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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />NOTICE OF DEED RESTRICTIONS
<br />de undersigned understands that this perlit lay be subject to -deed restrictions- wbieb lay be lOre restrictive tban City
<br />regulations. !be undersigned assutes responsibility for coap'iance lIith any applicable deed restrictiuoa.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to urnlerta~e work, they laY be required to be licensed in accorclance lIitb
<br />state and local regulations. If the contractor is not licensed as rSQUired by lall, both the OWDer and cOntractor laY be
<br />cited for a lisdeaeanor violation under state law. If the owner or intended contractor ace uncertain as to wbat licensing
<br />reguireaents laY apply for the intended work, they are advised to contact the City of Zepbyrbllls Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtberlOre, 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 IIbieb 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 tbe contractor lIisbes you to sign
<br />as contractor that laY be an indication that be is not properly licensed and is not entitled to perlitting 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 lIith a copy of -'lorida's COnstruction Lien Lall - HoIeoMDer's Protection
<br />Guide- prepared by the 'lorida DepartJent of Agriculture and ConsUll81' Affairs. If the applicant is SOlleOll8 other than the
<br />wOlIRer-, I certify that I bave obtained a copy of the above described docUl8Rt and prOlise in good faith to deliver it to the
<br />wowner- prior to COll8Dceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work lIill be done in COIpliance lIitb all
<br />applicable lalls regulating construction, loning, and land developllDt.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas COII8Ilced prior to issuance of a perlit and that all IIOrk lIill be perforJed to Jeet 8tandards of all lall8
<br />regulating construction, City codes, loning regulations, and land developlellt regulations in the jurisdictioo. I also
<br />certify that I understand that the regulations of other goveruental agencies JaY apply to the intended wort, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in cotpllance. Sueb agencies include but are not lillted to:
<br />t Departtent of KnvirODl8Dtal Regulation.- Cypress Baybeads, Metland Areas and EnviroDJeDtally Sensitive Landa,
<br />Mater/Mastellater !reallent
<br />t Soutbllest Florida Mater Managetent District - Veils, Cypress Baybea4s, Wetland Areas, Altering Matercourses
<br />. Arl' Corps of Ingineers - Seallalls, Docks, lavigable Materways
<br />. DepartJent of Health' Rebabilitative Services, KnvirOllll!Dtal Health Unit - Mells, Wastellater Ireat&t, Septic 'anks
<br />. US BnvirODlental Protection Agency - Asbestos abatllJeDt
<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 -coapensating volute- lIill be subtitted IIbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance. .
<br />
<br />A perlit issued sball be construed to be a license to proceed lIith the IIOrt and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the BuIlding Official froa thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOlB invalid
<br />unless the lIork authorhed by such perlit is COII8Ilced within sil IOIlths of issuance, or if 1I0rk autboriled by the perlit is
<br />suspended or abandoned for a period of all IOIlths after the tile the vork is co.enced. One 90 dar eatension of tile, lilY be
<br />allOlled for the perlit with fee charge of tI5.00. !be eatension shall be requested in writing to the Building Official. An
<br />approved inspection lust be logged during eaeb sil 8tb period, or the project 11111 be considered abandoned.
<br />MARNIIIG TO OMJfER: YOUR FAlLURI !O RlCORD A ROTICK 0' C(JtHIICBIIIHI HAY RlSULT IR YOUR PAYlIIG !MICK FOR IMPROVERS TO YOUR
<br />PROPBRTY. IF YOO IRIIID TO OBIlII PIIWICllG, COJISUL! MITH YOOft LlllDIR OR III AnoRIIIY BEFORI RICORDIIG YOUIIIO'IICK OF
<br />C(JlMiICIMBIIT. 7JOBS URDER $2,500 IN VALUE DO lOT REED !O RICORD AID POS! A -IOTICE OF COIHIIICBMlR!-.
<br />
<br />
<br />d-z/~7. (J~
<br />
<br />-1IG JURI: OIOl'BR OR AGB s~: COI'lRAC'lOR
<br />
<br />\~ '1-G\S
<br />STATE OF ~tUf l
<br />COUDY OF ~Q.. So
<br />The foregoing in.8t~~~,wa8 ~~owledged
<br />before me this ~ 19.:f:t by
<br />
<br />STA!E OF FLOBIDA b ~
<br />COUIIY OF Lv1
<br />The foregoing instrwl~t. was aqkn71edged
<br />before me this / , 19 <.. by
<br />.
<br />
<br />/1 }onJflJu..) {h r f\ l' f2 .
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />tak~an O$? '(f'p, ~
<br />'" ()/lo1.-,,/Y"Y'. e. .
<br />(Srgn ture)
<br />~ rnrr- \/ W fY17:nA--/I~
<br />(Name Typed,rPrinted or Stamped)
<br />NOTARY PUBLIC TAMMV W'. METCALF
<br />NOTARY PUBLIC, STATE OF FLORIO"
<br />My commission expires Aug, 17, 1996
<br />Commission No. C G 2 2 1 9 1 4
<br />
<br />S IhA/.e V t, N-lAx'W.G(;.<- 7C-
<br />who is personally known to me or who has
<br />prod ed f)/l..I Vb,-l c.n;;:.../4..4'c/L
<br />as tific,tfon d who did/did not
<br />a oath V
<br />
<br />S 51 atur,eJ C
<br />~L,c;;A v. ( )hAtl De~
<br />(Name Typed, Pr~ or Stamped)
<br />N . UBLIC
<br />
<br />
<br />
<br />LISA V. SHARPE
<br />· HOI.ry Public. Sial. 0' ".11
<br />My Camm. Exp. 8.13.98
<br />~".-nP.\ll:
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