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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this pemit .ay be subject to Ideed restrictionsP wbich JaY be lOre restrictive than City
<br />regulations. !be undersigned assUJeS responsibility for COIpliance 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 c-ontractor is not licensed as required by law, both the owner and contractor IilJ be
<br />cited for a .isdeJeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirl!lents lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (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 Sections I of this application for wbieb 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 work. 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 perJitting 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, have been provided with a copy of IFlorida's Construction Lien Law - HCIIeOWDer's Protection
<br />Guidell prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is SOIeODe other than the
<br />lownerP, I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the
<br />"owner I prior to COIIBDCel8Dt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIJation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, zoning, and land develo~t.
<br />
<br />Application is bereby Jade to ohtain a pemit to do work and insWlation as indicated. I certify that no work or
<br />installation bas C08enced prior to issuance of a pemit and that all work will be perfoIled to Jeet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governJental agencies JaY apply to the intended work, and that it is
<br />.y responsibility to identify what actions I JUSt take to be in COJpliance. Such agencies include but are not liJited to:
<br />t DepartJent of EnvirODJeJltal Regulation - Cypress Baybeads, Wetland Areas and Envirol\lentally Sensitive Lands,
<br />Water/llastewater !reatJent
<br />t Southwest Florida Water Hanagl!lent District - Wells, Cypress Baybea4s, Wetland Areas, Altering Watercourses
<br />t Amy Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health & Rehabilitative Services, EnvirODJeDtal Health Unit - lIells, lIastewater freatJent, Septic fanks
<br />t US EnvirODleDtal Protection Agency - Asbestos abateleDt
<br />I also certify that, if fill laterial is to be used in Flood Zone lAP or "A,etc.l, it is understood that a drainage plan
<br />addressing a 'COIpeIISating volUJeI will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to pemit issuance.
<br />
<br />A PeIlit issued sball 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 the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOle invalid
<br />unless the work authorized by such pemit is c~ced within sillOnths of issuance, or if work authorized by the peIlit is
<br />suspended or abandoned for a period of sillOntbs after the tile the work is C08enced. One 90 day l!Itension of tile, lilY be
<br />allowed for the pemit with fee charge of $15.00. !be l!Itension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each six IODth period, or the project will be considered abandoned.
<br />IIARNING fO OIINER: YOUR FAILURE fO RECORD A lorICE OF COMMDCBMBn' MAY RESULf II YOUR PAYING WlCE FOR IMPROVEIlmS fO YOUR
<br />PROPEm. IF YOU IBEID TO OBTAIN FIIAlCIIG, CONSOLT III'lH YOUR LEIDER OR AI AnORRlY BEFORE RECORDING YOUR IfO'flCE OF
<br />COMHEICEHEI1' . JOBS UNDER $2,500 IN VALUE 00 Nor NEED !O RECORD AND POSf A 'NorICE OF COMHEICEmI'.
<br />
<br />X ~~~~~A/-L
<br />SIGNA .OIINERJ OR AGEl!
<br />"'- /
<br />
<br />SIGNA'I'URI: COI'I'RAC!OR
<br />
<br />S'I'AT! OF FLORIDA P
<br />coum OF ~
<br />Tbe foregoing'irent ..as acknowledged
<br />before me this ~ r ,19ft. by
<br />
<br />PO.ulrt D_ (Jf)Wer<3J
<br />who is person ly known to or who has
<br />produced
<br />as identifi
<br />take an
<br />
<br />
<br />SfA'I'! OF FLORIDA Per
<br />coum OF dCCJ
<br />The foregoing ins~~t was acknowledged
<br />before me this 15 Z. , 19-.2L by
<br />/
<br />EOJ2L-Y J-)ClAJ/J~12-
<br />who is person ly known 'to e 0 who has
<br />produced
<br />as identification and who
<br />take an oa
<br />
<br />(Si
<br />
<br />
<br />JE:- .5
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<br />OFFICIAL NOTARY SEAL
<br />PEDRO M QUINONES
<br />NorARY PUBUC STATE OF FLORIDA
<br />COMMISSION NO, CC244913
<br />MY COMMISSION EXP, DEe. 7.1996
<br />
<br />OFFICIAL NOTARY SEAL
<br />PEDRO M QUINONES
<br />NorARY PUBLIC STATE OF FLORIDA
<br />COMMISSiON NO. CC244913
<br />MY COMMISSION EXP. DEe. 7.19%
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