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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perllt lilY be subject to .deed restrictions. wbich lily be lOre restrictive than City
<br />regulations. !be undersigned asBUJeS responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OlDer bas hired a contractor or contractors to undertake wrt, 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 0Iml!l' and contractor lay be
<br />cited for a lisdeleanOr violation under state law. If the mmer or intended contractor are uncertain as to "bat licensing
<br />requiretellu lilY apply for the intended wrt, they are advised to contact the City of Zepbyrhil1s Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtberJOre, if the OIIner 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 respoosible. If JOU, as the mmer sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the IIOrl. If the contractor "isbes fOIl to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to perJitting privileges in the
<br />City of &epbyrbills.
<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 - BcIIeolmer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUl8l' Affairs. If the applicant is 8OIl!OIle other than the
<br />.00000er", I certify that I bave obtained a copy of the above described doc1Jlent and prEse in good faith to deliver it to the
<br />.owner. prior to co.encetent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforliltion in this application is accurate and that all IOrt will be done in ~liance with all
<br />applicable 181ls regulating construction, loning, and land developl8llt.
<br />
<br />Application is hereby Jade 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 perIIit and that all IIOrk ,ill be perfoIled to Het staDdarda of all 181ls
<br />regulating construction, City codes, zoning regulations, and land develo(ll8llt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDlK!l1tal agencies lilY apply to the intended IIOfk, and that it is
<br />-r responsibility to identify wbat actions I lust take to be in cmpliance. Such agencies include but are not lilited to:
<br />. DepartJent of Envirolll8lltal Regulation - Cypress Baybeads, Wetland Areas and Invirolll8lltally Sensitive Lands,
<br />Water/lfastewater !reatlent
<br />I Soutbwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />. Arty Corps of Engineers - SeawallS, Docks, lIavigable Waterways
<br />. Departlent of Health & Rehabilitative Services, BnvirODlental Health Unit - Wells, Wastewater !reatlent, Septic 'Ianks
<br />I US Invirontental Protection Agency - Asbestos abatuent
<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 .cOlpeJlSating volute. ,ill 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 ,ith the wrk and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a perIIit prevent tbe Building Official f[(ll thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perlit issued shall becme invalid
<br />unless the wrk authorized by such Perlit is COMeIlced ,itbin sillODtbs of issuance, or if wrk authorlJed by the perIIit is
<br />suspended or abandoned for a period of sillODtbs after the tile the 110ft is C08eDced. One 90 day atension of tile, lilY be
<br />allowed for tbe perIIit ,itb fee charge of $15.00. 'Ibe 81tension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillODtb period, or the project ,ill be considered abandoned.
<br />IIARHIIIG TO OIfIIBR: YOUR FAILURE '10 RBCORD A 1I0001CE OF COIMIIfCBllll1' MlY RBSUL'I III YOUR PI G !IIICE FOR IMPROVBIIII'IS TO YOUR
<br />PROPIRn. IF YOU IOBIID to OB'IAIH FIIlAllCIHG, COIISUL! WItH YOOR LlllDER OR III A RICORDIIG YOUR O'IICE OF
<br />COMMBIICBHBM!. JOBS UNDER $2,500 III VALUE 00 101' mo fO RECORD lID POS! A '101'1 CBIIBI'lI
<br />
<br />,/~~
<br />SIGIIAfURI: (II)IIR OR' AGIO
<br />
<br />~~O~/~#,~~
<br />Tbe foregoing instrument was ~~wledged
<br />before me this tPd- s ,19~ by
<br />
<br />~ ~~\1 nt//?/
<br />who i person 1 y known to me or who has
<br />produced
<br />as identi
<br />take
<br />
<br />
<br />Notary :Puliflc; "State of FlorIda at tarp
<br />My CommiSSion Expires Dec. 11. 1995
<br />\ Bondedthru Agent's Notary Brokerage
<br />
<br />
<br />SIGIIA
<br />
<br />StAfl OF FLORIDA 1ft
<br />coum OF ;z;;J/le' 1:4-->
<br />Tbe foregoing inst~t was acknowledged
<br />before me tbis 3 ~&C/f; 19~ by
<br />
<br />It! / d;~~~
<br />who is(l)ersonall . mm:> to me or who bas
<br />produced
<br />as identification and wbO.d~/did not
<br />
<br />~,.tb(;). L.)~
<br />
<br />(~gnatule) W
<br />'(~c..,...~ W L01,J
<br />(Name Typed, Frinted or Stamped)
<br />NO'l".nv PHDLI'" 'd at Large
<br />AIU up. "" State o~ FlOrl a 995
<br />NotarVpuo,1C, . DDc.ll,l
<br />. . EX"I[e<; c. __
<br />My commiSSIon ~'N~tary Brol<er..,..
<br />Bonded tnru Agetlt_s
<br />
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