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<br />DEC-14-' 95 THU H::J: 06 ID:
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<br />TEL HCI: RBC--
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<br />,=:R'7I'l'J l:t071 P02
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<br />CONDITIONS OF PERMIT AFFIDAVI~
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Ihe underslgne4 understands that lhi9 Pe~tt lay be subject to 'deed restrictions' wbich la, be lOre rsatrlcti,e than City
<br />regulfttions. fbe underaigned aBSUle& reaponatbllity for COIpJiance vith 88Y applicable deed rlltrIctIone.
<br />
<br />a. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OlDer has bIred a contractor or contractors to undertake work, they lay be required to be licensed In accordance with
<br />state and locel regulation.. If the contractor is not Ucenael1 8S required by law, both the ower ID4 contrletDr IiIJ be ,
<br />cited for a .isdeleinor violation under state la.. If the owner or intended contractor are uncertain .s to vbat licensing
<br />reguireaents laY apply {or tbe intended work, they are advised to contact the City of ZepbJlhill1 BuIlding DepartJeot, (813)
<br />788-6611.
<br />
<br />furtberlOre, if the OIner bas bired a contractor or contractors, be is advise4 to bay. tbe contractor(l) 11gn portions of the
<br />.Contractor Sections" of this application for .hich thoy will be re.sponllble. If rou, u tile OlDer alp.. the contractor,
<br />yau are indicating tbat JOU, ratller than the contractor, are responSible for the work. If the contractor vll.. you to sign
<br />as contractor that lay be an indication that be is not properly llcensed and 18 not entitleb to pertlttiag prl,Ull9e1 in tbe
<br />City of Zepbyrbll18.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNBCTION FEBS
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMSlmBD)
<br />I certify that I, the applicant, have been prOVided v11ll a copy of "Fluride's Construction LIID Law - ~'I Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsUler AffeirB. If tbe applicant II IOIIOD8 otber than the
<br />"Okner", I certify that I bave obtained a copy of the above described docUleDt and prati.. lu goo4 f.lth to deliver It to the
<br />"owner" prior to COIIeOCetent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AF:fIDAVIT
<br />I certify tbat all the inforlatlon In tbiB application 18 accurate and that all IOrt will be done in cOIpllaocl with all
<br />applicable laws regulating conatructiDnt lonlng, and land developl8Dt.
<br />
<br />Application 18 hereby lade to obtain a perlit to do wort and installation a. indicated. I certify that no IOrt or
<br />in8tallatIon bas OOIIeDCed prior to Issuance of a petllt and that all work will be perfotlld to lilt .tandardI of III laws
<br />regulating construction, City codes, loning regulations, and land de'elap.ent regulatioDl In tbe jurlldlctlOD. 1 1110
<br />certify tbat I understand that the regulations of other go,ernaental agencies II, apply to tbe intea4ed wort, and that it is
<br />IY reaponalbility to identify what actions I iust take to bt! in cOlpUance. Buell agenda Include but are not Il11ted to:
<br />· Departlent of BnvlroDlental Regulation - Cypress Baybeads, Wetland Areaa and Bnvlronlentalll 8enaiti,e Landa,
<br />~ater/WlStevat9r !raatleDt
<br />t Southwest Plorida Water HanaaOl8Dt District - Wells, Cypres. 8aybeads, Wetland Areas, Alterinv Watercout1B8
<br />· Ar'-Y Co{ps of IngineerB - Seaval18, Docks, Navigable Waterway.
<br />t DapartJent of Health' Rehabilitative Services, Bn,iIODJental Health unit - Wells, laste.ater Tr..tleDt, Septic !antl
<br />t US InviIl1Dll!lltal Protection Agency - Aabest08 abatuent .
<br />I a180 certify that, If fill ..terial is to be,uaed in Plood Zone .AI or 'A,etc.', it is understood tbat a drainage plan
<br />addre88ing a .cQlP8D8ating volu.e" viII he sublitted wbicb is prepared by a profea.iooal engineer registered In tbe 8tate of
<br />Florida prior to pettit issuance.
<br />
<br />A per.1t iS8ued sball be construed to be a license to proclIQd tlith tbe worl and not as autboritJ to dolata, caaoel alter, or
<br />set saide any provisions of the technical codea, nor sball IIGuance of a peIlit prevent the Building Official fIDI thereafter
<br />requiring a correction of errora In plaua, construction, or violations of any code. Ivery petitt laauea &ball btcaIa Invalid
<br />unle89 the IOrk autbodled by 8ucb pertH is ~nced within all aonths of iS8uance, or if wort lutbodled by the perllt ia
<br />suspended or abandoned for a period of ail JOntha after the tile the work 18 co.enced. OM 90 d., ..tend. of tile, _y be
<br />allowed for the pemit with fee cbarge of *15.00. Tbe eatensiOD sbell be requested 1n writlnq to tbe Bul141ng Official. An
<br />approved lnapec:tion lUst be logged during each 8i1 IOntb period, or the project wUI be COO8iamalbaDcloDed.
<br />IIAlU1ING TO OWNER: YOUR FAltURI to RICORD A NOTICE OF mtHDCBllBIT HAY RESULt lit YOUR PAYIK DICK FOR I~S to YOUR
<br />PROPIRTY. IP YOU IMTIND TO OB'llIN FINAlCIJlG, COIrSULT IIIfD fOUR LINDER OR All ArfORIBY BlFORI RICORDINQ YOUIIfOJICl OF
<br />OIfHEHCIKllKT. JOBS UffDER $2,500 IN VALUB DO JlOI NUD TO RECORD AND POSI A -IOflel OF C(JGlllCIIIUl'".
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<br />
<br />SIW:flt.~ * BIGllmI: ctmIl1!M-
<br />
<br />SrAll OP PLORIDA #5..
<br />coom OP 4/ ' fnroljqh
<br />The foregoing inBt~t~~aB acknowlpdq~~
<br />before me this / ' f 19~ by
<br />behTQr'\e~ .
<br />who is personally kno n to me or who has
<br />produced
<br />8B identification and who did/did not
<br />~th.
<br />, .'^O ~\~ -"'__l! i l
<br />(s:~t G .
<br />~e \~.. \;\0. t--r-<:: \"\
<br />(Name yped, Printed or Stamped)
<br />NOTARY PUBLIC
<br />Y PfL DEENA HARREL.L
<br />~."..&~ COMM!SSION . CC .~1t8a
<br />:. ~ EXPIRES MAV 9,1000
<br />-~ ~ BONOEOTHAU
<br />~OF Vt-~ ATLANTIC ElONDIN() co., INC.
<br />
<br />SIAII OF FLORIDA
<br />coum OF
<br />The for~~~i~g iaatrumcnt was a~knowladg8d
<br />before lie this , 19 by
<br />
<br />who 1s personally known to me or who hae
<br />prOduced
<br />as identification and who didldid not
<br />take an oQ.th.
<br />
<br />~(S{9na'ture )
<br />
<br />(Name Typed, Printed or 8t~ed)
<br />NOTARY PUBLIC
<br />
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