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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'be undersigned understands that this perlit laY be subject to "deed restrictions" wbich laY be lOre restrictive than City
<br />regulations. 'l'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 with
<br />state and local regulations. If the contractor is not licensed as required by la", both the owner anel contractor .y be
<br />cited for a lisdelleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireaents .y apply for the intended wrk, they are advised to contact the City of Zepbyrbi.lls Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, he is advised to bave 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 wisbes you to sign
<br />as contractor that laY be an indication that be is not properly licensed and is not entitled to pertitting 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 - JIoIeoImer's Protection
<br />GuideR prepared by the Florida DepartJent of Agriculture and ConsllleI' Affairs. If the applicant is soteOlUl other than the
<br />Rawner", I certify that I bave obtained a copy of the above described dOCUlllllt and prOtise in good faith to deliver it to the
<br />"owner" prior to cOltellceaent.
<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 cQIPliance with all
<br />applicable laws regulating construction, loning, and land develoPElt.
<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 ~ced prior to issuance of a perti t and that all work will be perforJed to teet stanc1ards of all laws
<br />regulating construction, City codes, loning regulations, and lanel developaent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governtental agencies laY apply to the intended work, and that it is
<br />IJ responsibility to identify wbat actions I lust take to be in eotpliance. Such agencies include but are not lilited to:
<br />I DepartJent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and Environtentally Sensitive Lands,
<br />Water /Wastewater 'l'reatJent
<br />I Southwest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />I ArtY Corps of Engineers - Seawalls, Docks, Xavigable Waterways
<br />I Departtent of Health & Rehabilitative Services, EnvirODll!Jltal Health Unit - Wells, Wastewater 'l'reatJent, Septic 'l'ants
<br />I US EnvirODlental Protection Agency - Asbestos abateaent
<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 'eotpeJlSating voluteN will be saitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit 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 perlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every pertit issued sball beeme invalid
<br />unless the wrk authorized by such perlit is COII8Ilced within six IOnths of issuance, or if work authorized by the pertit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is co.enced. One 90 day eJtension of tile, .y be
<br />allowed for the pertit with fee charge of $15.00. 'l'be extension sba11 be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each sixlODth period, or the project will be considered abandoned.
<br />WAIUUXG 'l'0 (MfER: YOUR FAILURE 'l'0 RECORD A XorICE OF COIlMIJIClllBtf'l' HAY RESUL'l' IN YOUR PAYlXG 'NICE FOR IHPROVIIIII'l'S 'l'O YOUR
<br />PROPER'l'Y. IF YOU IJf'l'BKD 'l'0 OB'l'IIX FIWCIXG, CONSUL'l' IU'l'H YOUR LBIIDIR OR AX A'l"l'ORIIY BEFORE RBCOHDIXG YOUR IfO'l'ICB OF
<br />COMHENCEHEtf'l'. JOBS UXDIR $2,500 IX VALUE 00 xor NIID fO RECORD AXD POS'l' A "NO'rICE OF COMMIXCIHIII'I'.
<br />
<br />SIGlfAfURE: amR OR AGBtf'l'
<br />
<br />~~~
<br />
<br />S'l'A'l'E OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'l'A'l'E 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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