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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' wbich laY be lOre restrict~e than ~ity
<br />regulations. the undersigned asSUles responsibility for co.pliance 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 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 .isdl!leanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirelents laY 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 has bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />IContractor Sections' 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 the work. 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 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 - HOIeOIDer's Protection
<br />Guide' prepared by the Florida DepartJent of Agriculture and COnsUlBf Affairs. If the applicant is sOlBOne other than the
<br />'owner", I certify that I have obtained a copy of the above described docUlBDt and prOlise in good faith to deliver it to the
<br />"owner" prior to COllBDCelBDt.
<br />
<br />E. CONTRACTOR'SjOWNERrS AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, laning, and land developent.
<br />
<br />Application is bereby lade to obtain a perlit to do IIOrt and installation as indicated. I certify that no work or
<br />installation bas ~ced prior to issuance of a perlit and that all wort will be perforaed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developll!llt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governJelltal agencies laY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lUst take to be in colpIiance. Sucb agencies include but are not Ii.ited to:
<br />t Deparuent of EnvirolllleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDleDtally Sensitive Lands,
<br />Water/Wastewater TreatleRt
<br />t Southwest Florida Water Managel8nt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Ravigable Waterways
<br />t DepartJent of Health & Rebabilitative Services, InvirODleDtal Health Unit - Wells, Vastewater Treatlent, Septic Tanks
<br />t US Envil'ODllental Protection Agency - Asbestos abatl!llent
<br />I also certify that, if fill .aterial is to be used in Flood Zone lA' or "A,etc.', it is understood that a drainage plan
<br />addressing a uCOIpBD8ating volUIB' 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 construed to be a license to proceed with the wort 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 frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall beCOle invalid
<br />unless the wort authoriled by such perlit is COIIeDCed within sillODths of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work is ~ced. One 90 day Bltension of tile, laY be
<br />allowed for the perlit with fee charge of $15.00. Tbe Bltension sball 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 />WARRUG T FAILURE 10 RECORD A RO'I'ICE OF COIMDCBMm MAY RESULT I PIYIRG twICE FOR IMPIlOVEIIEIfS TO YOUR
<br />PROPEJm IF OU I E1ID TO AIR FIIIAIICIIG, CONSULT WI'fH YOUR LE1IDER OR no FORE ORDIHG YOUR IO'IICB OF
<br />COMMER . J UNDER 2, 0 LOE 00 10'1 REED TO RECORD AHD POST I RO'IICE C
<br />
<br />
<br />
<br />STATE OF F~ .. ~'?'\
<br />coum OF C\..SLQU.
<br />The foregoing ins~rument was Ac~ledged
<br />before me this::X: -1 ~ , 19~ by
<br />
<br />STilE OF FLORID~
<br />COUNfY OF r 01 seD
<br />The foregoing instrument was a~~edged
<br />before me this ~, 19~ by
<br />
<br />who is person~lY known to me or who has
<br />produced ~ .
<br />as identification and who did/did no
<br />take an 0
<br />
<br />who is p~ known to me or who has
<br />produced
<br />as identification and who did/did no
<br />take an oat
<br />
<br />
<br />(Si
<br />
<br />ed)
<br />
<br />...
<br />
<br />~-~-,.
<br />
<br />C 620.- 7yj"- C(r"- 22.0'- 0
<br />;:-v
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