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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />. !be undersigned understands that this perait JaY be subject to 'deed restrictions' wbieb Jay be lOre restrictive than City
<br />regulations. !be undersigned assUle& 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 JaY 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 JaY be
<br />cited for a lisdell!anor violation under state law, If the owner or intended contractor are uncertain as to wbat licensing
<br />reguirel8llts JaY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611,
<br />
<br />FurtherJOre, if the owner 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 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 lilY 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 'Plorida's construction Lien Law - BoIeowDer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUle1' Affairs, If the applicant is SOI8ODll other than the
<br />'owner', I certify that I have obtained a copy of the above described docUIent and pIlJlise in good faith to deliver it to the
<br />'owner' prior to COIIeDCl!l8llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT .
<br />I certify that all the infoIliltion in thill application is accurate and that all work win be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land develo~t,
<br />
<br />Application is bereby lade to obtain a peait to do work and installation as indicated, I certify that no work or
<br />installation has C31enced prior to issuance of a perIi t and that all work will be perforJed to _t 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 goveruental agencies lilY apply to the intended wort, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in COIpliance. Sueb agencies include but are not lilited to:
<br />t Departlent of Envirolll8lltal Regulation - Cypress Baybeads, Wetland Areas and EnvirOlll8lltally Sensitive Lands,
<br />Water /Wastewater !reatlent
<br />t Southwest Plorida Water Nanagell!Dt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, Xavigable Waterways
<br />t Departlent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater !reatlent, Septic tanks
<br />t US EnviIOlllental Protection Agency - Asbestos abatell!Dt
<br />I also certify that, if fill aaterial is to be used in Flood Zone 'A' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpeD8ating volUle' will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to peait issuance,
<br />
<br />A P8:f1it 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 pemit issued shall becoIe invalid
<br />unless the work authorized by sueb peait is COIIeDCed within sUlODtbs of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sUlODtbs after the tile the vork is COIIeDced, One 90 day utension of tile, lilY be
<br />allowed for the perlit with fee charge of $15,00, !be Bltension shall 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 />WARlUIIG !O OOBR: YOUR FAILURE !O RECORD A XO'fICE OF allllDCBIIIH! MAY RESUL! IX YOUR PAYIIfG !VICE FOR IJfPROVBIID!S !O YOUR
<br />PROPERfi, IF YOU IIIIIID !O OBIAII FIJIUCIXG, COIISQJ.! WIU YOUR LIJIDIR OR III InoRIIY BElORl. BiCORDIIG YOUR DICE OP
<br />COMMBIICIHBIft'. JOBS OIIDIR $2,500 IX VALUE 00 110'1 mD !O RECORD IIID POS! A '1IO'fICl OF COMMBIIclUII!',
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<br />cN~Q~
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<br />SIGJII'IURE: OOBR OR IGIIft'
<br />
<br />Cl0
<br />SIGJII!lJRE: COJI!RAC!OR
<br />
<br />SfA!1 OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S!A!I 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 />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stuped)
<br />NOTARY PUBLIC
<br />
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