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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!he undersigned understands that this penit JaY be subject to 'deed restrictions' wbich lilY be lOre restrictive than City
<br />regulations. 'fbe undersigned asSUles responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has 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 contractor is not licensed as required by law, both the ower and contractor lilY be
<br />cited for a lisd_anor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />reguirelents JaY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (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 />'Contractor Sections' of this application for wbich 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 wishes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to peraitting 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 - lIoIeolmer's Protection
<br />GuideN prepared by the Florida Departlent of Agriculture and COnsUlel' Affairs. If the applicant is BO.I8OIle other than the
<br />'ownerN, I certify that I bave obtained a copy of the above described c10cuIent and prOlise in good faith to deliver it to the
<br />Nowner' prior to COIIeDC8leDt. -
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the infoIlation in this application is accurate and that all wort will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land deve1opl8llt.
<br />
<br />Application is hereby lade to obtain a perUt to do wort and insWlation as indicated. I certify that no wort or
<br />installation bas COMenced prior to -issuance of a perlit and that all wort will be perfoCled to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goverDlental agencies lilY apply to the intended wort, and that it is
<br />IY responsibility to identify wbat actions I lUSt tate to be in COIpliance. Such agencies include but are not It.ited to:
<br />* Departlent of Envirolllelltal Regulation - Cypress Baybeads, Wetland Areas and Envirol1leDWly Sensitive Lands,
<br />Water/Wastewater 'freatlent
<br />* Southwest Florida Water Manag8leDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />· ArlY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />* Departlent of Health' Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater 'freatlent, Septic 'fants
<br />· US EnviroDleDtal Protection Agency - Asbestos abat8leDt
<br />I also certify that, if fill Jaterial is to be used in Flood ZOne 'A' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpensating vol_' will be saitted 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 with the wort and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor sball issuance of a peIlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every peait issued shall beCOle invalid
<br />unless the tlDrk authoriled by such peIlit is COIIenced within sil IOnths of issuance, or if tlDrk autboriJed by the peIlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the wort is COMenced. One 90 day I!Itension of u.s, lilY be
<br />allowed for the perlit with fee charge of $15.00. 'fbe l!ltension sball be requested in writing to the Building Official. An
<br />approved inspection .ust be logged during each sillOnth period, or the project will be considered abandoned.
<br />WARMIIG TO OIlIER: YOUR FAILURE TO RE IOTICI OF <XIfMEIfCBMm MAY BESOL! II YOUR PAYIIG fiUCH FOR 1M 5 ro YOUR
<br />PROPERlY. IF YOU II'fBND TO F C"IHG, CONSUL'f WI'fH YOUR LBlfDER OR AN AnoRIIBY BE OF
<br />COHMElCEMlN!. JO 500 I ALOE lOT HElD TO RECORD AND POS! A 'KOTICH
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<br />51
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<br />srUE OF FLORIDA ()
<br />COUNtY OF r ~
<br />The foregoing instrument was acknowledged
<br />before me this j:Jn--4~ 19-2.1:. by
<br />"KII v7J /I JJ JJ7L3
<br />who is personally known to me or wao aa&
<br />p&'oduced
<br />as id...tifi~ ,,00 .-,.did Dot
<br />take an oath. ;i! ~
<br />~~ "
<br />(Signature)j( J.J ~ pJ
<br />Jl m u::::;;c- CT. -L In ~
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />srArE OF FLORIDA Pt
<br />coum OF ~ Lo
<br />The foregoing ~t was aCknowledged
<br />before me this ~, 19 9~/ by
<br />,
<br />
<br />7(10/ IJ 1J)j J &ZS
<br />who is personally known to me or wile h..6
<br />,.......
<br />as id~ti~ieati8B aBd who~/did not
<br />take an oath~~ j\.~..-u;J. \
<br />
<br />(Signature)
<br />K./J:77.j~~-aJ J., K~JAJ
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />
<br />KATHLEEN J, BROWN
<br />Stale of Florida _
<br />... eomm, Exp. April 2, 1_
<br />.., CaIIIft.' CC 0lI&617
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