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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands tbat this perlit lay be subject to Ideed restrictionsU wbich aay be lOre restrictive than City
<br />regulations. !be undersigned assUles responsibility for cOlpliance with any applicableddeed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertake work, they lay 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 lay be
<br />cited for a lisdeeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireJents aay apply for the intended work, they are advised to contact tbe City of Zepbyrbills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtberJOre, if the owner bas bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of tbe
<br />IContractor Sectionsl of this application for wbich they will be responsible. If you, as tbe owner sign as the contractor,
<br />you are indicating that you, rather tban the contractor, are responsible for the work. If the contractor wishes you to sign
<br />as contractor that. lay 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 (CIlAPTER '113, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of IFlorida's Construction Lien Law - HoIeoIner's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and Consl1ller Affairs. If the applicant is SOleODe other than the
<br />lowner", I certify tbat I have obtained a copy of the above described docUJeDt and prOlise in good faith to deliver it to the
<br />"owner" prior to cOlleDceJent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in tbis application is accurate and that all work will be done in cOlpliance witb all
<br />applicable laws regulating construction, loning, and land developaent.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify tbat no work or
<br />installation has cOlleDced prior to issuance of a perlit and that all work will be perforJed to Jeet standards 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 governJental agencies aay apply to the intended work, and that it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance. Such agencies include but are not luited to:
<br />t Departlent of EnviroDlental Regulation - Cypress Bayheads, Wetland Areas and EnviroDJeDtally Sensitive Lands,
<br />Water/Wastewater !reatlent
<br />t Southwest Florida Water HanageJent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />t DepartJent of Health & Rehabilitative Services, EnvirODJeDtal Health Unit - Wells, Wastewater !reatJent, Septic ranks
<br />t US EnvirODlental Protection Agency - Asbestos abateJeDt
<br />I also certify that, if fill laterial is to be used in Flood ZOne "AIf or "I, etc. ", it is understood tbat a drainage plan
<br />addressing a IcOlpBDsating VOlUleR will be subJitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit 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 tbe technical codes, nor shall issuance of a perlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOle invalid
<br />unless the work authorized by such perlit is COlleDced within sillOntbs of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sillOntbs after the tile the work is cOlleDced. One 90 day extension of tile, aay be
<br />allowed for tbe perlit witb fee charge of $15.00. 1'he extension sball be requested in writing to tbe Building Official. An
<br />approved inspection lUst be logged during each sixlOnth period, or the project will be considered abandoned.
<br />WARMING 1'0 OWNER: YOUR FAILURE 1'0 RECORD A NorlCE OF CQHMENCmmNr HAY RESUL1' IN YOUR PAYING DICE FOR IHPROVBIIIN1'S 1'0 YOUR
<br />PROPER'IY. IF YOU INrEND 1'0 OB!AIN FlIlANCING, COJISUL1' WIrB YOUR LINDO OR U AnORDY BEFORE IIKCORDIlfG YOUR NorlCE OF
<br />CliIIIIICIlIlII. JOIIS 111DE1112,500 IN V~.UE.~ Nor NEIl.. ,0 TO RECORD AND POS1' A INorlCE ~F CtIlIIIII :."
<br />
<br />
<br />~ ~~ '/,/?,
<br />, '- ./.~ ~.
<br />~--- I Ar : OWNER OR AGENr . CONrRACTOR
<br />
<br />
<br />
<br />SlArE OF FLORIDA /2. '
<br />coum OF '-1/9r::$Co~
<br />The foregoing in~rument was acknowledged
<br />before me this5 .j)ec. , 19 9~ by
<br />
<br />srATE OF FLORIDA 11
<br />coum OF 'T~tZ.tJ
<br />The foregoing in~rQment was ackn~edged
<br />before me this.57 c1J.ec.. , 19~ by
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath. .-,- _
<br />~~-,LA~/~
<br />(Signature)
<br />
<br />who is personally kn~Jol1l--:to me or who has
<br />produced
<br />as identification and who did/did not
<br />ta~n oath. ~ / ~
<br />//~-
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />,,""\";1;\:" CARoLE IREL'N
<br />i'J'~f.'-' ':1"<, MY COMMISSION' cc 2lI0339
<br />~:~ EXPIRES: Aprtl '0.1997
<br />Jl Bonded lllRl NolIIY NlIIc \bIIIWIM
<br />..'
<br />~
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />
<br />NOT CAROLE IRELAN
<br />MY COMMISSION' CC..
<br />EXPIRES: ApdI '0. 1997
<br />Bonded 11nu No!IIy PIdIIIc tMlIINiIIn
<br />
<br />
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