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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands tbat this pertit lay be subject to 'deed restrictions. whicb lay be lOre restrictive tban City
<br />regulations. tbe 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 with
<br />state and local regulations. If the contractor is not licensed as required by law, both the cn,ner and contractor lay be
<br />cited for a lisdeleanor violation under state law. If the owner or jntended contractor are uncertain as to wbat licensing
<br />requirelents lay apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (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 than the contractor, are responsible for the work. If tbe contractor wisbes you to sign
<br />as contractor that laY be an indication that he is not properly licensed and is not entitled to perlitting privileges in tbe
<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 - HoIeowner's Protection
<br />Guide' prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOleone other tban the
<br />'owner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to COIIenceJent.
<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 with all
<br />applicable laws regulating construction, loning, and land developJent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas COIIenced prior to issuence of a perlit and that all work will be perforted 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 goveI1llental agencies laY apply to tbe intended work, 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 />A DepartJent of BnviroDJeDtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />Water/Wastewater treatJent
<br />A Soutbwest Florida Water HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />A DepartJent of Health' Rebabilitative Services, BnvirODlental Health Unit - Wells, Wastewater freatlent, Septic tanks
<br />t US BnvirODJeDtal Protection Agency - Asbestos abateJent
<br />I also certify that, if fill laterial is to be used in Flood Zone "A" or "A,etc.', it is understood tbat a drainage plan
<br />addressing a 'cOlpensating volUle' will be subJitted wbicb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued sball be construed to be a license to proceed witb 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 frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery pertit issued sball beCOle invalid
<br />unless the work autborized by such perlit is cOlIBnced within sil IOntbs of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sillOnths after the tile the work Is cOllellced. One 90 day f!ltension of tile, JaY be
<br />allowed for the pertit with fee charge of $15.00. tbe f!ltension sball be requested in writing to the Building Official. An
<br />approved inspection lust be logged during eacb sil IOntb period, or the project will be considered abandoned.
<br />WAMING fO OWNER: YOUR FAILURE to RECORD A IOTICE OF COIIMIICIlIlIlII' MAY RlBULf II YOUR PAYING !VICE FOR IMPROVIlIIHII'S 10 YOUR
<br />PROPER'fY. IF YOU IIlIBND fO OBrAIH PIIIAJICING, COHSULt WIIH YOUR LENDIR OR 11 AIIOMBY BEFORE RECORDING YOUR NO'rICE OF
<br />COHMIlICllIIHlt. JOBS UNDBR $2,500 II VALUE 00 lOT NBBD fO RICORD AND POSf A "IOTICB OF COMMENCIlIIHNf'.
<br />
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<br />s~~~
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<br />SIGIAfURE: COII'RACfOR
<br />
<br />SfAfB OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />SfAfE OF FLORIDA
<br />COUN'fY 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 o(t.th.
<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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