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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this peIlit lilY be subject to Ideed restrictions" wbieb lay be lOre restrictive than City
<br />regulations. !be undersigned asSUles responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the (MIer bas bired a contractor or contractors to undertake lIOrk, 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 mmer and contractor lilY be
<br />cited for a lisdeleanor violation under state law. If the mmer or intended contractor are uncertain as to wbat licensing
<br />requirl!leDts lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />. 788-6611.
<br />
<br />FurtbeIlOre, if the mmer bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sectionsl of this application for wbieb they will be responsible. If you, as the mmer 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 IPlorida's Construction Lien Law - lIoIeowner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and COnsUler Affairs. If the applicant is sOleOne other than the
<br />ImmerH, I certify that I bave obtained a copy of the above described docuIent and pIOlise in good faith to deliver it to the
<br />"mmer" prior to COll8l1Cl!lent.
<br />
<br />E. CONTRACTOR'S/OWNER'S 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, loning, and land developlt!llt.
<br />
<br />Application is bereby lade to obtain a peIlit to do IIOrk and installation as indicated. I certify that no work or
<br />installation bas ~ced prior to issuance of a perlit and that all work will be perfoIlecl to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developent 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 />If responsibility to identify wbat actions I lUst take to be in cOJpliance. Sueb agencies include but are not lilited to:
<br />t Departlent of BnvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and Bnvirolllelltally Sensitive Lands,
<br />Water /Wastewater Treatlent
<br />t Southwest Florida Water Hanagl!lent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AllY Corps of Engineers - Seawalls, Docks, Havigable Waterways
<br />t Departlent of Health i Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />t US EnviroDlelltal Protection Agency - Asbestos abatl!lll!llt
<br />I also certify that, if fill Iilterial is to be used in Flood Zone IAI or IA,etc.l, it is understood that a drainage plan
<br />addressing a lCOIpeDSating VOIUlleI will be subJlitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A peIlit issued sball be construed to be a license to proceed with the IIOrk and not as authority to violate, cancel alter, or
<br />Bet 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. Every peIlit issued shall beCOle invalid
<br />unless the work authoriled by sueb peIlit is cOll8llced within sil IOnths of issuance, or if work authorized by the peIlit is
<br />suspended or abandoned for a period of sil IOnths after the tile the work is ~ced. One 90 day l!Itension of tile, lilY be
<br />allowed for the peIlit with fee charge of $15.00. Tbe l!Itension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eaeb sillODth period, or the project will be considered abandoned.
<br />WARRIIG 'fO QWHIR: YOUR FAILURE TO RECORD A HorlCl OF COIMIHCBIIII! MAY RESULf II YOOR PAYlHG fWICI FOR IHPROVEMmS fO YOUR
<br />PROPERlY. IF YOU I 'fO OBfADI FIIlAlfCIIG, COISULT WI'fH YOUR LBIIDER OR U BEFORE RECORDIHG YOOR 1000lCl OF
<br />COMMEICBHBN'f. J S HR $2,500 II VALUE 00 MO'f mD 'fa RECORD AHD POST A OF C<JOOOfCBHB)I'l".
<br />
<br />
<br />
<br />STATE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STATE 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 oath.
<br />
<br />(Signature)
<br />
<br />(Name 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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