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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 'deed restrictions' wbich lay be lOre restrictive than City
<br />regulations;"fire undersigned assUles responsibility for COIpliance with any applicable deed restrictions. ~".., nl
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESrONSI8ILITIES
<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 lisdl!leallor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />reguirl!leDts laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611. " , I I '
<br />
<br />FurtheIlDre, if the owner bas bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />'Contractor Sections',. 9f, thi~ ,~wlication for wbich they will be responsible. If JQU, as the owner sign as the contractor,
<br />you.are indicating that you, 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 'Florida's Construction Lien Law - lkJIeoImer's Protection
<br />Guide" prepared by the Florida Deparblent of Agriculture and ConsUler Affairs. If the applicant is soaeone other tban the
<br />'owner", I certify that I ba~e obtained a copy of , the above described dOCUleDt and prOlise in good faith to deliver it to the
<br />'ownerl prior to COIHDCele1lt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all theinforlBtion in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable lil1ls regulating construction, laning, and land developent.
<br />
<br />, ~
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas ~ced prior to issuance of a perli t and that all work will be perfoIled to .et standards of all laws
<br />regulating construction, City codes, loning regulations, and land developl8llt regulations in the jurisdiction. I also
<br />certify that I understand that" t;he regulations of other gov~tal agencies laY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not lillted to:
<br />t Deparblent of EnvirollleDtal Re~lation - Cypress Baybeads, Wetland Areas and EnviroDlell,tally Sensitive Lands,
<br />. "" . '''', Water/Wastewater 'Ireatlent, , "
<br />t Southwest Florida Water Hanagl!leDt District~ Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Entineers - Seawalls, Docks, lavigable Waterways
<br />t Depart:lent of Health i Rebabilitative ServicQ$, EnvirOJlleDtal Health Unit - Vells, Wastewater 'freatlent, Septic .'fws
<br />t US EnvirOllleDtal Protection Agency - Asbestos abatl!leDt '
<br />I also certify that, if fill IBterial is to be used in Flood Zone 'A' or lA, etc. ", it is understood that a drainage plan
<br />addressing a 'cOJpeDSating volUle' will be snbllitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance. .
<br />
<br />A perlit issued sball 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 peIlit prevent the Building Official frol thereafter
<br />reqlliringa. ~~rr~ction of errors in plans, construction, or violations of any code. Ivery perlit 1ss1Jed sball.be~ invalid
<br />unless the work authoriled by such perlit is COlleDced within sil IOIltbs of issuance, or if wort authoriled by the penit is
<br />suspended or abandoned for"a period of sillOnths after the tile the work is C08eIlced. One 90 day utension of tile, laY be
<br />allowed for the perlit with fee charge of $15.00. 'fbe utension sball be ,requested in.riting to the Building Official. An
<br />approved inspection lUst be "logged during eacb sillOllth period, or the profect will be considered abandoned.
<br />WARMING 'fa ovJER: YOUR FAILURE to RECORD A NOIICE OF COIIMBRCBIIIlNl' MAY RESUL'f IN YOUR PAYING filCE FOR DIPROVEIIINl'S 'fa YOUR
<br />PROPERlY. IF YOU IIIDIID TO OBlAIN FINANCING, COlfSUL'f WID YOUR LBNDER OR 11 AftORDY BEFORI RlCORDIKG YOUR NOIICE OF
<br />COMHENCEHKNl'. JOBS UNDER $2,500 IN VALUE 00 NOI ,HIED to RICaRD AND POS'f A 'NOIICE OF C<IlIIINCBIIIlNl'I.
<br />
<br />, f21Z---A~
<br />~iGIfi.: ClHITHIC ,"/Y/--
<br />
<br />~ <) ~~
<br />SIGNATURE: OIIJlBJr'OR'~ "I ,
<br />
<br />-
<br />
<br />STAD OF FLORIDA
<br />coum OF "1:>\\')1--I ~ '
<br />The foregoing ins~ent was acknowledged
<br />before me this \?J ~ ' 19~-:- by
<br />
<br />H'~m S'.
<br />who i rsonay to me or who has
<br />produced
<br />as identificat.on and who did/did not
<br />ta th.
<br />
<br />STATE OF FLORIDA
<br />coum OF -:f)Y1)N ().:r{
<br />The foregoing inst~ent was acknowledged
<br />before me this \~ ~l~' 19~ by
<br />
<br />
<br />w~~BOD~~~ to me or who has
<br />produced
<br />as iden . " tion and who did/did not
<br />t oat
<br />
<br />
<br />h:b Iu
<br />Y
<br />
<br />
<br />(S'
<br />
<br />(Name 'l'yped, printec:i"'or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name 'l'yped, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />$-$.~~~ NIC~L~~,',I,A~J,.,ILGAN
<br />;*tl:; ;';~' <;.",,,1' i"". ;.,,- (\6-28-97
<br />~~f1$'AU.." ';r~~;f,~~;~;~~~0iCES
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<br />CC ,2982,201
<br />
<br />!l ! I
<br />
<br />~~~"~ NICOLE HARTIGAN
<br />!*l"1;'.".~*~ "OFFICIAL SEAL
<br />t~~~':<1E My Comm. Expires 06-28-97
<br />~:'::'6rf\.e~" BONDED THROUGH
<br />,~ ALAN, INSURANGE SERVICES
<br />CC 298220
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