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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />fbe undersigned understands tbat this perJit laY be subject to 'deed restrictions" wbieb lay be lOre restrictive than City
<br />regulations. 'be undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, tbey 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 lisd8leanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requir8lents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />DContractor 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 tban 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 peraitting 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 - HoIeor.oer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If the applicant is sOROlle other than the
<br />lowner", I certify that I bave obtained a copy of the above described dOCUl8Dt and prOlise in good faith to deliver it to the
<br />"ownerD prior to cOlleDceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developaent.
<br />
<br />Application is bereby lade to obtain a perJit to do work and installation as indicated. I certify that no work or
<br />installation has COIIeDced prior to issuance of a perJit and that all work will be perforJed to aeet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govel'Dlelltal agencies laY apply to the intended work, and that it is
<br />IY responsib,ility to identify wbat actions I lust take to be in cOlpliance. Sueb agencies include but are not luited to:
<br />* Departlent of EnvirODlental Regulation - Cypress Bayheads, Wetland Areas and Environaentally Sensitive Lands,
<br />Water/Wastewater TreatJent
<br />* Southwest Florida Water Hanageaent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />* ArJY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* DepartJent of Health & ~ehabilitative Services; EnvirODJeDtal Health Unit - Wells, Wastewater TreatJent, Septic lanks
<br />* US EnviIODlental Protection Agency - Asbestos abateJeDt
<br />I also certify that, if fill laterial is to be used in Flood Zone lAD or DA,etc.D, it is understood that a drainage plan
<br />addressing a 'cOlpeDsating VOIUleR will be subJitted wbieb is prepared by a professional engineer registered in the State of
<br />Flotida prior to perlit_ issuance.
<br />
<br />A perJit 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 perJit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery petlit issued shall beCOJe invalid
<br />unless the work authorized by such perJit is cOJJenced within six IOnths of issuance, or if work authorized by the perJit is
<br />suspended or abandoned for a period of sil IOntha after the tile the work is c~ced. One 90 day extension of tiJle, lay be
<br />allowed for the perJltwith fee ebarge of $15.00. Ihe extension shall be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eaeb sil IODth period, or the project will be considered abandoned.
<br />WARNIHG ro OWNER: YOUR FAILURE 10 RECORD A NOTICE OF C<IIMBRCBIIEMI HAY RESULT IN YOUR PAYING BICE FOR IMPROVEIIDl'S 10 YOUR
<br />PROPBR'fY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LlIfDER OR AN AftORRBY BEFORE RECORDIHG YOUR DICE OF
<br />COHHENCEHEtn' . JOBS UNDER $2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COHMDCEHBNI'.
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<br />
<br />, 1~ ~ ~'
<br />. 4' (/A-e' / Af'LA~ /~-6J f ~ /AA/
<br />IS GNA~ 0VNi{ OR AG ' IGNATURE: COtn'RACTO
<br />
<br />STArE OF FLORIDA
<br />coum OF
<br />The foregOing instrument was acknowledged
<br />before me this , 19 by
<br />--
<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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