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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />. . 'A~' NOTICE OF DEED RESTRICTIONS
<br />!be undersigned underatands that this pecait lay be subject to 'deed restrictions' which IIaJ be .re restricti" than City
<br />regulatiCllS. !he undersigned assUJeS responsibility for CCIIpliance wIth any applicable deed' restrictiCllS.
<br />
<br />B. UNLlCENSEDOONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractOR to undertake IOrt, they laY be reguired to be licensed in accordance with
<br />state and local regulations. If the contractor Is not licensed as rlQUired by law, both the DIdIer and contractor liar be
<br />cited for a lisdeleanor violation under state law. If the OIlIer or intended contractor are uncertain as to wbat licensing
<br />reguirBleDts IIY apply for the intended wort, they are advised to contact the City of Zepbyrhilll Building DepartBt, (813)
<br />788-6611.
<br />
<br />Furtheraore, if the OIfJ1er.has bired a contractor or contractoR, be is advised to have the contractor(.) sign portlOll8of the
<br />'Contractor. Sections' of this application for wbich ther will be responsible. If you, as the 0IIJ1er sign as the CIIIltractor,
<br />you are indicating that you, rather than the contractor, are responsible for the wort. If the cootractor IIi_ JOU to sign
<br />as cootractor that lIy be an indication that be Is not properly licensed and is not entitled to pmitting privileges In the
<br />City of Zepbyrbills.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY COHNBCTIONFEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMSlmED)
<br />I certify that I, the applicant, bave been provided with a copy of 'Plorlda's Construction Lien Law - RoIeowDer's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and CoaauIer Affairs. If the applicant il 8OII8OIl8 other than the
<br />'owner', I certify that I bave obtained a copy of 'the above described docUIent and p~ise in good faith to deliver' it to the
<br />'owner' prior to co.enCBleDt.
<br />
<br />E. CONTRACTOR ',S/OWHER IS AFFlDA"IT
<br />I certifr that all the infomtion in this application is accurate and that all IOrt will be done, in COIpliance with all
<br />applicable laws regulating conatruction, loning, and land llevelopleDt.
<br />
<br />Application ia hereby lade to obtain a pel'lit to c10 wort and installation aslndicatec1. I certify that DO wort or
<br />insWlation bas ~cedprior to issuance of a peraitanll that all wort will be perfo_ to _t stan4arcJa of all laws
<br />regulating construction, City codes, loning regulations, and lanel developMllt regulations in the jurildictiOll. I also
<br />certify that I unllerstand that the regulations of other gDYeruental, agencies IIr apply to the intended wort, and 'that it is
<br />I}' responsibility to identify what actions I lUSt tate to be in COIpliance. Such agencies include but are DOt lilited to:
<br />t Departlent of lnvil'OJllleDtal Regulation - Cypress Barbeada, VltlanelAreas and IDvirOlllentallr Sensitive Laac1s,
<br />Water/WUtenter freatlent
<br />t Southwest Florilla Water HanaOBleDt District - hlls, Cypress Bayheads,liIetland Areas, Iltering lfatercourses
<br />t ArlyCorps of lDQineers - Seawalla, Docts,MaVigable Waterways
<br />tDePil1:lent of Health i Rehabilitative Senices, IDviroa.ntal BealthDnit - ileUs, Wastewater freatlent, Septicfanb :
<br />t US IDviroa.ntal Protection"lgency - Asbestos abat8EDt
<br />I also certify that, if fill aaterial is to be used in Flood Joae 'I' or II,etc.', it is ,UDderatood tbat a drainage plan
<br />addressing a 'CQIIpeD8ating 101_' will be subaitted wbich ia prepared by a professional iDtineer registered in the8tate of
<br />Florida prior to petlit issuance.
<br />
<br />A petlit issued shall beconatruec1 to be a license to proceed with the work and DOt asautlloritr to .iolate,caDCe1 alter, or
<br />set aside any provisions of the technical codes, nor ahall isaUIDCI of a petlit prevent the Builc1ing Official frol thereafter
<br />reguiriDg a correction of errOR in plana, CODStructiOll, or violatiOll8of IDY code. IYerJ ptrIit lu. allall beae iDvalid
<br />unless the work autlloriled by such petlit is cc.encec1 within 8il IODths of i88U8DCI, or if work autlIorlled by the pel'Iit i8
<br />suspended or abandoned for a perioc1 of Iii IOIlths after the tile the wort is c_enced. One 90 day atension of tile, IIY be
<br />allOlled for the perlit with fee charge of $15.00. !he at_ion sball be reqUested in writinq to the Building Official. In
<br />approved inspection I08t, be logged during each ail IODth perIod, ,or the project will.. be consideredabandonecJ.
<br />DRIIIIG to CJIIR: YOUR FAILURB to RECORD A IOIICE OF CCIMDCBIIIJr lilY DSULf II YOOI PIYIIG flllCE FOR DlPlmlllln8 to YlJJI
<br />PROPIRfY. IF YOU IImD to 0Bf1IJl FIIWrCDG, CClfSOLf .11I0 YOUR LIIIDIR OR 11 IftORDY, BIFORI RICOIIDIIG YOUR DICE OF j
<br />
<br />
<br />::~:-NdaEMD~
<br />
<br />StAR OF FLORIDA /J
<br />coumoP /- ~ CO
<br />
<br />The foregOing instrt1llent was acknowledged
<br />before me this :pI s- , 19~ by
<br />
<br />StiR OPFLORIDI /-::J
<br />courm OF r,f?YC-d
<br />The foregoing inst~t was acknowledged!
<br />before lie this 3,L2- , 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 ~~~ ~
<br />
<br />(Signature)
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />
<br />:~:u~if?~~
<br />
<br />
<br />(Name Typed, Print
<br />ROTARY P ". KEITH CORREIA '
<br />~'~~'\ MY Cl)MMI8SION , cc 461416
<br />a.: :"E EXPIRES' May 13 1999
<br />w~: 'P\IbIlC' \.IndIlWII*I
<br />..,~... ......'f>.~ Bonded TllN No\llIY
<br />"Rf,n'~
<br />
<br />(Name Typed,
<br />NOTARY
<br />
<br />
<br />Printed 0
<br />i<E\TH coRREIA
<br />llOMM\88ION , 0045141.
<br />MV IXPI""': Mav 11. ~
<br />8OnlIIII'tlINtlG\IIYfIUlI\lO
<br />
<br />..
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