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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this pemit laY be subject to ndeed restrictions" wbieb lilY be lOre restrictive than City
<br />regulations. Ibe undersigned assUles responsibility for cOlpliance 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 owner and contractor lily be
<br />cited for a .isdeJeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireJeJlts lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />nContractor Sectionsl of this application for wbieb 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 the contractor wishes 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 - lDeoJmer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and COnsUIeI Affairs. If the applicant is soeone other than the
<br />lowner", I certify that I bave obtained a copy of the above described docURJIt and prOlise in good faith to deliver it to the
<br />"owner" prior to COlllenCeJeJlt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is bereby lade to obtain a pemit to do work and installation as indicated. I certify that no work or
<br />installation bas COMenced prior to issuance of a pemit and that all work will be perfoIJed to .et standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlent 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 />IY responsibility to identify wbat actions I lUst take to be in colpliance. Sueb agencies include but are not liJited to:
<br />t Departlent of BnvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and Envirolllf!lltally Sensitive Lands,
<br />Water/Vastewater TreatJent
<br />t Southwest Florida Water HanageJeJlt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />t DepartJent of Health i Rebabilitative Services, BnvirODJeDtal Health Unit - Wells, Wastewater TreatJent, Septic Tanks
<br />t US BnviIODJental Protection Agency - Asbestos abateJeJlt
<br />I also certify that, if fill Iilterial is to be used in Flood ZOne "AI or nA,etc.", it is understood that a drainage plan
<br />addressing a lCOIpeJlsating vol.R "ill be subJiUed "bieb is prepared by a professional engineer registered in the State of
<br />Florida prior to pemit issuance.
<br />
<br />A petlit 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 sball issuance of a pemit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery perlit issued sball beCClle invalid
<br />unless the work authoriled by sueb perJit is COIIeDced within sillOnths of issuance, or if work authorized by the petlit is
<br />suspended or abandoned for a period of six IODtbs after the tile the work is C08eDced. One 90 day 81tension of tile, lilY be
<br />allowed for the pemit with fee charge of $15.00. The 81tension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb six IODth period, or the project will be considered abandoned.
<br />WARlUMG TO CMfBR: YOUR FAILURE TO RECORD A MorICE OF COIIMBRCBIlEMt' HAY RESULT IK YOUR PAYIMG NICE FOR IMPROVBIID!S '1'0 YOUR
<br />PROPBm. IF YOU IJl!BIfD TO OBTAIM FIWCIMG, COISULT IIITH YOOR LBIIDER OR AIf A'1"1'ORDY BEFORE RBCORDIKG YOUI MorICE OF
<br />COIIHBlfCBHBIf'1'. JOBS UlfDBR $2,500 II VALUE DO lor NBBD TO RECORD AIfD POST A "MorICE OF ClIlMEIfCBIlEMt'l.
<br />
<br />SIGMA'1'URB: 0WJfER OR AGBIf'1'
<br />
<br />SIGIATURB: COIf'1'IIAC'1'OR
<br />
<br />srAR OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STArE 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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