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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />I'he undersigned understands that this peait lap be subject to 'deed restrictions' which lap be lOre restrictive than Citp
<br />regulations. !he undersigned asSUle& responsibilitp for CfIIpliance with any applicable deed restrictiODS.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has bired a contractor or contractors to undertake work, thep lap be required to be licensed in accordance with
<br />state and local regulaticms. If the contractor is not licensed as required by law, both the owner and contractor IIBY be
<br />cited for a .isd_anor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requirl!lents IIBp applp for the intended work, thep are advised to contact the Citp of Zepbyrbills Building DepartJent, (813)
<br />788-6611.
<br />
<br />Furthel'lOre, if the owner 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 wbich thep 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 wort. If the contractor wisbes you to sign
<br />as contractor that IIBY be an indication that be is not properly licensed and is not entitled to perJitting privileges in the
<br />Citp of Zepbprbills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certifp that I, the applicant, have been provided with a copy of 'Florida's COnstruction Lien Law - lkJIeowner's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUIeI Affairs. If the applicant is 8OIII!ODe other than the
<br />"owner., I certify that I have obtained a copy of the above described docUIIent and pIalise in good faith to deliver it to the
<br />"owner" pdor to co.eDCeIeIlt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in cOlPliance with all
<br />applicable laws regulating construction, loning, and land develo.-ent.
<br />
<br />Application is hereby lade to obtain a Perlit to do work and installation as indicated. I certify that no wort or
<br />installation bas (DIeDced prior to iSsuance of a perJit and that all work will be perfOlll!d to _t standards of all laws
<br />regulating construction, City codes, loning regulations, and land developl8Jlt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gDV8IDIeIltal agencies lay apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lUSt tate to be in COIpliance. Such agencies include but are not lilited to:
<br />t Departlent of BnvirODleDtal Regulation - Cppress Bapbeads, Vetland Areas and InviIOlllentally Sensitive Lands,
<br />Vater /Wastewater I'reat:lent
<br />t Southwest Florida Water Hanagl!l8llt District - VeIls, Cppress Baylteads, Wetland Areas, Altering Vatercourses
<br />t lIlY Corps of Bngineers - Seawalls, Docks, lavigable Vatenays
<br />t DepartJent of Health i Rehabilitative Services, InviIODl8Dtal Health Unit - VeIls, Wastewater I'reat:lent, Septic !ants
<br />t US InviIODlental Protection Agency - Asbestos abat8lent
<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 "C0Jpen8ating vol_" will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A peI'lit issued shall be construed to be a license to proceed with the wort and not as authority to violate, cancel alter, or
<br />set aside anp provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall becCII8 invalid
<br />unless the wort authorized by such peIlit is ~ced within sillODtbs of issuance, or if work authoriJed by the perlit is
<br />suspended or abandoned for a period of sillODtbs after the tile the wort is ~ced. One 90 day 8Itension of tile, lIBy be
<br />allowed for the perJit with fee charge of $15.00. I'be 8Itension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or the project will be considered abandoned.
<br />WARRIIG TO OVIIR: YOUR FAILURE TO RECORD A IOI'ICH OF C<lElCIIIBMI HAY RESULI' II YOUR PAYIIG !IIICH FOR DIPROVIIIIITS 1'0 YOUR
<br />PROPIRIY. IF YOU II'rBJID 1'0 OMAII FIIIAICIIG, COISULI' VID YOUR LBMDIR OR U InoRIIY BI10RE RICORDIIG YOUR DICH OF
<br />motDCBIIBMl'. JOBS UNDER $2,500 II VALUE DO 101' NEED to RECORD AMD POSI' A -IOI'ICI OF aJIIIDCBIIBMl'''.
<br />
<br />
<br />04t,#~~... tJl ~
<br />
<br />/ SIGIIA'lURI: (IftIBR GIll SIGIIA'fURI: COI!IIAC!OR
<br />/
<br />/
<br />
<br />STATI OF FLORIDh
<br />coum OF E~c.o
<br />The foregoing instI'WIent was acknowledged
<br />before me this Ih; I D , 19 Cf c.f by
<br />
<br />--s- ~.~ t?tlu lM~ +t'\J u...
<br />who is personally knOwn to me or who has
<br />produced ~
<br />as id fication and who did/did not
<br />take oath. i cf/- /Jt1. c~
<br />
<br />( ~~ure) C r (
<br />~ ~ ,0..,0 A yYl \......e l It. 'V\
<br />(Rame Typed, Printed or Stamped)
<br />ROTARY PUBLIC
<br />
<br />STAI'E OF FLORIDA ?
<br />COUI'lY OF A ~ c 0
<br />The foregoing instrument was aCknowledged
<br />before lie this (JfJ}7 I () , 19.,fL by
<br />
<br />'}../,., /-J,HJ E., TfdVJt~S
<br />who is personally know.n to me or who has
<br />produced FL.' r s: L,~ 0f c-c..-
<br />as ident' ication and who did/did not
<br />take o~th. c#' #I( ~
<br />
<br />(S' r )
<br />
<br />
<br />......
<br />.:.;.-~, OFfiCIAL SEAL
<br />(_ \ SUS."N A. McCOllUM
<br />: My Commission fl(;)lres
<br />: Apr1/16.1997
<br />~Qt~.. Comm. No. CC 268679
<br />........
<br />
<br />
<br />.~.~' OFFICIAL SEAL
<br />I \ SUSAN A. McCOLLUM
<br />1 ~ My Commission Expires
<br />t J April 16. 1991
<br />.....~ ~.' Comm. No. CC 268679
<br />
<br />.....~~ ....,.
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