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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perlit JaY be subject to 'deed restrictions' wbich JaY be lOre restrictive than City
<br />regulations. !be undersigned asSUles responsibility for allpliance 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 JaY be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by lil1f, both the owner and contractor JaY be
<br />cited for a lisdl!leilllOr violation under state law. If the mmer or intended contractor are uncertain as to wbat licensing
<br />requireleJlts JaY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbich they 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 IIOrk. If the contractor wisbes you to sign
<br />as contractor that JaY 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, bave been provided ,ith a copy of 'Florida's Construction Lien La, - lkIIeolmer's Protection
<br />GuideN prepared by the Florida Departlent of Agriculture and ConsUJer Affairs. If the applicant is SOIeOJle other than the
<br />'owner", I certify that I have obtained a copy of the above described dOCUJeDt and pImlise in good faith to deliver it to the
<br />'OIfIler' prior to co.encelellt.
<br />
<br />E. CONTRACTOR'S/OWER'S AFFIDAVIT
<br />I certify that all the infoIlition in this application is accurate and that all work ,ill be done in COIpliance with all
<br />applicable lil1fS regulating construction, loning, and land developll!Jlt.
<br />
<br />Application is hereby Jade to obtain a perlit to do wort and installation as indicated. I certify that no IOrk or
<br />installation bas ~ced prior to issuance of a perlit and that all work will be perfoIJed to _t standards of all laws
<br />regulating construction, City codes, loning regulations, and land developleJlt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveI1lllelltal agencies JaY apply to the intended work, and that it is
<br />Ii responsibility to identify wbat actions I lUSt take to be in COIpliance. Such agencies include but are not luited to:
<br />I Departlent of EnviIODlelltal Regulation - Cypress Baybeads, Wetland Areas and Envirolllentally Sensitive Lands,
<br />Ilater /Vastewater 'I'reatlent
<br />I Southwest Florida Water ManageleJlt District - Wells, Cypress Bayheads, lIetland Areas, Altering Watercourses
<br />t ArIy Corps of Engineers - Seawalls, Docks, Ifavigable lIatenays
<br />I Departlent of Health i Rehabilitative Senites, EnvirODlelltal Health Unit - lIells, Wastewater !reatlent, Septic !ants
<br />I US Envil'ODll!lltal Protection Agency - Asbestos abateleJlt
<br />I also certify that, if fill Eterial is to be used in Flood ZOne 'A' or 'A, etc. " it is understood that a drainage plan
<br />addressing a 'CQlpeDBating volute' will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel alter, or
<br />Bet aside any provisions of the technical codes, nor sball issuance of a perlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall becoIe invalid
<br />unless the work authorized by sucb perlit is ~ced within sillODtbs of issuance, or if lort authorized by the perlit is
<br />suspended or abandoned for a period of Sil IODtbs after the tile the work is co.enced. One 90 day utension of tile, 18y be
<br />allowed for tbe perlit with fee charge of $15.00. !be I!ltension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODth period, or the profect ,ill be considered abandoned.
<br />WARNING fa OIlIER: YOUR FAILURE !O RECORD A NO'I'lCE OF CCIIMBRCINIIft' MAY RESUL! IIf YOUR PAYING !IIICE FOR IJIPROVBIIEUS !O YOUR
<br />PROPER'lY. IF YOU IIft'BMD !O OB'lUIf. FIIWICING, COif SOL! IUft YOUR LODER OR 1If InoRREY BEFORE RICORDIKG YOUR MOriCE OF
<br />COMMEMCEMEIft'. JOBS UlmER $2,500 1M VALUE DO If 0'1' IfEED !O RECORD 1IfD POS! A '.O'I'ICE OF COMMEMCINIIft'-.
<br />~,IS:l-'1Y- l./O?'-G ~ ~. '
<br />
<br />C --"--- 1iJJ~
<br />SIGKA!URE: ODER OR AGD'I' . ~ COIft'IIACf4)R'
<br />
<br />S'I'A'fE OF FLORID~
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this :J'lJ rve cJ.../ , 19_~ by
<br />
<br />C. ~~~/t '.e fV1 eJ 0;-
<br />who is ersonally known 1;.0 me or@o hao
<br />Oduce bRt veo ).../~('>A/S c
<br />1 entification and who did/did not
<br />take oath.
<br />
<br />S!AfE OF FLORIDA /J
<br />coom OF U..---- aa.-c.....o
<br />The foregoing instrument was acknowledged
<br />before me this ~~ ~I , 19~ by
<br />
<br />~"I ~e/((..t-
<br />~ is ersonall to me~r who has
<br />produced
<br />as identification and who di
<br />take an th.
<br />
<br />
<br />
<br />
<br />Typed, Printed or Stuped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />JAMES A. STONE
<br />Notary Public, State of Florida
<br />My comm expires May 16, 1995
<br />CC110274
<br />
<br />JAMES A. STONE
<br />Notary Public, State of Florida
<br />My comm. expires May 16, 1995
<br />CC110274
<br />
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