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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this peClit aay be subject to Ideed restrictions I wbich aay be lOre restrictive than City
<br />regulations. Ybe undersigned assUles responsibility for cDlpliance 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 lay be required to be licensed in accordance with
<br />state and local regulations. If tbe contractor is not licensed as required by law, both the owner and contractor lay be
<br />cited for a lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents aay apply for tbe intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner has bired a contractor or contractors, he is advised to have tbe contractor(s) sign portions of the
<br />.Contractor Sections" of this application for which 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 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 IFlorida's Construction Lien Law - HOIeOIDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture,and ConsUlar Affairs. If the applicant is sOleone other than the
<br />lowner", I certify that I bave obtained a copy of the above described dOCUleDt and prOlise in good faith to deliver it to the
<br />"ownerl prior to cOllencelent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cDlpliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<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 cOllenced prior to issuance of a peClit and that all work will be perforJed to lIeet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify tbat I understand that the regulations of other goverDIeDtal agencies aay 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 />t Departlent of EnviroDlental Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater Yreatlent
<br />t Southwest Florida Water HanageleDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AClY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health & Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater YreatJent, Septic Yanks
<br />t US EnvirDnleDtal Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood Zone HAl or "A, etc. I, it is understood tbat a drainage plan
<br />addressing a UcOlpeDsating volUleN will be sublitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it 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 tbe technical codes, nor shall issuance of a peClit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every peClit issued sball beCOle invalid
<br />unless the work authorized by such peClit is cOlllellced within six IOnths of issuance, or if work authorized by the peClit is
<br />suspended or abandoned for a period of six IOnths after the tile the IfOrk is cOlleJlced. One 90 day extension of tile, lay be
<br />allowed for the peClit with fee cbarge of $15.00, Tbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEIn' MAY RESULT IN YOUR PAYING !WlCE FOR IMPROVEIlEIft'S TO YOUR
<br />PROPERTY. IF YOU INTEIID TO OBTAIN FINANCING, CONSULT WITH YOUR LEIIDER OR AN AnORHEY BEFORE RBCORDING YOUR IfO'fICB OF
<br />COMMENCEMENT. JOBS UIIDER $2,500 IN VALUE DO NO'f NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
<br />
<br />SIGJlATURB: OWNER OR AGENT
<br />
<br />SIGJlATURB: CONTRACTOR
<br />
<br />STATE OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />STATE 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 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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