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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />fbe undersigned understands that this penit lilY be subject to 'deed restrictions' ,bieb lilY be lOre restrictive tban City
<br />regulations. !be undersigned Willes responsibility for cmpliance ,ith any applicable deed restrictiODB.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the 0IDeI bas bired a contractor or contractors'to undertake IOrk, they .y be required to be licensed in accordance with
<br />state and local regulations. If the contractor is not licensed as reguired by law, both the mmer and contractor lilY be
<br />cited for a lisdeEallOr violation under state law. If the owner or intended contractor are uncertain as to wllat licensing
<br />requirell!Dts lilY apply for the intended wrk, they are advised to COAtact the City of Zepbyrbills Building Deparblent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the OIIler bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor SectiODB' of this applicatioo for which they ,ill be responsible. If you, as the OIIJler sign as the contractor,
<br />you are indicating that JOu, rather than the contractor, are responsible for the IOrk. 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 peIJitting 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 lith a copy of 'Florida's Construction Lien Law - BcIIeoImer's Protection
<br />Guide' prepared by the Florilla Departlent of Agriculture and ConsUIIeI Affairs. If the applicant is 8ClIl!One other than the
<br />'OIIleru, I certify that I bave obtained a copy of the above described docuIent and prrmBe in good faith to deliver it to the
<br />'owner" prior to ~Cell!Dt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the intonation in this application is accurate and that all work will-be done in CCJlpliance lith all
<br />applicable laws regulating construction, loning, and land developlellt.
<br />
<br />Application is hereby aade to obtain a peIJit to do work and installation as indicated. I certify that no IOrk or
<br />installation bas CDlenCed prior to issuance of a perlit and that all IOrk ,ill be perfoIJed to lleet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlleDt regulations in the iurisdictioo. I also
<br />certify that I understand that the regulations of other gOYerDlleDtal agencies lilY apply to the intended wort, and that it is
<br />If responsibility to identify ,bat actions I lUSt take to be in COIpliance. Such agencies include but are not luited to:
<br />I Departlent of InvirOlllelltal Regulation - Cypress Baybeads, Wetland Areas and InviroDleDtally Sensitive Lands,
<br />Water/Wastewater freatlent
<br />I Southwest Florida Water Ilanagl!leDt District - Wells, Cypress Baybea4s, Wetland Areas, Altering Watercourses
<br />I ArJy Corps of Inqineers - Seawalls, Docb, Ravigable Waterways
<br />I Departlent of Health' Rehabilitative Services, InvirOJll8l1tal Health Unit - Wells, Wastewater freatlent, Septic rants
<br />I us InviIODleDtal Protection Agency - Asbestos abatl!lleDt
<br />I also certify that, if fUllilterial is to be used in Flood Zone 'A' or 'A, etc. " it is understood that a drainage plan
<br />addressing a 'CQI(leDSating vol_' ,ill be s_tted ,bich is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A ~it 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 shall issuance of a perait prevent the Building Official fIOl thereafter
<br />requiring a correctioo of errors in plans, constructioo, or violations of any code. Ivery perait issued shall bec:GM invalid
<br />unless the wort authorized by such perait is ~ced within sillOntbs of issuance, or if IOrk authorized by the perIIit is
<br />suspended or abandoned for a period of sillODtbs after the tile the work is ~ced. One 90 day atension of tile, lilY be
<br />allowed for the perlit with fee charge of $15.00. fbe atension shall be requested in writing to the Building Official. An
<br />approved inspection at be logged during each sillODth period, or the project ,ill be considered abandoDed.
<br />WARJIIlfG to (lIfER: YOUR FAILURE to RICORD A ROIICI OF CCllllBlCIIIIIf MAY RlSULf IIf YOUR PAYIIfG DICI PORIIIPROVIIIDfS to YOUR
<br />PROPIRTY. IF YOU III!BID to am FIUlCIIG, COJISDLf lID YOOR LDDIR OR 11 IffORIIY BI10RB RlaJRDIIG YOUR JIOfICI OF
<br />aJlMDCIMDf. JOBS URDU '2,500 IN VALUE DO 101 NIID to RKCORD lID POSf A 'NOIICI OF CCIIIBICBIIDfI.
<br />r] l/ -
<br />"/JI. It. 77,'.:- Kef:sc~<-, ~/1C.
<br />41 ~~ -7 7Z4k1-<-j. .
<br />SIGllAflJRB: COII!RACfOR A--oi S P N icJ.ersLY,
<br />
<br />· ifffd-
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<br />~::r O~F FLORIDAraXJCO
<br />The foregoing inst~t was a~ledged
<br />before me this 14) e, 19~ by
<br />LD\ ~ P' r\
<br />who i rsonally known me or who has
<br />produc
<br />ot as identification and who di
<br />/1t~tak _ .,th.
<br />
<br />(51 t e JJ SA r /vlCU>--Ld
<br />(Name Typed, Pr1nted or Stallped)
<br />NOTARY PUBLIC
<br />
<br />
<br />
<br />(51 ature
<br />r
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />f..~~.. OFFICIAL SEAL
<br />~ \ SUSAN A. McCOLLUM
<br />.
<br />l : My Commission Expires
<br />\ ! April 16. 1997
<br />"'~~OF~." Comm. No. CC 268679
<br />.....IlI....
<br />
<br />......... LISA F. MCLEOD
<br />/$-~i!'M~~ MY COMMISSION' CC 389366
<br />~.: ; ~ EXPIRES: JIH1I 30. 1998
<br />~ ~ ~
<br />, ...~~ OF -.,.,~., Bonded Thnl NollIIY PublIc
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