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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perait lay be subject to .deed restrictions. wbich lay be lOre restrictive than City
<br />regulations. Tbe undersigned assUles responsibility for COIpliance 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 JaY 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 />requireJIents JaY apply for the intended work, they are advised to contact the City of Zepbyrbills Building DepartJent, (813)
<br />788-6611.
<br />
<br />FurtberJOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />.Contractor Sections I! of this application for wbich they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather than the contractor, are responsible for the work. If the contractor wisbes you to sign
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to peraitting 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, bave been provided with a copy of IIFlorida's Construction Lien Law - HOII!OImer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is SOJK!One other than the
<br />lIowner", I certify that I have obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the
<br />"owner" prior to COJJenCeJent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforJation in this application is accurate and that all work will be done in cOJpliance with all
<br />applicable laws regulating construction, zoning, and land developlent.
<br />
<br />Application is bereby lade to obtain a perait to do work and installation as indicated. I certify that no work or
<br />installation bas cOlleDced prior to issuance of a perJit and that all work will be perforaed to Jeet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developleDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other governJeDtal agenCies JaY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lUst take to be in COIpliance. Such agencies include but are not lilited to:
<br />· DepartJent of Bnvirolllental Regulation - Cypress Baybeads, Wetland Areas and Bnvirolllentally Sensitive Lands,
<br />Water/lfastewater TreatJent
<br />· Southwest Florida Water HanageJeDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />· ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />· DepartJent of Health & Rebabilitative Services, EnvirODlental Health Unit - Wells, Wastewater TreatJent, Septic fants
<br />· US BnvirODJeDtal Protection Agency - Asbestos abateJent .
<br />I also certify that, if fill Jaterial is to be used in Flood Zone "All or "A, etc. ", it is understood that a drainage plan
<br />addressing a .cOJpeDsating vollllel! will be subJitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perait issued shall 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 the technical codes, nor sball issuance of a perait prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued sball becoJe invalid
<br />unless the 1Iork authorized by such perait is COIIenCed within sillOnths of issuance, or if work authorized by the perait is
<br />suspended or abandoned for a period of sil IOntbs after the tile the work is coaenced. One 90 day eltension of tile, lilY be
<br />allowed for the perlit with fee cbarge of $15.00. Tbe eltension shall be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each sillODth period, or the project will be considered abandoned.
<br />WARNIlfG TO 0IfHBR: YOUR FAILURE TO RECORD A NOflCE OF C(JtMDCIIIDf MAY RESULf IN YOUR PAYING niCE FOR IHPROVIIImS TO YOUR
<br />PROPERfY. IF YOU IJlfBlfD fO OBfAIN FlIfAHCING, COIISULT wlm YOUR LllDIR OR 111 AftORDY BEFORE RICORDING YOUR IfOflCE OF
<br />COMMBNCEMm. JOBS UlfDBR $2,500 IN VALUE DO 1101 NBBD fO RECORD 1IfD POST A "NOfICE OF COMIlDCEm'l".
<br />
<br />
<br />~^t~
<br />SIGlA'fURE: -
<br />
<br />STATB OF FLORIDA
<br />coum OF fAsc 0
<br />The foregoing instrument was acknowledged
<br />before me this __t AA-Al) , 19!1...L by
<br />
<br />~~ ~. Kfl;~
<br />who is personall ~own to me or lmg has
<br />produced
<br />as identification and who~/did n~t
<br />
<br />tan;;! ~(t -
<br />~iiure) / -.......,
<br />fRaJJ.//1) EoIJM
<br />ame Typed, Printed or Stamped)
<br />NOT Y PUB IC.
<br />i' DAVID RONDA
<br />i ., ... "A1& OF Fla.IDA
<br />CllIiIIDCJIIIIla: MMcH 27, 3llOlI
<br />CllIiI-=c 101I2
<br />
<br />Sf ATE OF FLORI9J
<br />coum OF ~ <;0.::>
<br />The foregoing i9strument was acknowledged
<br />before me this..-k M~ ' 19~ by
<br />
<br />;~feJLl~~ to _ Dr ~_ h~
<br />
<br />p:roj:>.__11
<br />as identification and who BiV/did not
<br />
<br />ta,.0"tW'2t !pel..
<br />~uJ.,E!) ( ~
<br />~ a:f:) "t:-01...)J::JA
<br />Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~
<br />
<br />DAVID RONDA
<br />STA1& OF FlORIOA
<br />CCM IillPIRE8: MARcH 27 ~
<br />COM lIICC 54343:z . ~~"
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