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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />fbe undersigned understands that this Perlit JaY be subject to "deed restrictions" wbich laY be lOre restrictive than City
<br />regulations. fbe 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 .ay 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 laY be
<br />cited for a .isdl!lleaDor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />reguiruents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartEnt, (813)
<br />788-6611.
<br />
<br />Furthemore, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />"Contractor 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, 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 pemitting 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 "Plorida's Construction Lien Law - lDeolmer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and COnsUler Affairs. If the applicant is SOEH1a other than the
<br />"owner", I certify that I have obtained a copy of the above described dOCUleDt and pr~ise in good faith to deliver it to the
<br />"owner" prior to COIIeIlCeEllt.
<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 COIpliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is bereby .ade to obtain a peait to do work and installation as indicated. I certify that no work or
<br />installation bas CDIeI1ced prior to issuance of a pemit and that all work will be perforJed to Jeet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land develoPEDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govl!Illlel1tal agenCies laY apply to the intended wort, and that it is
<br />~ responsibility to identify wbat actions I .08t take to be in co.pliance. Such agencies include but are not liUted to:
<br />t Departlent of Envil'OlllleDtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDleDtally Sensitive Lands,
<br />Water /Wastewater !reatlent
<br />t Southwest Florida !fater HanageJellt District - !fells, Cypress Baybeads, !fetland Areas, Altering !fatercourses
<br />t AI'IJ Corps of Enqiileers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health' Rebabilitative Services, EnvirODlleDtal Health Unit - Wells, Wastewater !reatlent, Septic rants
<br />t US EnviI'ODleJltal Protection Agency - Asbestos abatuent
<br />I also certify that, if fill oterial is to be used in Flood Zone "A" or "A, etc. ., it is understood that a drainage plan
<br />addressing a "COIpenSating volUJe" will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to peait issuance.
<br />
<br />A Perlit issued shall 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 peait prevent the Building Official flOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every peait issued shall becCIIe invalid
<br />unless the work authorized by such peait is COIIeIlced within sillOnths of issuance, or if work authorized by the pemit is
<br />suspended or abandoned for a period of sil IODtbs after the tHe the wort is co.enced. One 90 day utension of tile, laY be
<br />allowed for the peait with fee charge of $15.00. !be extension shall be requested in writing to the Building Official. 'An
<br />approved inspection .lUst be logged during each sil IODth period, or the project will be considered abandoned.
<br />WARJfIIG 'fO OIRfER: YOUR PAILURE fO RECORD A NOUCH OF COIIIlDCBIIBIft' HAY RESULf II YOUR PAYIIG DICE FOR DIPROVIIIIIfS 'fO YOUR
<br />PROPmY. IF YOU IIImD 'fO OMAIN PIIfAHCIHG, COIfSUL! WIfH YOOR LBJIDER OR U AnomY BIFOHB RECOHDIIG YOUR IfO!ICE OP
<br />COMHIlCEMBtI!. JOBS UlWBR $2,500 II VALUE 00 IOf HEED 'fO RECORD AID POS! A "mICE OF aJOIBJfCJDIIIf!".
<br />
<br />SIGIfA!URI: 0IIIfKR OR AGBIft'
<br />
<br />SIGIfA!URB: COII!RAC'lOR
<br />
<br />S!A!B OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S!A!K OF FLORIDA
<br />coum OP
<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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