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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />rbe undersigned understands that this pemit aay be subject to Ideed restrictions I wbieb aay be lOre restrictive than City
<br />regulations. the undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIIIler 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 mmer and contractor laY be
<br />cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireIeDts aay apply for the intended wrk, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />. 788-6611.
<br />
<br />FurtherlOre, if the mmer bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbieb they will be responsible, If you, as the OIIIler sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the lIOrk. 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 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, have been provided with a copy of 'Florida's Construction Lien Law - HOII!OlII1er's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleone other than the
<br />'owner', I certify that I have obtained a copy of the above described docuIent and prOlise in good faith to deliver it to the
<br />Ummer" prior to COlll!llCl!l8Jlt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all 1IOrk will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land develo.-ent.
<br />
<br />Application is hereby Jade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas COIIeDced prior to issuance of a pemit and that all work will be perforted to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDleDtal agencies laY apply to the intended wrk, and that it is
<br />IY responsibility to identify wbat actions I lUst take to be in cOlpliance. Sueb agencies include but are not lilited to:
<br />t Departtent of BnvirODJeDtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />Water/Wastewater treattent
<br />t Southwest Florida Water Managel8llt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />t Departlent of Health & Rehabilitative Services, EnvirODl8ntal Health Unit - Wells, Wastewater rreatlent, Septic tanks
<br />t US EnvirODJelltal Protection Agency - Asbestos abateleDt
<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 '~ating volUleu will be subllitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to pemit issuance.
<br />
<br />A pemit issued sball be construed to be a license to proceed tlith the work and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a pemit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery pemit issued sball beCOle invalid
<br />unless the work authoriled by sueb pemit is COIIllDced within sil IOnths of issuance, or if 1IOrk authoriled by the pemit is
<br />suspended or abandoned for a period of Sil IODtbs after the tile the work is coaenced. One 90 day l!Itension of tile, laY be
<br />al101led for the pemit with fee ebarge of $15.00. rbe l!Itension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eaeb SillODth period, or the project will be considered abandoned.
<br />WAIUUNG ro OOBR: YOUR FAILURE ro RECORD A IIO'l'ICE OF COHMBRCBNm MAY RESULr IN YOUR PAYING 'fIIICE FOR IMPROVEMBJI!S to YOUR
<br />PROPBm. IF YOU III'lHIID to OBfIIII FIWCIIIG, COIfSULr WID YOUR LHllDER OR AN AnORDY BBFORE RECORDIIIG YOUR NOTICE OF
<br />COMMBIICBMEtn'. JOBS OlDER '2,500 IN VALUE 00 1IO'r NEED ro RECORD AIfD posr A "NO'rICE OF COIIIBNCBMm".
<br />
<br />SIGllAtURE: COtl!RAC'fOR
<br />
<br />SIGJlArURI: 0IfIIER OR AGElI1'
<br />
<br />StArE 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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