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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this penit laY be subject to Ideed restrictions I wbich lily be lOre restrictive than City
<br />regulations. The undersigned asSUES responsibility for COIpliance with any applicable deed restrictions. '
<br />
<br />B. UNLICENSEP CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they lilY 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 lilY be
<br />cited for a lisdl!leaJlor violation under state law. If the owner or intended contractor are uncertain as to wllat licensing
<br />reguirelents lilY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />IContractor Sections~ of this application for which they will be responsible. If rou, 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 wishes you to sign
<br />as contractor that lilY be an indication that be is not properly licensed and is not entitled to perli~ting 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 IPlorida's Construction Lien Law - lbIeolmer's Protection
<br />Guidel prepared by the Florida Departlent of Agriculture and ConsUler Affairs. If the applicant is 8OMOD8 other than the
<br />lownerl, I certify that I have obtained a copy of the above described dOCUleDt and pr~ise in good faith to deliver it to the
<br />lownerl prior to COIIeDCelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work viII be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is bereby lade to obtain a perait to do work and installation as indicated. I certify that no wort or
<br />installation bas c.encecl prior to issuance of a perlit and that all work will be perfolled to Ieet staDdarda 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 goverDleDtal agencies lilY apply to the intended wort, and that it is
<br />IY responsibility to identify wbat actions I lust tate to be in COI(lliance. Such agencies include but are not lilited to:
<br />t Departlent of EnvirollJelltal Regulation - Cypress Baybeada, Wetland Areas and EnvirollleDtally Sensitive Lands,
<br />Water/lfastewater TreabeDt
<br />t Southwest Florida Water HanageJellt District - Nells, Cypress Baybeacls, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docts, Ifavigable Waterways
<br />t Departlent of Health i Rehabilitative Senices, EnvirODleDtal Health Unit - Wells, Wastewater rreablent, Septic rws
<br />t US Bnvil'ODllelltal Protection Agency - Asbestos abat8lent
<br />I also certify that, if fill nterial is to be used in Flood Zone IAI or lA, etc. I, it is understood that a drainage plan
<br />addressing a lCOIpeDSating vol.1 will be saitted wbich is prepared by a professional engineer registered in the State of
<br />Plorida prior to perlit issuance.
<br />
<br />A perlit 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 fIOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued shall becme invalid
<br />unless the IIOrt authoriled by such Perlit is COIIeDced within sillOntha of issuance, or if wort authoriled by the perlit is
<br />suspended or abandoned for a period of sil IOntha after the tile the worl is ~cecl. One 90 day I!Itension of tile, Iil, be
<br />allowed for the perlit with fee charge of $15.00. !be I!Itension sllall 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 />WARRING TO OIIE: YOUR FAILURE ro RlCORD A KorICE OF CC>>IIIDCEIIMI HlY RESUL! IN YOUR PIYIIG DICE FOR IIIPROVIIIEIl'S ro YOUR
<br />PROPERTY. IF YOO IlfllD ro 08'1111 FIIAIICIIG, CONSULr WIrB YOUR LODER OR II ArromY BE10RI RICORDIIG YOUR DICE OP
<br />COHMEIcmtm. JOBS UNDER '2,500 1M VILUE DO Mor IfEED ro RlCORD lID POST A 'MorICE OF C<HIDCEIIEIff'.
<br />
<br />
<br />~ G7.t'~
<br />S 'lURI: CON!
<br />
<br />~~~ ~~~-A__ J
<br />IGlltuRIl: OR
<br />
<br />STATE OF FLORIDA 11
<br />COUll'Il OF ~
<br />The foregoing instrument was aCknowledged
<br />before me this JItZ1 , 19..i.2:. by
<br />7717
<br />
<br />who is personally known to me or who has
<br />produced n"....'''''''~
<br />as identificati9#\~~...~ .i/4.id/did not
<br />take an (lath. /!!;~ .~.......~ %
<br />~ . .-
<br /><:! ./Y1 '. :.
<br />(Signa~ure) ~ + \ * ) + ~
<br />"J) (fl)Jlo.J)4 4~RZ.J)W '--
<br />(Namp. Typed, pir . d..or~' peel)
<br />NOT'. ny PUBLIC "//// 0 f f \. \l \\\\\'
<br />Aft 1/!lr!r1l1l1\\\\\\'
<br />
<br />srAR OF FLORIDA~
<br />coum OP :...a.-L-()
<br />The foregoing instrument was acknowledged
<br />before me this /1 tIJ '7lJ7 ' 19 ~ by
<br />
<br />who is personally known to me or who has
<br />produced ~""..
<br />as identifi" . ........~/~bo did/did not
<br />take an oi\tlo \..... .... . <' %
<br />, ~ ~./ ~ ... /' ~
<br />(Signatur~)to \ * i + ~
<br />:v/~J~\L. .-y~Pt4J)F-L/
<br />(Name Type ..~~rin.~" . '" Stamped)
<br />P L//+ Of f~"" \,'-'
<br />NOTARY UB.I: /11/11111\\\\\\\\\\\
<br />
<br />
<br />Notary Public, State cl Florida
<br />DIANNA L. TF1ZNAOEL 'lI1"""'J/~' )90'-
<br />My Comm. Exp. Nov. 11, 1995 II V&/ F LV7 F ~
<br />Comm. No. CC 159184
<br />
<br />Notary Public. State of Flcrioda
<br />DIANNA L. TRZNADEL ~ -rz. Q u r-
<br />My Comm. E"P.Nov.ll. 1.9.gs '#7/'" II (.,#'{ 1/ YO
<br />Comm. No. CC 159184
<br />
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