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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this pertit lily be subject to 'deed restrictions' wbich lilY 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 liar be
<br />cited for a lisdeEanor violation under state law. If the owner or intended contractor are uncertain as to "bat lic8D8ing
<br />requirl!l8Du lilY apply for the intended work, they are advised to contact the City of Zepbyrbills BuildiDg Departlent, (813)
<br />788-6611.
<br />
<br />FurtberJore, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />IContractor Sections I of this application for which they will be responsible. If you, as the OlDer sign as the contractor,
<br />you are indicating that fOU, rather than the contractor, are responsible for the work. If the contractor wiabes fOU to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to pemitting 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 - lkIIeoImer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsWler Affairs. If the applicant is 8OIeOIle other than the
<br />lowner", I certify that I have obtained a copy of the above described dOCUJellt and prOlise in good faith to deliver it to the
<br />lowner' prior to co.enCl!l8Dt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land developlellt.
<br />
<br />Application is bereby Iilde to obtain a perlit to do wort and installation as indicated. I certify that no work or
<br />installation has cmlenced prior to iss~ce of a pemit and that all work will be perfoIJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlellt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agencies laY apply to the intended work, and that it is
<br />III responsibility to identify what actions I lUSt take to be in COIpliance. Such agencies include but are not lilited to:
<br />t Departlent of EnvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and Envirolllelltally Sensitive Lands,
<br />Water/Vastewater !real:lent
<br />t Southwest Florida Water Jlanagl!l8Dt District - Wells, Cypress Baybead8, Wetland Areas, Altering Watercourses
<br />t Ally Corps of Engineers - Seawalls, Docks, lIavigable Watenays
<br />t Departlent of Health' Rehabilitative Services, EnvilODlelltal Health Unit - Wells, Wastewater !reatlent, Septic !ws
<br />t US BnvirOllleDtal Protection Agency - Asbestos abatl!l8Dt
<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 'CalpenSating vol_I will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A pemit 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 any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official fl'Ol 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 authoriled by such perlit is COIIeJIced within sil IODthS of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work is IDIeDced. One 90 day eltension of tile, lilY be
<br />allowed for the perlit with fee charge of $15.00. !be eztension shall be requested in writiDg to the Building Official. An
<br />approved inspection lUSt be logged during each six IODth period, or the profect will be considered abandoned.
<br />WARlfIIIG !O 0WIfER: YOUR FAILURI !O RlCORD A IIOtIC! OF aJlMDCIIIIJft' NAY RlSULI III YOUR PAYIIfG DIC! FOR DIPROVIIIIIft'S !O YOUR
<br />PROPEm. IF YOU IJIDIiD !O 0B!111l PlIlAlfCIIIG, COISUL! WIR YOUR LlllDIR OJ! AllftOJlllY BIFORI RICOJIDIIG YOUR JIO'fICI OF
<br />crJIIEllCEHKIf!. JOBS UllDIR $2,500 III VALUE DO IfO! IfUD !O RICOJID AIfD POS! A IIIOtIC! OF C(llMBJfCllllll!I.
<br />
<br />(\ n;1 /);/ f // t?
<br />\~~__-<_~//~ ~ ...-/ L~~__(/r
<br />SIGlAmO: (MIIR OJ! AGIII1' SIGIf1!URI: COJ!RlC!OJI
<br />
<br />
<br />SIAII OF ~
<br />coum OF Sf. n
<br />The foregoing i~trument was acknowledged
<br />before me this .....qP \t; ~, 19 q\..~ by
<br />
<br />\-t" ~'('\ p\.z' \-\\~->0
<br />who is personally kDown to me or who has
<br />produced \-'Q (:"'CiYO \\ q \/~(\'''''l'''~\,
<br />as identification and who did/did not
<br />ta~ an oath.
<br />~ " ~\^- ~!LA, ~ f'. _" \,('
<br />(Signature)
<br />( .f'. t \p P V.I ',> \ -( ~t+-
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />SIAR OF FLORIDA
<br />coom OF \-=t... '\( 0
<br />The foregoin~ i~trument was ac~r-ledged
<br />before me thl.s INIO I C, , 19q - by
<br />
<br />_ \01. (' ~l e r~) W (Y'(.. n
<br />who is pers~ll~ kn~ to me or who has
<br />produced 'fl.. \).{ ,\k'( S. LtC,
<br />as identification and who did/did not
<br />
<br />takeC: ~~~ ,- ~~~-~~
<br />
<br />(Signature)
<br />('0) \\ Q <:l .",-. ~ \ ,,\.::.) \--\-
<br />(Name Typed, Printed or Stallped)
<br />NOTARY PUBLIC
<br />
<br />............,
<br />..~y~..
<br />/# t>\. OFFICIAL SEAL
<br />: ~ i COLLEEN STROTT
<br />\ ! My Commission Expires
<br />...:'>.;, ., ~.. .Jan. 20. 1996
<br />t. ~ OF flP':.' Co N
<br />......... mm. cr. CC 174750
<br />
<br />...........
<br />....~ PI./lI;:..;..... OFFICIAL SEAL
<br />i _: COLLEEN STROTT
<br />i .: My Commission Expires
<br />......... - A/ Jan. 20. 1996
<br />......~ di"":'.
<br />..~Off~.* C'.'mm. N'J.. CC 174750
<br />........
<br />
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