnviroDleDtally Sensitive Lands,
<br />WaterfWastewater Treablent
<br />t Southwest Florida Water HanageleDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Havigable Waterways
<br />t Departlent of Health , Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />t US BnvirODleDtal Protection Agency - Asbestos abateleDt
<br />I also certify that, if fill laterial is to be used in Flood Zone IAI or "A,etc.., it is understood that a drainage plan
<br />addressing a ICOlpeDsating VOlUleI will be sublitted wbicb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />Bet 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. . Bvery perlit issued shall becoIe invalid
<br />unless the work authorized by such perlit is coaenced within sillODths of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of sillODths after the tile the work is COMenced. One 90 day utension of tile, laY be
<br />allowed for the perlit with fee charge of $15.00. Tbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each sillOnth period, or the project will be considered abandoned.
<br />WARNING TO OVIIlR: YOUR FAILURIl TO RECORD A 1000ICE OF COMMBIICEHBHT HAY RESULT IH YOUR PAIIIG 'nIICH FOR IHPROVBIIBHTS TO YOUR
<br />PROPBRTY. IF YOU IHTBHD TO OBTAIH FlHAHCIIG, COHSULT WITH YOUR LBHDIR OR AX ATTORHBY BBFORE RBCORDIHG YOUR MarICH OF
<br />COMHBHCBHBHT. JOBS UlmBR '2,500 IH VALUB DO H01' HlBD TO RECORD AND POST A IH01'ICB OF C(lllBHCBMDI..
<br />
<br />SIGHATURB: COmACTOR
<br />
<br />SIGHATURB: OIftIBR OR AGBNT
<br />
<br />STATE OF FLORIDA
<br />COUHTY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STATB 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 oClth.
<br />
<br />(Signature)
<br />
<br />(Nue 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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