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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />rbe undersigned understands that tbis pemit laY be subject to "deed restrictiOll8" wbich lay be lOre restrictive than City
<br />regulations. !be undersigned USUMS responsibility for cmpliance witb any applicable deed restrictiOll8.
<br />
<br />B. UNLICENSED, CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbe owner bili' bired a contractor or contractors to undertate work, tbey lilY be required to be licensed in accordance witb
<br />state and local regulations. If tbe contractor is not licensed as required by law, botb tbe owner and contractor lilY be
<br />cited for a tisdeleanor violation under state law. If tbe mmer or intended contractor are uncertain as to wbat licensing
<br />requirl!lents aay apply for tbe intended work, they are advised to contact tbe City of ZepbJIbills Building Deputlent, (813)
<br />788-6611.
<br />
<br />FurtberlOre, if tbe owner bas bired a contractor or contractors, be is advised to bave tbe contractor(s) sign portions of tbe
<br />"Contractor Sections" of tbis application for which tbey will be responsible. If you, as tbe OIIDer lign as the CODtractor,
<br />you are indicating that you, ratber tban the contractor, are responsible for tbe wort. If tbe contractor wilbes you to lign
<br />as contractor that aay be an indication that he is not properly licensed and is not entitled to perlitting priVileges in tbe
<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 AHENDED)
<br />I certify that I, tbe applicant, bave been provided witb a copy of "Plorida's COnstruction Lien Law - BcIIeoImer'l Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUlll!I Affairs. If the applicant is 8OIIlODe other than the
<br />"owner", I certify tbat I bave obtained a copy of tbe above described docuJent and pIOlise in good faitb to deliver it to tbe
<br />"owner" prior to COlleDCeJeI1t.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all wort will be done in co.pliance with all
<br />applicable lavs regulating construction, loning, and land developleDt.
<br />
<br />Application is hereby lade to obtain a perlit to do IfOrt and installation as indicated. I certify that no IOrt or
<br />installation bas cmleDced prior to iasuance of a perlit and that all II01't ,ill be perfOlled to _t stancJards of all laws
<br />regulating construction, City codes, loning regulations, and land developleDt regulatiOll8 in the jurisdiction. I also
<br />certify that I understand that the regulations of otber goveIDlleDtal agencies l18y apply to the intended 1101'1, and tbat it is
<br />If responsibility to identify what actions I lUSt tate to be in COIpliance. Such agencies include but are not lUlted to:
<br />t Dellarblent of EovirOlllt!Dtal Regulation - Cypress Baybeada, Vetland Areas and BnvirollleDtally Sensitive LaDds,
<br />Vater/llastewater !reablent
<br />t Southwest Florida Vater Hanagl!leDt District - Vells, Cypress Baybeada, Vetland Areas, Altering Vatercourses
<br />t ArJy Corps of Engineers - Seawalls, Docb, Navigable Vatenays
<br />t DepartJent of Healtb i Rehabilitative Senices, EovirODleDtal Healtb Unit - lIe11s, Vastewater !rea_t, Septic !ants
<br />t US EovirOnlental Protection Agenc, - Asbestos abatl!leDt
<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 "COIpeD8ating vol." will be sublitted wbich is prepared by a professional engineer registered in tbe State of
<br />Florida prior to peIlit issuance.
<br />
<br />A per.it issued sball be construed to be a license to proceed witb the wort and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall iasuance of a pemit prevent the Building Official, fa thereafter
<br />requiring a correction of errors in plans, construction, or violations of any coele. Ivery pertit issued sball beeme invalid
<br />unless tbe vort autboriled by such peIlit is co.enced witbin sh IODtbs of iasUIDce, or if 1IOrt authoriled by the pmit is
<br />suspended or abandoned for a period of sil moths after the tile the II01't is ~ced. One 90 day atension of tile, lily be
<br />allowed for the perlit witb fee charge of $15.00. !be atension shall be rl!CJl1ested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sil IODtb period, or the project will be considered abanc1oned.
<br />IIARRING !O OIIIIR: YOUR FAILURE !O RECORD A NO'lICE OF aIIIIBICIIIBJft HlY RBSUL! IN YOUR PAYIIG ICE FOR DIPROVIIIIJIIS !O YOOB
<br />PROPERn. IF YOU ID'IRD !O OB1'IIN FIJIlRCING, CONSUL! WI!B YOUR LDDBR OR AM InoRDY IIG YOUR DICE OP
<br />OIIHEJIClllEHI'. JOBS UlmER' $2,500 IN VALUE DO 1O'f IfDD TO RECORD ARD POS! A "1O'f1' . .
<br />
<br />
<br />~ti:rJ~
<br />
<br />STArE OF FLORIDA
<br />COURY OF 'P^S<-O
<br />The foregoing instruJlent was acknowledged
<br />before me this \ -to! , 19'15 by
<br />
<br />STIli OF fIOIIIII C?t J '
<br />coum OF ~(
<br />The foregOing ins ~was acknowledged
<br />before me this ~ 4 , 19 q 5 by
<br />
<br />R.lc..4ARD c.. BARTLETT
<br />who is personally known to me or who has
<br />produced I? c \2- S0 1--.>14 L L '-( K to 0 \-0 0
<br />a i tification and who did/did not
<br />t ke 0.,1:4.
<br />
<br />
<br />LD\L L lAM A12-00TJ
<br />who is personally known to me or who has
<br />produced l= L \ D L
<br />entification and who did/did not
<br />ake oath.
<br />L5'-..
<br />Signature)
<br />
<br />
<br />u
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC ,DE8BIE A. ROWELC, '
<br />NOTARY PUBLIC, STATE OF FLORIDA
<br />My commission expires Mar. 21, 1997
<br />Commission No. C C 2 7 0 2 4 9
<br />
<br />(Na.e TYPed, Printed or Sta.ped)
<br />NOTARY PUBLIC
<br />
<br />DEBBIE A. ROWELL
<br />N,OTARY PUBLIC, STATE OF FLORIDA
<br />My commission expires Mar. 21, 1997
<br />Commission No. C C 2 7 0 2 4 9
<br />
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