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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perlit laY be subject to 'deed restrictions I ,bieb lilY be lOre restrictive than City
<br />regulations. !be undersigned asSUle& responsibility for capliance lith any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIfIIer bas bired a contractor or contractors to undertake IOrk, they lilY 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 0IIIIer and contractor lilY be
<br />cited for a .isdeleanor ,iolation under state law. If the OlDer or intended contractor are uncertain as to wbat licensing
<br />requireleDts lilY apply for the intended IOrk, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the OIfIIer bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />.Contractor Sections' of this application for ,bich they ,ill be responsible. If you, as the OlDer sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wishes 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 LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, bave been provided lith a copy of 'Florida's Construction Lien La, - lDeolmer's Protection
<br />Guidel prepared by the Florida DepartJent of Agriculture and COnsUler Affairs. If the applicant is sOl8ODe other than the
<br />'OIDer-, I certify that I have obtained a copy of the above described docuIent and pro.ise in good faith to deliver it to the
<br />-OIDerl prior to co.enCeleDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all IOrk ,ill be done in COIPliance ,ith all
<br />applicable laws regulating construction, loning, and land develO(lleDt.
<br />
<br />Application is hereby Iilde to obtain a peIlit to do IIOrk and installation as indicated. I certify that no IOIk or
<br />installation bas co.IeDced prior to issuance of a perlit and that all IOrk ,ill be perfoIled to l8et standards of all laws
<br />regulating construction, City codes, loning regulations, and land develOpEDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agencies lilY apply to the intended IIOrl, and that it is
<br />If responsibility to identify ,hat actions I lUSt take to be in COIPliance. Such agencies include but are not luited to:
<br />t DepartJent of EnvirODleDtal Regulation - Cypress Baybeads, Wetland Areas and InviroDleDtally Sensitive Lands,
<br />Water /last8later !reatJent
<br />t Southwest Florida Water Hanagel8Dt District - Wells, Cypress Baybea4s, Wetland Areas, Altering Watercourses
<br />t ArIy Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />t Departlent of Health i Rehabilitative Services, BnvirODl8Dtal Health Unit - WelIs, Wastewater !reablent, Septic 'anks
<br />t US BnvirODleDtal Protection Agency - Asbestos abatl!lleDt
<br />I also certify that, if fllllilterial is to be used in Flood Zone HA' or 'A,etc. I, it is understood that a drainage plan
<br />addressing a 'COI(l8I1Bating volue- ,ill be sulllitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed lith the IOrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official fro. thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perJit issued shall beco.e invalid
<br />unless the work authoriled by such peIlit is ~ced within sillDDths of issuance, or if IOrk authoriled by the peIlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the IOrk is co.enced. One 90 day eztension of tile, lilY be
<br />allowed for the perlit ,ith fee charge of $15.00. fbe eztension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillOnth period, or the project ,ill be considered abandoned.
<br />WIlING !O OIlER: YOOR FAILURE !O RECORD A IO!ICE OF aJIMBICBMm MAY RESULf II YOUR PAYIIG nICE FOR IMPROVBIID!S fO YOUR
<br />PROPIRfY. IF YOU III'DID !O OB!ADI FIIIAICIIG, CONSOL! lID YOUR LBIIDBR OR 11 AnoRDY BlFORE RBCORDIRG YOUR DICE OF
<br />ClIIIIIlIICIIII. JOBS 1IIIDIII11,5GO II '_DO IOf RID 10 IIIIllIIIIJ m PCSf I "IImcl OF ~
<br />
<br />
<br />~~f. cOd.- ~~ ~
<br />
<br />SIGIA!URB: OIlIER OR ~ SI !URB: C H IA (~n'lJ-d Fi lee.;
<br />
<br />SfAfi OF FLORIDA fA
<br />coum OF r=J.S G. 0
<br />The foregoing i~~rument was a9~Wledged
<br />before me this . '4 ~ , 19 by
<br />
<br />r::Q../9I1.1/C I- (r/ C'.. 0" D {:.-,...(
<br />who is personally known to me or who has
<br />produced Pf......oR. /....t ~~ AI~ ~
<br />as identification and who didldid not
<br />
<br />~ oath. ·
<br />.. ';"_ JA.J
<br />(Signa~~; ~~~~'~~-rV
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />SfAfl OF FLft.,DA
<br />coom OF n{" e. 0
<br />The foregoing instrument was acknowledged
<br />before me this I+fr, J C{- , 19~ by
<br />
<br />il/ejra_42j! n k iL-
<br />who is personally known to me or who has
<br />produced r/ ])/e....L I c-
<br />as identification and who did/did not
<br />a an 0 tho
<br />
<br />
<br />2--
<br />
<br />..~1.it4 MARJORIE eSHRIVER
<br />*Jj* MyC~.lonCC315866
<br />Expires Sep. 14, 1997
<br />~ Bonded by ANB
<br />'f1t.,;.d' 800-852-5878
<br />
<br />1~C1rARY I"UBLIC ST
<br />
<br />.i1Y COMMISSION' EX AT!! OF FlORIDA
<br />iIIl:lNCEO'rH"u PIIIES; MAY 30 .
<br />NOTARY pl'Gt.IC UN . ., 8'4,
<br />C>Jrlflftll't.'tt#!f.
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