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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Ibe undersigned understands that this penlt lily be subject to 'deed restrictions' wbieb Iilf be lOre restrictive than City
<br />regulations. !be undersigned assU188 responsibility for ~liance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED, CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bai'bired a contractor or contractors to undertake work, they lilY be required to be licensed in accordance with
<br />state and local regulations. If the contractor Is not licensed as required by lilli, both the lJIIDer and contractor _y be
<br />cited for a lisc1e1ei1lOr violation under state law. If the owner or intended contractor are uncertain as to wbat lic_iog
<br />requirl!leDu lilY apply for the intended wort, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />Purthenore, if the owner bas hired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this applicaUOIl for wbieb they will be responsible. If fOU, as the OlDer sign as the contractor,
<br />you are indicating that JOu, rather than the contractor, are responsible for the wort. If the contractor wishes you to sign
<br />as contractor that lily be an indication that he is not properly licensed and is not entitled to peraitUng privileges in the
<br />City of Zepbyrbllls.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMEMDED)
<br />I certify that I, the applicant, have been provided ,ith a copy of 'Florida's Construction Lien Law - lIoIeoImer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUII8I Affairs. If the applicant is 80180I18 other than the
<br />'owner', I certify that I bave obtained a copy of the above described docuIent and prOlise in good faith to deliver it to the
<br />'owner' prior to co.enCl!IeDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforliltlon in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable lillls regulating construction, loning, and land developleDt.
<br />
<br />Application is bereby lade to obtain a perlit to do work and insWlation as indicated. I certify that DO work or
<br />installation baa CDIeJ1ced prior to issuance of a perait and that alllOIk will be perfOIJed to _t standard8 of all lillls
<br />regulating construction, City codes, loning regulations, and land deve1Op181lt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gOY8IDII!Iltal agencies lilY apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lUst take to be in COIpliance. Sueb agencies include but are not luited to:
<br />t Departlent of InvirOllll!lltal Regulation - Cypress Baybeau, IIetland Areas and InviroDlenWly Sensitive Lands,
<br />IIater/lfastewater lreatlent
<br />t Southwest Florida later Hanagl!ll!llt District - IIells, Cypress Baybeada, Wetland Areas, Altering IIatercourses
<br />t lIly Corps of Engineers - Seawalls, Docks, lavigable IIatenays
<br />I Departlent of Health' Rehabilitative Services, InvIrOllllllltal Health Unit - ileUs, IIastewater Ireatlent, Septic lanks
<br />I US BnvirODlental Protection Agency - Asbestos abat8lll!Dt
<br />I also certify that, if fill literia! is to be used in Flood ZOne 'I' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'CDpeII8ating vol_' ,ill be sublitted whieb is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit 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 i88uance of a perlit prevent the Building Official fa thereafter
<br />requiring a correctioo of errors in plans, construction, or violations of any code. Ivery peIllt i88ued shall becDe invalid
<br />unless tbe work authoriled by sueb peIlit is co.enced within sUlOIltbs of issuance, or if work authoriled by the perlit is
<br />suspended or abandoned for a period of su IOIltbs after the tile the work is co.encecl. ODe 90 day utensioo of tile, lily be
<br />allowed for the penit with fee charge of tI5.00. Ihe utensloo shall be requested in writing to the Building Official. An
<br />approved inspection IUIt be logged during eaeb 8il IOIlth period, or the project will be considered abandoned.
<br />IfIlRHllfG TO omR: YOUR FIILURI 'fO RlCORD A IOIICK OF aJIIDCBIIBII HAY RESULI II YOUR PAYDfG !lIICK FOR IHPIlOVBIIIIIS 'fO YOUR
<br />PROPIIIY. IF YOU IIIBKD 'fO OBIIDf FIIIIKCIIfG, COISULI IIIIB YOUR LBIDBR 01 II 1!'fOIIIBY BlFORE RBCORDIIG YOUR JOIIC! OF
<br />n mUIDIR :.500 II ~1ILIIl DO IIll _IV -I~ ~ I 'IIllICI or~.
<br />
<br />
<br />~{i ~vQ;tUO~~
<br />SIGJlAIURB: oma 01 JGDI' / , SIGJlAIURB: COIIIRlC'fOI
<br />
<br />SIAD OF FLORIDA D
<br />COOllY OF -----1Qr:..~O
<br />Tbe foregoing instrument was acknowledged
<br />before me this~,.,d 1:>~L.-, 19--2t:. by
<br />/
<br />1>- ~ ll.~
<br />who i~erS~aIIY kn~ or wbo bas
<br />produ~
<br />as identification and wbo did/did not
<br />
<br />ta~~~A-- ~.~~
<br />(Signature)
<br />(Na.e Typed, Printed or St~ed)
<br />NOTARY PUBLIC
<br />
<br />S!A!I OF FLORIDJ..-
<br />coum OF r-' a.. ~ l!D
<br />The foregoing inst~ent was acknowledged
<br />before me this ~~ ~, 19~ by
<br />/
<br />
<br />
<br />P1.--
<br />who is ersonally know.o to e or who has
<br />produce
<br />as identification and wbo did/did not
<br />
<br />~:~. ~. ~a-L-<
<br />(Signature)
<br />(Name TYPed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~~~
<br />'.IJIIU'II
<br />
<br />KAALA L ItAER
<br />Notary 1I'ubHc. 810M ~f'-rilla
<br />My Comm. Exp. June '9. ItM
<br />No. CC 382~
<br />
<br />~~
<br />'';'ft
<br />
<br />KARLA L iAER
<br />Notary Public. State ot FIerido
<br />My Comm. Exp. June 19. 1998
<br />No, CC 382444
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