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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS .
<br />The undersigned understands that this perJit laY be subject to "deed restrictionsP wbich lay be lOre restrictive than 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 hired a contractor or contractors to undertake work, they JaY 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 JaY be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!ll!Dts lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />IIContractor Sections" of this application for wbich they will be responsible. If you, as the owner -sign as the contractor,
<br />you are indicating that you, ratber 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 Law - HoIeowner's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsWler Affairs. If the applicant is sOleOne other than the
<br />Pownerll, I certify that I have obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to cOllellcelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in tbis application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developaent.
<br />
<br />Application is bereby lade to obtain a perJit to do work and installation as indicated. I certify that no work or
<br />installation bas cOlleDced prior to issuance of a perJit and that all work will be perfoIled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDleDtal agenCies lily apply to the 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 />· Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />· Southwest Florida Water Hanagelent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />· ArJY Corps of Engineers - Seawalls, Docks, Xavigable Waterways
<br />· Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater TreatJent, Septic Tanks
<br />· US EnvirODleDtal Protection Agency - Asbestos abateleDt
<br />I also certify that, if fill .aterial is to be used in Flood ZODe "A" or "A,etc.lI, it is understood that a drainage plan
<br />addressing a uCD,lpeDsating volUleu will be subJlitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />
<br />A perlit 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 perJit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery peIlit issued shall becOle invalid
<br />unless the work autborized by such perJit is COllenced within six IOnths of issuance, or if work authorized by the perJit is
<br />suspended or abandoned for a period of six IOJltbs after the tile the work is cOBenced. One 90 day l!Itension of tile, lay be
<br />allowed for the perJit 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 each sil IOJlth period, or the project will be considered abandoned.
<br />WARHIllG TO OWNER: YOUR FAILURE TO RECORD A XOIICE OF C(JfMBIfCEllllff MAY RESULT III YOUR PAYIIfG TWICE FOR IHPROVIIIDfS TO YOUR
<br />PROPERTY. IF YOU IIDIfD TO OBTAIIf FIIfAIICIIfG, COIfSULT WITH YOUR LlllDIR OR All AffORIfEY BEFORE RlCORDIIfG YOUR DICE OF
<br />COMHEHCEMEfft' . JOBS UHDIR $2,500 IX ALUI 00 HOI HEED TO RECORD AIfD POST A "HOIICI OF COHNEIICEHDfIl
<br />;' / ,.
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<br />U-c/ t--
<br />
<br />
<br />S IE OF FLORIDA
<br />COUtlTY OF
<br />The foregoing instrument was acknowledged
<br />before me this __.___.__, 19_ by
<br />
<br />ST I OF FLORIDA
<br />COUNTY 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~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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