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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this peIlit uy be subject to 'deed restrictions I wbieb laY be .re restrictive than City
<br />regulations. The undersigned asSUleS responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OIfIIer 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 lil1l, both the lJIIIler anc1 contractor laY be
<br />cited for a lisdelelllor violation under state law. If the O1IIler or intended contractor are uncertain as to wbat licensing
<br />requirelenu laY apply for the intended IOrk, 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, he is advised to have the contractor(s) sign portions of the
<br />IContractor Sections~ of this application for wbieb they will be responsible. If you, as the lJIIIler sign as the contractor,
<br />you are indicating that JOU, rather than the contractor, are responsible for the IOrk. If the contractor wishes JOu to sign
<br />as contractor that laY be an indication that be is not properly licensed and is not entitled to perlit.ting 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 'Plorida's Construction Lien Law - lDeoImer's Protection
<br />Guide' prepared by the Plorida Departlent of Agriculture and Cons\lleI Affairs. If the applicant is 8OII!OIle other than the
<br />'OIfIler', I certify that I bave obtained a copy of the above described c10cuIent and pro.ise in good faith to deliver it to the
<br />100000erl prior to co.enCel8llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that alllOrk will be done in cOlpliance with all
<br />applicable lad regulating construction, laning, and land developlent.
<br />
<br />Application is bereby lade to obtain a peIlit to do work and installation as indicated. I certify that no IOrk or
<br />installation baa cmI8Ilced prior to issuance of a pmit andtbat alllOrk will be perf OIled to .et standards of alllil1ls
<br />regulating construction, City codes, loning regulations, and land developll!llt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDl8lltal agencies laY apply to the intenc1ec1lOrk, and that it is
<br />If responsibility to identify wbat actions I lust take to be in COIpliance. Sueb agencies include but are not lilited to:
<br />. DepartJent of Bnvirol1leDtal Regulation - Cypress Baybeads, Wetland Areas and BnviroDlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />. Southwest Florida Water Managl!lleDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t Arl' Corps of Bngineers - Seawalls, Docks, lavigable Watenays
<br />t Departlent of Health i Rehabilitative Services, BnvirOJlleDtal Health Unit - IIells, IIastewater Treatlent, Septic Tanb
<br />t US BnvirOJlleDtal Protection Agency - Asbestos abateJll!llt
<br />I also certify that, if fill ..terial is to be used in Plood Zone 'A' or 'A,etc.', it is understood that a drainage plan
<br />addressing a ICOlpell8ating vol_I will be sublitted wbieb 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 shall issuance of a peIlit prevent the Building Official fa thereafter
<br />requiring a correction of errors in plans, construction, or violations of any coele. Bvery pemit issued shall becme invalid
<br />unless the IIOrl autboriled by sueb peIlit is COMenced within Sil IOIltbs of issuance, or if IIOrl autborbed by the per.it is
<br />suspended or abandoned for a period of sl1lODtbs after the tile the IOrl is ~ced. One 90 day 81tension of tile, laY be
<br />allowed for the pmit with fee charge of $15.00. the 81tension sball be requested in Iriting to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sl1lOJltb period, or the project will be considered abanc1ODed.
<br />"ARHIRe 'f0 omR: YOUR FAILURE 'f0 RlCORD A 10000ICI or allMElCIIIII! MAY RBSUL'f 1M YOOR PAYING NICS FOR IItPROVIIID'1'S TO YOUR
<br />PROPER'fY. IF YOU mElD TO OBTAIJI PIIlUCIRG, COJISULT IIITH YOUR LODER OR IIIAnORm BlFORI RlCORDIJIG YOOR MO'1'ICE OP
<br />aJlMBlICDIEI'1' . JOBS OlDER '2,500 II VALOI DO 10'1' IUD TO RECORD IIID POST A 'DICE OP C(JIMBICBIID!I.
<br />
<br />SIGIA'1'URI: 0IIlIER OR IGBJI'1'
<br />
<br />~ ~L-2LJ(J
<br />S :COxI R ~
<br />
<br />STATB OF FLORIDA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19_ by
<br />
<br />STATB OF FLORIDA
<br />coum OF \'f\~CO
<br />The foregoing instrument was aCkn~ledged
<br />before me this (~T" I 3 , 19 q by
<br />
<br />EXX.0ARD VEri ( IJ-..JG
<br />who is personally known to me or who has
<br />produced r L- ,1::>L
<br />a . entification and who did/did not
<br />ke an oath.. '. . ~ r
<br />..~ ..~~
<br />(Signature)
<br />
<br />
<br />who is personally known to lie or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />(Signature)
<br />
<br />(Nut!. Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />(Name Typed, Printed oX)fSl>4Il-.paa) 0'1, F :.t.
<br />NOTARY PUBLIC NOTI'.RY i'ulk..C, :..:A':.. vr i-:OR'DA
<br />My c;,:'r:1rr>Js;,,'i'"' ~'.;>l~"._: \"i,Y --!1 :<:'Jl
<br />Commlsslon Ni), C C Z l j '" .;. 9.
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