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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that tbis pmit JaY be subject to 'deed restrictions' wbieb JaY be lOre restrictive tban City
<br />regulations. Tbe undersigned asSUles responsibility for COIpliance witb any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake IOrk, they illY be reguirec1 to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as required by law, both the mmer and contractor liar be
<br />cited for a lisd_anor violation under state law. If the owner or intended contractor are uncertain as to "bat licensing
<br />requireJellts lilY apply for the intended IIOrk, 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, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbieb they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather tban the contractor, are responsible for the vork. If the contractor "isbes you to sign
<br />as contractor that JaY 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 UTILI~ 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 - lIoIeoImer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUl8l' Affairs. If the applicant is SOII8OI1e other than the
<br />lowner', I certify that I bave obtained a copy of the above described docUJeDt and prOlise in good faith to deliver it to the
<br />"owner" prior to COlleDCl!IeDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforliltion in this application is accurate and that all IOrk will be done in OOIPliance "itb all
<br />applicable lallS regulating construction, loning, and land developaent.
<br />
<br />Application is bereby Jade to obtain a perlit to do work and installation as indicated. I certify that no vork or
<br />installation bas ~ced prior to issuance of a perlit and that all vork will be perfoIled to leet standards of all laws
<br />regulating construction, City codes,. loning regulations, and land developleDt regulations in tbe jurisdiction. I also
<br />certify tbat I understand tbat tbe regulations of otber goverDleDtal agencies lilY apply to tbe intended vort, and that it is
<br />IY responsibility to identify wbat actions I lUSt take to be in COIpliance. Such agencies include but are not luited to:
<br />* Departlent of InviroDleDtal Regulation - Cypress Bayheads, Wetland Areas and BnviroDleDtally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />* Soutbwest Florida Water Managl!l8l1t District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />* AllY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />t Deparblent of Health & Rehabilitative Services, EnvirODleDtal Health Unit - Wells, Wastewater Ireablent, Septic lants
<br />t US InvirODleDtal Protection Agency - Asbestos abateJellt
<br />I also certify that, if fill Iilterial is to be used in Flood ZOne 'A' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpensating volue' will be sublitted wbieb 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 "itb the vork 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 tbeBuildiDg Official fIOl tbereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery peIlit issued shall becme invalid
<br />unless the vork authorized by such peIlit is COII8Ilced lIitbin sillOntbs of issuance, or if vork authorized by the perlit is
<br />suspended or abandoned for a period of si1lODtbs after tbe U. tbe 1IOrk Is c~cecl. One 90 day ateDsion of tiE, IlaY be
<br />allowed for tbe pmit "itb fee charge of $15.00. Tbe 81tension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sil IODtb period, or the project "ill be considered abandoned.
<br />WARlIRG TO OIlIER: YOUR FUtURE TO RECORD A IOI'ICE OF aIIIIIICIIlBIf! MAY RBSULI II YOUR PAYIIG !IIICE FOR IMPROVBIImS TO YOUR
<br />PROPERlY. IF IOU IJIDID TO 081111 FIlIAIIClKG, COISULI WIIH 1008 LBlDIR OR 11 AftORBY BIFORB RICOBDIIG YOUR lorlCE OF
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<br />
<br />~m~~
<br />.SIGIII!' ' -. - 11 AGiIr - 811:1-111III: nmA ~
<br />
<br />STATE OF FLO~
<br />coum OF ~O
<br />The foregoing instrument was acknowledged
<br />before me this r~ 'I , 19!JL by.
<br />
<br />1J1~ IJfoAl)N</C~A/
<br />who is pe sonallv known to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />~a~~
<br />( gnature)
<br />
<br />(Rame Typed, Printed or Stamped)
<br />ROTARY PUBLIf., S A STONE
<br />. JAME. ..
<br />Notary Public, State ot Florida
<br />My comm. expires May 16, 1995
<br />CC11 02T~
<br />
<br />STATE OF FLORIJ)A) ,
<br />coum OF -/-" A.S' C/o
<br />The foregoing instrument was acknowledged
<br />before me this '\.TiJ.^J ~ tt/ , 19 9r- by
<br />
<br />~~~#/?/Zf';V
<br />,~o . 11 y known to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />~th~~
<br />S' ature)
<br />
<br />(Rame Typed, Printed or Stamped)
<br />ROTARY PUBLIC
<br />
<br />!d.~.
<br />" JAMES A, STONE
<br />Notary Public, State of Florida
<br />My comm. expires May 16, 1995
<br />CC110274
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