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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTl;CE QF DEED RESTRICTIONS
<br />!be undersigned understandsYthaf this penit lay be subject to "deed restrictions" which lily be lOre restrictive than City
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired 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 IilJ be
<br />cited for a lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireleDts lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtberlOre, if the owner bas bired a contractor or contractors, he is advised to have tbe contractor(s) sign portions of the
<br />"Contractor Sections" of this application for wbicb 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 tbe 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 ~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 - HoIeowner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is sOleOlle other than the
<br />"owner", I certify that I bave obtained a copy of the above described dOCUleDt 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 tbat all the infoIJation in this application is accurate and that all work will be done in cOlpliance witb all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is bereby Iilde to obtain a penit to do work and installation as indicated. I certify that no work or
<br />installation bas COIIeDced prior to issuance of a penit and that all work will be perforled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developleDt regulations in th~ jurisdiction. I also
<br />certify that I understand that the regulations of other goveIlllental agencies laY apply to the intended work, and that it is
<br />If responsibility to identify Ihat actions I lust take to be in cOlpliance. Sucb agencies include but are not lilited to:
<br />t DepartJent of BnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and BnvironJentally Sensitive Lands,
<br />Water/Wastewater TreatJent
<br />t Southwest Florida Water ManageleDt District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Bngineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health i Rehabilitative Services, BnvirODlental Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />t US BnvironJeDtal Protection Agency - Asbestos abatelent
<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 "COIpeDsating volute" will be sublitted Ihicb is prepared by a professional engineer registered in the State of
<br />Florida prior to penit, issuance.
<br />
<br />" . penit issued sball be construed to be a license to proceed with the lork 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 fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery penit issued shall beCOle invalid
<br />unless the work authorized by such penit is cOllenced within sillOnths of issuance, or if work authorized by the penit is
<br />suspended or abandoned for a period of sil IOnths after the tile the lfOrk is c~ced. One 90 day l!Itension of tile, lilY be
<br />allowed for the penit lith fee charge of $15.00. !be eltension shall be requested in lriting to the Building Official. An
<br />approved inspection lUst be logged during each sillOnth period, or the project lill be considered abandoned.
<br />IIARJIIfG TO OIlIER: YOOR PAILURE TO RECORD A 10TlCE OF CClfMKlCEMm MAY RESULT II YOUR PAYING TWICE FOR IMPROVIMmS TO YOOR
<br />PROPERTY. IF roo IIImD TO OBtAII FIMAlCIIG, CONSULT WITH YOUR LENDER OR AI AftORm BBFORE RECORDIIG YOUR MOTICE OF
<br />CCJOO:ICIMm. JOBS OlDER $2,500 IN VALUE 00 NOT NBED TO RBCORD AND POST A "NOTICB OK~CBMlNT..
<br />
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<br />~~~ ~~~ )c2 5JYWL J..e-___
<br />SIGNATURE: OIIIIBR OR GENT SIGNATURE: CONTRACTOR
<br />
<br />STATB OF FWRIDA
<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 />(Rame Typed, Printed or Stamped)
<br />ROTARY PUBLIC
<br />
<br />(Signature)
<br />
<br />(Rame Typed, Printed or Stamped)
<br />ROTARY PUBLIC
<br />
<br />~
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