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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'Ibe undersigned understands that this pemit laY be subject to Ideed restrictions I wbieb lay be'lOre reStrictive than City
<br />regulations. !be undersigned assUleS responsibility for cmpliance 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 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 laY be
<br />cited for a .isdeJeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents IlaY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Deparblent, (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 />IContractor Sectionsl of this application for wbieb they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that fOU, rather than 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 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 IFlorida's Construction Lien Law - lkIIeolmer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and Consllll!I' Affairs. If the applicant is BOI8OI1e other than the
<br />"owner", I certify that I bave obtained a copy of the above described docUIent and pr€Ese in good faith to deliver it to the
<br />Downer" prior to COIIl!IlCeJellt.
<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 COIpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is hereby lade to obtain a pemit to do work and installation as indicated. I certify that DO work or
<br />installation has CDlenced prior to issuance of a perlit and that all work will be perforJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land develOpll!Jlt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gOYerDIl!Dtal agencies IlaY apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in COIpliance. Sueb agencies include but are not laited to:
<br />t Depart:lent of EnvirODlental Regulation - Cypress Baybeads, Wetland Areas and Enviroll.l8lltally Sensitive Lands,
<br />Water /Wastewater 'Ireablent
<br />t Southwest Florida Water Ilanagl!le1lt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t Ally Corps of Engineers - Seawalls, Docks, lIavigable Waterways
<br />t Departlent of Health & Rebabilitative Services, EnviIOlllelltal Health Unit - Wells, Wastewater 'Ireat:lent, Septic 'Ianks
<br />t US EnvirODllental Protection Agency - Asbestos abat8leJlt
<br />I also certify that, if fill llaterial is to be used in Flood ZOne "AI or "A,etc.l, it is understood that a drainage plan
<br />addressing a Ico.pensating vol.1 will be saitted whieb is prepared by a professional engineer registered in the State of
<br />Florida prior to pemit issuance.
<br />
<br />A perlit issued shall he 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 pemit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCCII8 invalid
<br />unless the work authoriled by sueb pemit is COII8Ilced within sillOntbs of issuance, or if work authoriled by the pemit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work is coaenced. One 90 day utension of tile, IlaY be
<br />allowed for the pemit with fee charge of $15.00. '!he l!Jtension 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 />IImIIIG 'to OIlIER: YOUR FAILURE 'to RECORD A lIarICH OF dlMDCBIlm MAY RESULt III YOUR PAYIIIG RICH FOR DIPROVIIID'IS '10 YOUR
<br />PROPBR'IY. IF YOU ImMD '10 OBIIII FIMAXCIXG, COISOL'I WI'IH YOUR LllfDER OR 111 AftORIBY BIFORB RICORDIIG. YOUR DICH OF
<br />COMMDCBHm. JOBS UXDER '2,500 III VALUE 00 110'1 tfEED 'to RECORD AMI) POS'I A IlXO'1ICH OF COIIIDCBIIUIII.
<br />
<br />ce:b~ ~~ -S.-/i:J:fj&
<br />SIGIA!URE: (IfJER OR AGm
<br />
<br />S'IA'IE OF FLORIDA
<br />coum OF tf/LJ-S bot<oJrJ-fi
<br />The foregoing instrument was acknowledged
<br />before me this /tIlty /3'fH , 19!1L by
<br />
<br />who is I)ersonally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />tak~~~~
<br />(Si tu )
<br />...:JU\:o v fhlte Ie. -rt1 C!.,-1I'~ /!.uJo
<br />(Name Typed, Printed or Stamped)
<br />NOTARY ~.ua~C
<br />'f... ~r .~ Op.f.tCJAl ~AL
<br />f ~ \ JI,I4!y Marie Tagltarl~o
<br />: I My Commission Expires
<br />~<l),,- I Oct. 8.1996
<br />'f.'~OFftOI'~.." Comm. No. CC 23445i
<br />....,"'........
<br />
<br />SIGIIA'IURB: COIl!JIACtOR
<br />
<br />S'IATE OF FLORIDA
<br />coum OF /I ILLS. 6oteoJ o-/f
<br />The foregoing instrument was acknowledged
<br />before me this MItY J.3'1'Jr , 19~ by
<br />,
<br />
<br />who is personally known to lie or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />tak~~th~~
<br />
<br />(Si~)
<br />dUDv fl')/U!.I,e --rAt.-L.Jltel,Jo
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />....;s;~~~"" OFFiCIAL S~A~
<br />l ilt> \ Judy Marie TagllarlnO
<br />: : My commission ExpireS
<br />~ ! Oct. 8. 1996 .
<br />..:!>4" d#;;'- c mm No. CC 234451
<br />...~~~ F\!.II... 0 .
<br />
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