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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'fhe undersigned understands tbat this penit tay be subject to 'deed restrictions" wbicb tay be lOre restrictive than City
<br />regulations. 'fhe undersigned assUles responsibility for coapliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe 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 lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireleDts tay apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtbellOre, if the owner has bired a contractor or contractors, be 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 tban the contractor, are responsible for the work. If tbe contractor wishes you to sign
<br />as contractor that lilY be an indication tbat be is not properly licensed and is not entitled to penitting privileges in the
<br />City of Zepbyrbills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN ~AW (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 ~ HOIeOIDer's Protection
<br />Guide' prepared by the Florida DepartJent of Agriculture and ConsllIer Affairs. If the applicant is so.eone other than the
<br />'owner', I certify that I bave obtained a copy of the above described docuaent and prolise in good faith to deliver it to the
<br />"owner' prior to COIleDCeleDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and tbat all Ifork will be done in cOlpliance witb all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is bereby lade to obtain a penit to do work and installation as indicated. I cert~fy that no work or
<br />installation bas CDllenced prior to issuance of a penit and that all work will be perf oIled to teet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in th~ jurisdiction. I also
<br />certify that I understand that the regulations of other governleDtal agencies lilY apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lUst take to be in cOlpliance. Sucb agencies include but are not Iilited to:
<br />t Departlent of KnviroDJental Regulation - Cypress Baybeads, Wetland Areas and KnviroDlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Vater Managaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health , Rehabilitative Services, EnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />t US EnvirODleDtal Protection Agency - Asbestos abatetent
<br />I also certify tbat, if fill laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a 'COIP8Dsating volUle' will be subtitted wbicb is prepared by a professional engineer registered in the State of
<br />Florida prior to penit. issuance.
<br />
<br />. 4 petlit issued sball be construed to be a license to proceed witb tbe Ifork and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a penit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, or VIolations of any code. Every penit issued shall beCOll! invalid
<br />unless the work autOOrized by such penit is cOIII!nced witbin sillOnths of issuance, or if work authorized by the penit is
<br />suspended or abandoned for a period of sil IOntbs after the till! the work is cOllel1ced. One 90 day 81tension of tile, lily be
<br />allowed for the petlit with fee charge of $15.00. Tbe extension shall be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each sillOnth period, or the project will be considered abandoned.
<br />WADIIfG TO OIlIER: YOOR FAILURE TO RECORD A NOTICE OF C<JIMDCENEtl1' MAY RESULT IN YOUR PAYING TWICE FOR IMPROVIMEtl1'S TO YOOR
<br />PROPERTY. IF YOO IIImD TO OmAIN FIlfANCIIG, CONSULT 111m YOUR LIIIDIR OR AI AnoRRBY BlFORB RBCORDING YOUR DICE OF
<br />C_IfCBIm'. JOBS. OlD IR $2,500 II VALIlE 00 IIOr IIEID TO HIlCllIIO AID POST A "01I~ OF COIIIEIICIIJIIR'~
<br />
<br />)0 ~ tJ~ XJ Ln/tJo
<br />
<br />I SIGKJltuRE: ownR OR AGENT I SIGNATURE: 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 />wbo 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 />
<br />j
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