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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'be undersigneel understands that this pel1lit IIaY be subject to -deed restrictiOll8- .bich lilY be lOre restrictive than City
<br />regulations. !be undersigneel asSOles responsibility for co.pliance .ith anJ applicable deeel restrictions.
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<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they lilY be reguireel to be licensed in accordance .ith
<br />state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor lilY be
<br />cited for a lisdeJeallor violation under state la., If the owner or intended contractor are uncertain as to wbat licensing
<br />requirBlents IilJ apply for the intended work, they are advised to contact the City of ZepbJrhUls Building Departlent, (813)
<br />788-6611,
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<br />FurtherlOre, if the OIner bas bired a contractor or contractors, be is adviseel to bave the contractor(s) sign portions of the
<br />-Contractor Sections- of this application for .bich they will be responsible. If Jou, as the OlDer sign as the contractor,
<br />you are indicating that you, 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 be is not properly licenseel and is not entitleel to perlitting privileges in the
<br />City of ZepbJrbills,
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided .ith a cOPJ of -Plorida's construction Lien Law - lIoIeowner's Protection
<br />Guide- prepared by the Plorida Departlent of Agriculture and COnsUlBr Affairs. If the applicant is 8OIBOD8 other than the
<br />-owner-, I certify that I have obtained a cOPJ of the above described docuIent and prOlise in good faith to deliver it to the
<br />"owner- prior to COII8IlCl!lBJ1t,
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all .ort will be done in cOlpliance .ith all
<br />applicable laws regulating construction, loning, and land developlBllt.
<br />
<br />Application is bereby lade to obtain a perlit to do wort and installation as indicated. I certifJ that no work or
<br />installation bas CDlBDceel prior to issuance of a pel1lit and that all wort will be perfol1ll!d to Jeet standarc1s 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 goveIDleDtal agencies IilJ apply to the intended work, and that it is
<br />IY responsibilitJ to identify what actions I lUSt tate to be in COIpliance, Such agencies include but are not lilited to:
<br />t Departlent of EnvirODlental Regulation - Cypress Bayheads, lIetland Areas and EnviroDleDtally Sensitive Lands,
<br />lIater/llastewater !reatJent
<br />t Southwest Florida lIater HanagBlBDt District - Wells, Cypress Baybeads, lIetland Areas, Altering lIatercourses
<br />t ArlY COIPS of Engineers - Seawalls, Docb, Navigable Waterways
<br />t Deparblent of Health' Rehabilitative Services, BnvirODleDtal Health Unit - Wells, Wastewater !reablent, Septic !ants
<br />t US BnvirODleDtal Protection Agency - Asbestos abatl!lBllt
<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 -COIpensating vol.- will be subJlitted which is prepareel by a professional engineer registereel in the State of
<br />Florida prior to pel1lit issuance. '
<br />
<br />A pertit issued sball be construed to be a license to proceed "ith the vork 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 the Building Official fa thereafter
<br />requiring a correction of errors in plans, construction, or violations of anJ code. BvetJ perlit issueel shall beCCE invalid
<br />unless the .ort authorized by such perlit is COll8llCeel within sillODths of issuance, or if wort authorized by the pel1Iit is
<br />suspendeel or abandoneel for a period of sil IODtbs after the tile the vort is co.enced. One 90 day utension of tille, lily be
<br />allo.eel for the pel1Iit with fee charge of $15.00, Ibe utension sball be requested in writing to the Building Official. An
<br />approveel inspection lUSt be logged during each sillOllth period, or the project will be considereel abandoned.
<br />IIARIlING 10 omR: YOOR FAlLURlIO RlCORD A NOt'ICE OF alfMBNCDIBIft' HlY RlSULI IN YOOR PAYING !VICE FOR IIIPROVIHD!S '1'0 YOUR
<br />PROPERft. IP YOU lJDIO) 10 OBtAIN FIlWICIIG, COJfSULI WI'I'H YOOR LINDER OR AI A'l'IOIIUY BEFORI RlCOHDIIiG YOUR IIOfICE OP
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<br />SIGIII!. - 01 - - 'JJfL - - S 11IOI: CIuDt1Ul -
<br />
<br />S'I'A'I'B OF FLOR~
<br />COUNTY OF 6t!.O
<br />The foregoing instrument was acknowledged
<br />before me this GAN, frJ,-, 19~by.
<br />
<br />(Y/Aterv /Jfo,v'j,IP'<<-e#
<br />~ho'is petsonally known to m~ or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />~~.~..
<br />(S. ature)
<br />
<br />. (RiIIIIe Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />S'l'IIE OF FLORI9&. . '
<br />coum OF 1:11 SC 0
<br />The foregoing instrument was aCknowledged
<br />before me this;7A~ 9fA; , 191:C" by
<br />
<br />,ho ~~t~~t!~t:~~hO has
<br />
<br />produced .
<br />as identification and 0 did/did not
<br />take oath.
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />,,'
<br />
<br />JAMES A, STONE
<br />Notary Pubiic, State of Florida
<br />My comm. expires May 16, 1995
<br />CC110274
<br />
<br />JAMES A, STONE
<br />Notary Public, State of Florida
<br />My (;omm. expires May 16, 1995
<br />CC110274
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