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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perlit lay be subject to 'deed restrictions" wbicb lay be lOre restrictive than City
<br />regulations. !be undersigned assUJes 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 JaY be required to be licensed in accordance witb
<br />state and local regulations. If the contractor is not licensed as required by law, both the mmer and contractor lilY be
<br />cited for a lisdell!anor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireJeDts lilY 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 bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for Ibich 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 lilY be an indication that be is not properly licensed and is not entitled to perlitting 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 - HOJeOMDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and CODSUler Affairs. If tbe applicant is sOJeOne other than the
<br />'mmer", I certify that I have obtained a copy of the above described docUIent and prOJise in good faith to deliver it to the
<br />"owner' prior to cOllll!Ilcelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance lith all
<br />applicable lalS regulating construction, loning, and land developlent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas CDleDced prior to issuance of a petlit and that all work will be perfoIJed to Jeet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveruental agenCies lilY apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in cOlpliance. Such agencies include but are not lilited to:
<br />. Departlent of EnviroDlel1tal Regulation - Cypress Bayheads, "etland Areas and EnvirollJelltally Sensitive Lands,
<br />Water/tlastewater !reatlent
<br />. Southwest Florida "ater HanageJeDt District - Wells, Cypress Baybeads, "etland Areas, Altering Watercourses
<br />. AIly Corps of Engineers - Sealalls, Docks, lavigable Watenays
<br />. Departlent of Health i Rebabilitative Services, EnvirODleDtal Health Unit - "ells, "astewater !reatlent, Septic tanks
<br />. US EnviIODleDtal Protection Agency - Asbestos abatl!lleDt
<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 'cOJpellSating 901018' will be subaitted Ihich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A petlit issued sball be construed to be a license to proceed lith 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 perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOJe invalid
<br />unless the work authoriled by such perlit is COII8Ilced lithin six IODthS of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of Sil IODtbs after the tBe the work is ~ced. One 90 day l!ltension of tBe, laY be
<br />allowed for the perlit with fee charge of $15.00. !be l!ltension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillOnth period, or the project will be considered abandoned.
<br />WARMING '1'0 lMIR: YOUR FAILURE TO RECORD A BOTlCE OF C(JItDCEIlBKI MAY RESULT II YOUR PAYING TWICE FOR IMPROVEHmS TO YOUR
<br />PROPERTY. IF YOU IIITDD TO OBtAIN FItfAtfCING, CONSULT "UK YOUR DO OR All AnOmY BEFORE RECORDING YOUR NOTICE OF
<br />COMHENCIHBHT. JOBS UHDO $2,500 IN VALUE DO NOT mo '1'0 RECORD AND POST A "NOTICE OF COHHEtICEHEtII".
<br />
<br />~~~c6 '
<br />SIGKA!URE: OOKR OR AGBII'f ~
<br />
<br />~~~~
<br />
<br />S'fATE OF FLORIDA
<br />COUlllY OF Hernanao
<br />The foregoing instrument was acknowledged
<br />before me this:T 111 y ? 7 , 19--9.5- by
<br />
<br />Edward L. Larisey
<br />who is personally known to me BIt*ibmxIr.aIK
<br />produced
<br />as' tification ~d who did/did not
<br />ak a oath.,:, / /1 ~
<br />_U! L. .~- . ") q~
<br />(SIgnature)
<br />Patricia F. Felaer
<br />(Name Typed, printed or Stamped)
<br />NOTARY PUBLIC ~ /1/'18/
<br />
<br />SorA!E OF FLORIDA
<br />COUK'fY OF Hernt=lndo
<br />The foregoing instrument was acknowledged
<br />before me this July 27 , 19~ by
<br />
<br />Edward L. Larisey
<br />who is personally known to me O:O{]d&~
<br />produced
<br />as identification and who did/did not
<br />t~k~~ oath., . /\ ~ :
<br />L/'---tL)..VCdL L7. l_iZtJ~t~)
<br />(Signature) C
<br />Patricia F. Felger
<br />(Name Typed, Prin1ted or Stamped)
<br />NOTARY PUBLIC (2(!- IF) / if6/
<br />
<br />NOTARY PUBLIC, STATE OF FLORIDA.
<br />MY COMMISSION EXPIRES: Dee. 26, 1995-
<br />_ ~ TllRV NOTARY PUBUC t1NDIRWIIlTERS.
<br />
<br />
<br />
<br />NOTARY PUBLIC, STATE OF FLORIDA.
<br />MY COMMISSION EXPIRES: Dee. 26, 1995.
<br />BONDED TBRU NOTARY PUBLIC lJND&Ilwurus.
<br />
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