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<br />1.- ....~
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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be undersigned understands that this perait laY be subject to 'deed restrictions' wbich lilY be lOre restrictive than City
<br />regulations. !he undersigned iIS8UIIe& responsibility for cmpliance 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 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!lM!anOr violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireteJlts lilY apply for the intended work, they are advised to CORt,act 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 />'Contractor Sections' of this application for wbich they will be responsible. If you, as the owner sign as the contractor,
<br />you are inc1icating 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 pertitting 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 'Florida's Construction Lien Law - JIOII!OIIIler's Protection
<br />Guide" prepared by the Flori4a Departlent of Agriculture and ConsUlel' Affairs. If the applicant is 8OIeOIle other than the
<br />'owner", I certify that I bave obtained a copy of the above described docUIent and p1'Olise in good faith to deliver it to the
<br />"owner" prior to COll8llCl!IeDt.
<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 with all
<br />applicable laws regulating construction, loning, and land develo~t.
<br />
<br />Application is bereby tade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas w.mced prior to issuance of a perait and that all work will be perforteel to teet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlll!llt regulations in the jurisdictioo. I also
<br />certify that I understand that the regulations of other goveIDllelltal agencies lilY apply to the intended wort, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in coapliance. Such agencies include but are not lilited to:
<br />t Departlent of Envil"Olll8lltal Regulation - Cypress Bayheacls, IIetland Areas and BnviroDleDtally Sensitive Lands,
<br />IIater /Wastewater Ireatlent
<br />t Southwest Florida IIater Manageaent District - IIells, Cypress Baybea4s, IIetland Areas, Altering Watercourses
<br />t ArtY Corps of Bnqineers - Seawalls, Docks, Il'avigable Vaterways
<br />t Departaent of Health i Rehabilitative Senices, BnvirODleDtal Health Unit - IIells, Wastewater Ireatlent, Septic lants
<br />t US Bnvirouental Protection Agency - Asbestos abatellellt
<br />I also certify that, if fill Iilterial is to be used in Flood Zone 'A' or "A,etc.', it is understood that a drainage plan
<br />addressing a 'coapensating volute' 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 wort and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a peIlit prevent the Building Official f1'Ol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every penit issued shall becme invalid
<br />'unless the work authorized by such perlit is co.nced within six IODthS of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sillODtbs after the tile the work is co.enced. One 90 day 81tension of tile, lilY be
<br />allowed for the peIlit with fee charge of $15.00. !be 81tension sball be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each sillOJ1th period, or the project will be considered abandoned.
<br />VAIUIUG '10 0VIl'ER: YOUR FAILURE '10 RECORD A miCE OF CCllMBlCIIIIRt MAY RESULI Ill' YOUR PAYIRG NICE FOR DIPROVEIIBIIS '10 YOUR
<br />PROPERTY. IF YOU IJft'DD '10 0B'l111l' FIlIAHCIIl'G, COHSUL'I' II11H YOUR LlHDBR OR All AnomY BEFORE RICORDUG YOUR ROIlCE OF
<br />llIlIlEIICIIIII. JlIIS IJIDBR 12,5GO II VAllJIlIlO IOf _10 RIIlIIIl :ZCl Ol' ~~
<br />
<br />
<br />~ e ~AJ..ft, ~~
<br />SIGItA!URB: (MIIR OR AGIII'I SIGItA'IURI: COlI'IIlACfOR
<br />
<br />SIAlE OF ~A
<br />coum OF \--"CLO LU
<br />The foregoing instrument was acknowledged
<br />before me this 0 n r. \ , , 19~ by
<br />
<br />~A e. ~LDeLL
<br />who is personally known to me or who has
<br />produced ~~O}.) ~ .I if tN Ot.u ~
<br />as identifi ation and wh did/did not
<br />t~ oath.
<br />. ^ Olly... ~ ~A~
<br />(Signature) D (
<br />~lE~EeJ-J (\'\. R-u '''.;"'-'11
<br />(Name Typed, Printed or Stampe )
<br />NOTARY PUBLIC
<br />
<br />S'I'AB OF FLORIDA
<br />coum OF
<br />The foregoing instrullent was acknowledged
<br />before me this , 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 OCf.th.
<br />
<br />(Signature)
<br />
<br />(Naae Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~\~,
<br />triJ.
<br />~Off\.-;-
<br />
<br />CLEREEN M BRUNTY
<br />My Commission CC383730
<br />Expiles Jun. 15, 1998
<br />Bonded by ANB
<br />800-852-5878
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