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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perlit lay be subject to Ideed restrictions I wbich JaY be lOre restrictive than City
<br />regulations. Tbe undersigned assUles responsibility for COJp1iance with any app1icab1e'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.law, both the owner and contractor JaY be
<br />cited for a .isdeJeallor violation under state law. If the owner or intended confractor are uncertain as to wbat licensing
<br />requireJents JaY apply for the intended work, they are advised to contact the City ofZepbyrbills Building DepartJent, (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 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 resporisible for the work. If the contractor wishes you to sign
<br />as contractor that JaY be an indication that be is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zepbyrbil1s.
<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 - HOJeOWner's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is sOleone otber than the
<br />"owner., I certify that I have obtained a copy of the above described docUJeDt and prOJise in good faith to deliver it. to the
<br />"owner" prior to COll9JlCeJent. -
<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 developleDt.
<br />
<br />Application is bereby Jade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas COIIeDced prior to issuance of a perlit and that all work will be perfoIJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developll!Dt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agencies JaY apply to the intended work, and that it is
<br />.Y responsibility to identify wbat actions I lust take to be in COIpliance. Sucb agencies include but are not liJited to:
<br />t DepartJent of invirolllental Regulation - Cypress Baybeads, Wetland Areas and inviroDJentaUy Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Water Hanagl!leDt District - WeUs, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t Arl' Corps of ingineers - Seawalls, Docks, Mavigable Waterways
<br />t DepartJent of Health , Rehabilitative Services, invirODJeDtal Health Unit - Wells, Wastewater rreatJent, Septic ranks
<br />t US EnvirODJental Protection Agency - Asbestos abatl!leDt
<br />I also certify that, if fill laterial is to be used in Flood Zone "AI or "A,etc.", it is understood that a drainage plan
<br />addressing a "cOlpensating VOlUIBI 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 />set aside any provisions of the technical codes, nor sball issuance of a perlit prevent ~e Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code.,ivery perlit issued sball beCOll! invalid
<br />unless the work authoriled by such perlit is COIIenced within sil IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the work is COIII!!nced. One 90 day extension of tile, JaY be
<br />allowed for the perlit with fee charge of $15.00. Tbe extension shaU be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eaeb sillOnth period, or the project wiU be considered abandoned.
<br />NAIUIIMG TO OIIMER: YOUR FAILURE 1'0 RECORD A MOTICE OF COHHBMCBHm' MAY RESULT 1M Y IHPROVBHm'S TO YOUR
<br />PROPERTY. IF Y T T WITH YOUR LBRDER OR Y ICB OF
<br />COHHEMC . JOBS 1'0 RECORD ARD PO
<br />
<br />
<br />/(JJbc.JN
<br />
<br />
<br />J<NnJN
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF y? .4....') e-o
<br />The foregoing instrument was acknowledged
<br />before me this Jt.-u"",/ 2~, 19~ by
<br />
<br />KAY' DAAJI ~I 5-
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />~~~L.~
<br />(S19 ature) fJ-B
<br />K A TH I F'EA.J J :if'dW AI
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />STATE OF FLORIDA t?
<br />coum OF T2l- -S e.D
<br />The foregoing instrument was acknowledged
<br />before me this Jt.t..J.. y ;22, 19 9 t/ by
<br />
<br />~y :J)J};J/ E?-S
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />ta~e",JD _o~t9,. LO
<br />~J9' ~A'7L~
<br />(Signature)
<br />(Name'~~/pd~ ;,fSt~~^J
<br />NOTARY PUBLIC
<br />
<br />I{i;"
<br />
<br />KAT~I_F"!I. P,ROWN
<br />
<br />MyG;, ..." , ,,1995
<br />Cc,',rn. ii .~'~ '" ,,)~~ 7
<br />
<br />.~."
<br />f .I!',,~^..,
<br />J>:2>
<br />
<br />KATHLEEN J. B!'OWN
<br />f;'i.;:~e c,f F'Orj.ja
<br />My C~m,~.. Exp. April 2. 1995
<br />Comm. # CC 095617
<br />
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