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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />'l'be undersigned understands tbat this perlit JaY be subject to -deed restrictions- wbich lilY be lOre restrictive than City
<br />regulations. !be undersigned asBUJeS responsibility for CCIIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OImer bas hired a contractor or contractors ~ to undertake work, they .y be required to be licensed in accordance with
<br />state and local regu1atiOll8. If the contractor is not licensed as required by law, both the 0IIIleI and contractor lilY be
<br />cited for a lisdelll!anor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelll!llts lilY apply for the intended work, they are advised to CODt..act the City of Zepbyrbi11s Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the 0IIIleI 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 lIi11 he responsible. If you, as the OIIler sign as the contractor,
<br />you are indicating tbat you, rather than the contractor, are respoosible for the work. If the contractor wi8bes you to sign
<br />as contractor tbat lilY be an indication that be is not properly licensed and is not entitled to peIlitting 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 tbat I, the applicant, have been provided with a copy of -Florida's construction Lien Law - lkIIeoImer's Protection
<br />Guidell prepared by the Florida Departlent of Agriculture anciConsUIBI Affairs. If the applicant is ~ other.than the
<br />-OIIDerll, I certify that I bave obtained a copy of the above described docuIent and prolise in good faith to deliver it to the
<br />1I000er- prior to COllBllCl!lBllt.
<br />
<br />E. CONTRACTOR'S/OWHER'S AFFIDAVIT
<br />I certify that all the infOIliltion in this application is accurate and tbat all work lIill'be done in CCIIpliance with all
<br />applicable laws regulating construction, loning, and land developlBDt.
<br />
<br />Application is hereby lade to obtain a peIlit to do work and, installation as indicated. I certify tbat no work or
<br />installation bas CDIeIlced prior to iuuance of a perlit and that all work will be perfOIllld to Jeet standards of all 1_
<br />regulating construction, City codes, loning regulations, and land develO)llBJlt regulations in the jurisdiction. I also
<br />certify tbat I understand tbat the regulations of other gOYerDlBDtal agencies lilY apply to the intenc1ed IIOrt, and that it is
<br />If responsibility to identify wbat actions I lUSt take to ,be in COIpliance. Such agencies include but are not lilited to:
<br />I Departlent of BnvirOlllBl1tal Regulation - Cypress Baybeads, Wetland Areas and BnviIOllll!Dta11y Sensitive Lands,
<br />Water /Wastewater 'l'reatlent
<br />I Southwest Florida Water ManagBlBDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />I AIIY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />I DepartJent of Health i Rehabilitative Services, Bnvirouental Health Unit - Wells, Wastewater 'l'reatlent, Septic!anks
<br />I US BnviIODleDtal Protection Agency - Asbestos abatelll!llt
<br />I also certify that, if fi11lilterial is to be used in Flood zone IIAII or HA,etc.lI, it is understood tbat a drainage plan
<br />addressing a llCOJP1lDSating vol_II will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
<br />
<br />A ~it issued shall be construed to be a license to proceed with the IIOrk and not as autborityto ,iolate, caDCel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery pemit issued aball bec:oE invalid
<br />unless the vork authoriled by such perlit is ~ced within sillODtbs of issuance, or if vork autboriled by tile perlit is
<br />suspended or abandoned for a period of sil IODtbs after the tile the vort is ~ced. ODe 90 day stension of tile, laY be
<br />allOlled for the perlit with fee charge of $15.00. 'l'be stension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sil IODth period, or the project will be considered abandoned.
<br />WARRING '1'0 <*IIR: YOUR FAILURI '1'0 RECORD A 10'l'ICK OF <XIIIDCBIIII! MAY RESUL'I' II YOUR PAYIIG fiICK FOR IMPROVIIIII'lS 'l'O YOUR
<br />PROPIR'I'Y. IF YOU IJIDID 'l'O OB'lAD FIWCIIG, COKSUL'l' 1lI'l'B YOUR LODER OR AI AftORIBY BIFORI RICORDIIG YOUR IO'l'ICE OF
<br />C(JUII:r. JOBS OIDBR $2,500 II VALUE DO 10'1' DID 'l'O RECORD AID POS'l' A III , OF ClIUIIICBIIII!-.
<br />
<br />
<br />~ ~ / I
<br />( ~ _1- .-/ .
<br />
<br />~P/J'LL ~~ ;4'
<br />S GIA!UIlI: (MIIR
<br />
<br />
<br />S'l'A'l'! OF FLORIDA flt
<br />COumOF tl~
<br />The foregoing instrument was acknowledged
<br />before me thiS!J'7 JIn , 19-2.2: by
<br />
<br />STA'l'B OF FLORI~
<br />coum OF ~
<br />The foregoing instrument was acknowledged
<br />before me this 07 l/.p. ' 19 -2:S::... by
<br />r7
<br />
<br />who is personally known to me or who has
<br />produced ,,\\ . .
<br />as identificaJt~..~~d,..~did/did not
<br />take an oath}.,./ cI. ~
<br />(})~-A~ . \-
<br />(Signature) '~<I'\'. .:' + t _
<br />~I't-.v a~ ....~ - :T~~ >'l ~(:---' v
<br />(Name ed, ~4itAil.;Qt:,~ amped)
<br />III r""f \. ,\'
<br />ROTARY PUBLIC //1/1111111,,\1\\'
<br />
<br />who is personally known to lie or who has
<br />produced
<br />as identifica~~. HII;~,who did/did not
<br />,-,-' . -'1;l y p "///.
<br />take an oat:\l!"~::T...~~~
<br />r;n/(~". ....~
<br />(Signature~ . f . (' S
<br />"P r 11 ~ tAn *1. !~ Z-tV t4 PE L-
<br />(Name Type~v~l;'inted ..~ -Stamped)
<br />ROTARY PUB~ ................~ \.~,,:'"
<br />,Or f \. I7l ",
<br />///1/11111\ II \11\\\'
<br />
<br />Notary Public, State at Fiorida
<br />DIANNA L. Tf/ZNADEL
<br />My Comm. Exp. Nov. 11, 1995
<br />Comm. No. CC 159184
<br />
<br />Notary Publk SL: ,
<br />DIAf"..JNA l l~t7c~~~-''-'llUd
<br />My Comm. Exp. N'o~: 11,":'t .J95
<br />Camm. No. CC 159184
<br />
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