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<br />CONDITIONS OF PERMIT AFFIDAVIT'
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this peIlit laY be subject to Ideed restrictions I wbieb laY be lOre restrictive than City
<br />regulations. !be undersigned asSUles 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 undertate 1fOrt, 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 JaY be
<br />cited for a lisdeIeaDor violation under state law. If the ower or intended contractor are uncertain as to wbat licensing
<br />requiruents lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner has bired a contractor or contractors, be is advised to have the contractor(s) sign portions of the
<br />IContractor Sectionsl of this application for wbieb they will be responsible. If you, as the O1IIler sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the 1fOrk. If the contractor .isbes you to sign
<br />as contractor that laY be an indication that be is not properly licensed and is not entitled to pertitting 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 IFlorida's Construction Lien Law - lfOIIemmer's Protection
<br />Guidel prepared by the Plorida Deparuent of Agriculture and ConsUler Affairs. If the applicant is SOIIeOne other than the
<br />lowerl, I certify that I bave obtained a copy of the above described docuIent and pCOlise in good faith to deliver it to the
<br />"owner I prior to COllenC8leDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all work will be done in COIpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is bereby Iilde 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 perti t and that all IIOrt will be perforted to Ret 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 goverDlleDtal agencies laY apply to the intended IIOrk, and that it is
<br />If responsibility to identify wbat actions I lust take to be in coapliance. Sueb agencies include but are not laited to:
<br />t Departlent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDleDtally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />t Southwest Florida Water Managuent District - NeIls, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AllY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t Departlent of Health i Rehabilitative Services, BnvirODlental Health Unit - Wells, Wastewater treatlent, Septic 'anks
<br />t US EnviIODlental Protection Agency - Asbestos abatuent
<br />I also certify that, if fill Jaterial is to be used in Plood Zone IAI or IA,etc.", it is understood that a drainage plan
<br />addressing a llC01peDsating VOlUleI will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A pemit issued shall be construed to be a license to proceed with the 1fOrk 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 tbe Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued &ball beCOle invalid
<br />unless the work authorized by sueb pemit is COIIeDced within sillODths of issuance, or if work authorized by the pemit is
<br />suspended or abandoned for a period of sillODtbs after the u.e the wort is cOlleDced. One 90 day extension of tae, lilY be
<br />allowed for the pemit with fee cbarge of $15.00. !be 81tension sball be requested in .riting to the Building Official. An
<br />approved inspection lUst be logged during eaeb sillODth period, or the project will be considered abandoned.
<br />NARNING '1'0 omR: YOUR FAILURE '0 .~COJ.D A. NOTICE OF C<IDIEI!CEIIEN! MAY RESULt IN YOUR PAYING !VICE FOR IMPROVIIIEI!S TO YOUR
<br />PROPIRfY. IF YOU IBBHD TO OB!lIlf PIWCING, CONSULT lID YOUR LBHDIR OR D AnomY BEFORE RECORDING YOUR DICE OF
<br />COMMENC . JOBS UNDIR $2,500 IN VALUI DO NOT NEID to RECORD AND POST A INOTICE OF COMMDCIIIEN!".
<br />
<br />
<br />fd~J ~
<br />
<br />
<br />srATE OP FLORIDA /)
<br />COUN!Y OF (/-(L.~
<br />The foregoing instrument was acknowledged
<br />before me this (JU d5, 199 V by
<br />
<br />U~~ ~o. 4~
<br />who is personally known to me or who has
<br />produced
<br />as identificati;7on~ d who did/did Dot
<br />take an oath. LI ~
<br />"- J
<br />/l ' ..,
<br />(~ature)
<br />- VEI3/f/t ~.E. STI(E.~?3
<br />(Hame, Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />SIArE OF FLORIDA
<br />coum OF P o..-{L~"A.'r
<br />The foregoing instrument was acknowledged
<br />before me this Oc-c,;{ 5 J , 19~ by
<br />
<br />'tJ~nLJ jJ.8 a.dc..--
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath. I..JJ~ k -&P.f'L:-::?
<br />(Signature)
<br />---uE t3 /'f .4-5iL E. ;:)~77c. E E /,S
<br />(Hame Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />DEBRA SUE S':;'",;r;;:'P~
<br />N..t.....D..L ......_il'"
<br />aiu-' rugJiC: St;2~~ ef Fll))'1:b
<br />-,caram'OXPlf~C Oct 29, 1905
<br />No. CC-;Et':~'J
<br />rtcc/s,{,..:<'lY
<br />
<br />/ _I'M SUtiE ::r.iT;i!l~'fiS
<br />Notary Public, St3:~Hj! f'l0:::h
<br />My comm. GXpl:'~,: a:i 7."\ ':
<br />No.C:
<br />rFee/S'G.-<9P
<br />
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