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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 'deed restrictions' which lay be lOre restrictive than City
<br />regulations. The undersigned assDles responsibility for cOlpliance witb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired 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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents laY apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtberlOre, 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 wbicb they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather tban the contractor, are responsible for tbe work. If the contractor "isbes 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 - HOIeOMDer's Protection
<br />Guide" prepared by tbe Florida Departlent of Agriculture and ConsDler Affairs. If the applicant is SOIeODe other than the
<br />"owner", I certify that I bave obtained a copy of the above described docuIent and prOlise in good faith to deliver it to the
<br />"owner" prior to cOlleDcelent.
<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 cOlpliance "ith all
<br />applicable laws regulating construction, loning, and land developleDt.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify tbat no work or
<br />installation bas cOllenced prior to issuance of a perlit and tbat all work will be perfoIJed to leet 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 goveIDlental agencies laY apply to the intended worl, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />t Departlent of HnviroDlental Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Bngineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health i Rehabilitative Services, BnvirODlental Health_Unit - Wells, Wastewater !reatlent, Septic ranks
<br />t US BnvirODleDtal Protection Agency - Asbestos abatelent
<br />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
<br />addressing a 'cQlPeDsating volDle" will be sublitted wbicb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A per~it issued sball 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 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. Bvery perlit issued shall beCOle invalid
<br />unless the work authoriled by such perlit is COll8llCed within six IOnths of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of six IOntbs after the tile the work is co.enced. One 90 day utension of tile, laY be
<br />allowed for the perlit with fee cbarge of $15.00. !be extension sbal1 be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each sil IOIlth period, or the project "ill be considered abandoned.
<br />WARNING TO OIftfER: YOUR FAILURE to RECORD A NO'I'ICE OF mtHElCBIIBfIf MAY RESUL! IN YOUR PAYING ""ICE FOR DIPROVIIIBIfS to YOUR
<br />PROPERTY. IF YOU IIft'BHD 10 OBTAIN FINANCING, COMSULT WITH YOUR LErmER OR AJllnoRRBY BEFORE RECORDING YOUR NO'I'ICE OF
<br />COHHENCEHlIf1'. JOBS UlfDER $2,500 1M VALUE 00 NOt MEED to RBCORD AIfD POST A INO'I'ICE OF COMHBBCBIIBIff".
<br />
<br />SIGNAtURE: OIftfER OR AGBIfJ
<br />
<br />SIGMATURE: COIfJRACTOR
<br />
<br />STATE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STAtB OF FLORIDA
<br />COURTY 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 bas
<br />produced
<br />as identification and wbo did/did not
<br />take an oatb.
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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