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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'Ibe undersigned understands that this pemit JaY be subject to Ideed restrictions II wbich lilY be lOre restrictive than City
<br />regulations. !be undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they lay 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 owner and contractor laY be
<br />cited for a lisdl!leanor violation under state law, If the owner or intended contractor are uncertain as to wbat licensing
<br />reguirl!lents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611, .
<br />
<br />FurtheIlOre, if the owner has bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />nContractor Sectionsl 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 wisbes you to sign
<br />as contractor that laY be an indication that be is not properly licensed and is not entitled to perJitting 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 IFlorida's Construction Lien Law - BoIeo1mer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUJel' Affairs, If the applicant is SOJH!OI1e other than the
<br />lowner", I certify that I bave obtained a copy of the above described docUleDt and p~ise in good faith to deliver it to the
<br />lownerll prior to COIIeIlCl!leJlt,
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulatinq construction, zoning, and land developlent,
<br />
<br />Application is bereby lade to obtain a pemit to do work and installation as indicated. I certify that no work or
<br />installation bas COIIeIlced prior to issuance of a pemit and that all work will be perfolled to leet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other gove11llelltal agencies lilY apply to the intended work, and that it is
<br />Ii responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />* Departlent of EnviroDlelltal Regulation - Cypress Baybeads, Wetland Areas and EnvirollleJltally Sensitive Lands,
<br />Water/Wastewater !reatlent
<br />* Southwest Florida Water Managetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />* AIIY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* DepartJent of Health i Rehabilitative Services, EnvirODJeDtal Health Unit - IIells, Wastewater 'Ireatlent, Septic 'Ianks
<br />* US EnvirODJeDtal Protection Agency - Asbestos abatl!leJlt
<br />I also certify that, if fill Iilterial is to be used in Flood ZOne IIAI or IA,etc,l, it is understood that a drainage plan
<br />addressing a ICOJpen8ating VOlUleI will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to pemit issuance,
<br />
<br />A peIlit issued sball 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 sball issuance of a pemit prevent the Building Official fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code, Every pemit issued sball beCDe invalid
<br />unless the work authorized by such perlit is COIIIlIlced within sixlOntbs of issuance, or if work authorized by the pemit is
<br />suspended or abandoned for a period of six IODths after the tile the work is co.enced. One 90 day extension of tile, lilY be
<br />allowed for the perlit with fee charge of $15,00, !be extension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each six IODth period, or the project will be considered abandoned.
<br />IIARHING '10 (MfBR: YOUR FAILURE '10 RECORD A NorICE OF COIlMDCBIIm MAY RESUL'I IN YOUR PAYING 'l'IIICE FOR IMPROVBHmS TO YOUR
<br />PROPER'IY. IF YOU IJIUlID TO OB'lIIH FINANCING, CONSUL'I VI'IH YOUR LlllDER OR AM AnoRIEY BEFORE RECORDING YOUR HO'IICE OF
<br />COMMENCBHEK'I, JOBS UNDER $2,500 IN VALUE 00 Nor MEED '10 RECORD AIID POS'I A INorICE OF COHMDCEMEII'II,
<br />
<br />r'}/7/7 _ l> !2.. I) c,
<br />//t~& Le~ _~ft'~-:n-
<br />
<br />SIGlA!URB: OOER OR AGm'
<br />
<br />??zc~~ tc/~~L~::--? 0
<br />
<br />SIGIIl!URE: COIl'lRAC'lOR
<br />
<br />S'IA'lE OF FLO~
<br />coum OF 9!0
<br />The foregoing instrument was acknowledged
<br />before me this J"i:J1V' I b , 19 'I r by
<br />
<br />nJ,Chf1~/ w.' 1/,/1;" 5'
<br />who is personal Iv known to me or who has
<br />.
<br />produced
<br />as identification and who did/did not
<br />take oath.
<br />
<br />S'IA'IE OF 110A
<br />COUK'tY OF A.~ l!.Q
<br />The foregoing instrument was acknowledged
<br />before me this :::TAN' liD , 19~ by
<br />
<br />~APj l~', Il,~
<br />who is personally known to m~ or who has
<br />produced
<br />as identificatio
<br />take an oath.
<br />
<br />
<br />
<br />
<br />e Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />Name,Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />JAMES A. STONE
<br />Notary Public, State of Florida
<br />My comm. expires May 16, 1995
<br />CC; 1f'?'7d
<br />
<br />~.. JAMES A, STONE
<br />Notary Public, State of Florida
<br />My comm. expires May 16; 1995
<br />CC1i0274
<br />
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