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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perait lay be subject to 'deed restrictions' "bieb JaY be lOre restrictive than City
<br />regulations. !be undersigned assUIeB responsibility for C(II()liance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertake work, they aay 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 JaY be
<br />cited for a lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requireaents laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
<br />788-6611.
<br />
<br />Furtheraore, if the owner bas bired a contractor or contractors, be is advised to have 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 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 peraitting 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, have been provided with a copy of 'Florida's construction Lien Law - BoIeolmer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and Consuaer Affairs. If the applicant is llOJIeOIle other than the
<br />'owner', I certify that I have obtained a copy of the above described docuaent and pra.ise in good faith to deliver it to the
<br />'owner" prior to CQII8Dceaent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforJation in this application is accurate and that all work "ill be done in cOlPliance "ith all
<br />applicable laws regulating construction, loning, and land c1evelopaent.
<br />
<br />Application is bereby Jade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas C31eDced prior to issuance of a perait and that all work "ill be perforaed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlellt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governaental agencies laY apply to the intended wort, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in coapliance. Sueb agencies include but are not lilited to:
<br />. Departaent of Environaental Regulation - Cypress Baybeads, "etland Areas and Environaentally Sensitive Lands,
<br />"ater /Vaste1fater 'freatJent
<br />. Southwest Florida Water Manageaent District - Wells, Cypress Baybeads, "etland Areas, Altering Watercourses
<br />. AIIY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />. DepartJent of Health i Rehabilitative Services, Invironaental Health Unit - "ells, "astewater 'freatlent, Septic 'fanks
<br />. US Invironaental Protection Agency - Asbestos abateaent
<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 'co.pensating voluae' will be sublitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perait issued shall 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 shall issuance of a perlit prevent the Building Official fra. thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery perait issued shall beCClle invalid
<br />unless the work authorized by sueb perlit is COIIeIlced within sllaontbs of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of silaontbs after the tile the work is co.enced. One 90 day eJtension of tile, lay be
<br />allowed for the perait with fee charge of $15.00. !be eJtension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillODth period, or the project "ill be considered abandoned.
<br />WARlUIG fO (MIIR: YOUR FAILURE fO RECORD A rmICE OF C<IIMDCIIlIIf MAY RESUL'f II YOUR PAYIIG 'NICE FOR IMPROVIMBlI!S 'f0 YOUR
<br />PROPERTY. IF YOU III'OID 'f0 OBTAIN FlIIDCING, COISULf "UH YOUR LIJIDIIl OR AI AnoRDY BEFORE RECORDIIG YOUR rmICE OF
<br />
<br />
<br />~~~_~~m~~
<br />
<br />S'fA'fE OF FLORIDA n
<br />COUIfY OF 111) ~ {lO
<br />The foregoing instrument was acknowledged
<br />before me this tyJfil2drt _3 , 19.LC..- by
<br />
<br />tiJ!J IJ"'I-, {f!!f.i/JFlI'lIZ-~,J
<br />who is' ROm 1 own to me or who has
<br />produced
<br />as identification and who did/did not
<br />take oath.
<br />
<br />STAfE OF FLOR~
<br />coum OF 5; ('J 0
<br />The foregoing instrument was acknowledged
<br />before me this m//p.e.i1 3 , 19-f.Lby
<br />
<br />(Y) AP.;-~ fflotJbIU(/le~
<br />who is pers ally known to me or who has
<br />produced.
<br />as identification and who did/did not
<br />take oath.
<br />
<br />
<br />
<br />e Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />p'- JAMES A. STONE
<br />Notary Public, State of Florida
<br />My comm. expires May 16, 1995
<br />eel 10274
<br />
<br />(N Typed, Printed or Stamped)
<br />NOTARY PUBLI~P;; JAMES A. STONE
<br />Notary Public, State of Florld~
<br />\1y comm. expires May H" .1895
<br />,CC11O~74
<br />
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