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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS _
<br />The undersigned understands that this penit laY be subject to "deed restrictions" wbich 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 owner bas bired a contractor or contractors to undertake work, they lay be required to be licensed in accordance .ith
<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 />requireJents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />. 788-6611.
<br />
<br />Furtheaore, if the owner bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections' of this application for .bich they .ill 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 perJitting 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 La. - HOIeOIDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is SOJH!One other than the
<br />"owner", I certify that I bave obtained a copy of the above described docUJent and p~ise in good faith to deliver it to the
<br />"otmer" prior to COIIIIeDCeJellt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforJation in this application is accurate and that all work will be done in cOIpliance with all
<br />applicable laws regulating construction, loning, and land developllent.
<br />
<br />Application is bereby lade to obtain a peIlit to do work 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 perforled to lI!et standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlellt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governJental agenCies laY apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lUst take to be in colpliance. Such agencies include but are not lilited to:
<br />* Departlent of Envirollll!l1tal Regulation - Cypress B8yheads, Wetland Areas and Envirolllelltally Sensitive Lands,
<br />Water/Wastewater !reatlent
<br />* Southwest Florida Water HanageJellt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />t Departlent of Health i Rebabilitative Services, EnvirOJlleDtal Health Unit - Wells, Wastewater !reatlent, Septic rants
<br />t US EnvirOJlleDtal Protection Agency - Asbestos abateJellt
<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 "co.pensating volDle" will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A perJit 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 peIlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall becoIe invalid
<br />unless the work authoriled by such peIlit is COIIllJlced within s1llOnths of issuance, or if work authoriled by the peIlit is
<br />suspended or abandoned for a period of sillOnths after the tille the work is co.enced. One 90 day utension of tille, laY be
<br />allowed for the penit .itb fee charge of $15.00. The utension shall be requested in .riting to the Building Official. An
<br />approved inspection nst be logged during each sillOnth period, or the project .ill be considered abandoned.
<br />WARlIIG to omR: YOUR FAILURE 10 RECORD A IOIICE OF aJlHDCBIIItII MAY RESULI II YOUR PAYIIG IIlICE FOR IHPROVEHmS 10 YOUR
<br />PROPERlY. IF YOU IIUIiD to OBlADf FIJlANCIIG, CONSULI WIm YOUR LBIIDER OR 1JI AnomY BEFORE RBCORDIIG YOUR IfO'fICE OF
<br />COMHEICEHD'l. JOBS UlDER '2,500 II VALUE 00 101 mD to RECORD AID POSI A 'IOIICE OF C(JfIIIICEHm".
<br />
<br />SIGIIA!URI: CIfIIlI OR AGm
<br />
<br />o ~ #-
<br />~~ ['.. . . tjo/> ..
<br />SIGIA'IURE: CORIRAC1OR 7
<br />
<br />SIAlE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SIAIE 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 />(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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