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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perlit laY be subject to Ideed restrictions I wbieb 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 (MIer bas bireda 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 ower and contractor lay be
<br />cited for a lisdl!ll!allor violation under state law. If the OlOler or intended contractor are uncertain. as to wbat licensing
<br />requiruents laY apply for the intended work, they are advised to contact the City of Zepbyrbl~ls Building Depart:Jent, (813)
<br />788-6611. .,
<br />
<br />Furthel'lOre, 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 wbieb 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 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 (CHAPTER 713, FLORIDA STATUTES, AS AMENDED) ,
<br />I certify that I, the applicant, bave been provided with a copy of IFlorida's Construction Lien Law - HOJeOIIDer's Protection
<br />Guide' prepared by the Florida Depart:Jent of Agriculture and ConsUlBl' Affairs. If the applicant is SOIBOne other than the
<br />'owner., I certify that I bave obtained a copy of the above described dOCUlBDt and prOlise in good faith to deliver it to the
<br />lownerl prior to COllBDCBlBDt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is hereby Jade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation baa ~ced prior to issuance of a perIIit and that all work will be perfoned to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlBDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govel1llBDtal agencies laY apply to the intended work, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in COIpliance. Sueb agencies include but are not lilited to:
<br />t Departlent of EnviroDlBDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlBDtally Sensitive Lands,
<br />Water/Wastewater Treat:Jent
<br />t Southwest Florida Water HanagBlBDt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, lavigable Waterways
<br />t DepartJent of Health & Rehabilitative Services, InvirODlBDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />t US EnvirODlental Protection Agency - Asbestos abatuent
<br />I also certify that, if fill laterial is to be used in Flood Zooe lA' or 'A,etc.l, it is understood that a drainage plan
<br />addressing a lCOIpensating volUIB' will be sublitted wbieb 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 the technical codes, nor sball issuance of a perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every peIlit issued shall beCOlB invalid
<br />unless the work authoriled by such perlit is COIIBDCed within sil IOOths of issuance, or if work authoriled by the per.it is
<br />suspended or abandoned for a period of sillOnths after the tile the IIOrk is co.enced. One 90 day Bltension of tile, laY be
<br />allowed for the peIlit with fee charge of $15.00. fbe Bltension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb sillODth period, or the project will be considered abandoned.
<br />WARNIMG fO OVIflR: YOUR FAILURE fO RECORD A MOIICH OF COHHIIfCIMIIIf HAY RESULf 1M YOUR PAYlMG fWICH FOR IHPROVEHEllfS fO YOUB
<br />PROPERfY. IF YOU IIfBMD to 0B11IH iIIWICIKG, COJISULf WIfH YOUR LBIIDER OR AM AffOJUIBY BEFORE RECORDING YOUR MOIICK OF
<br />COHHIMCIHIIf. JOBS UHD $2,500 1M VAL DO MOl MElD to RECORD AJID POSf A -MOIl OF COOIEMClHllfI.
<br />
<br />
<br />
<br />SIGlATURE:
<br />
<br />STATE OF FLORIDA
<br />coum OF .p r0 r!-o
<br />The foregoing instrument~as acknowledged
<br />before me this yluJg 1:., 19~ by
<br />
<br />JlI-13 ~fi: or '- c::; I /../...5
<br />who is personally known to me OF TI~Be has
<br />produced
<br />as ~dcutlfi~8tiQR and who &ie/did not
<br />
<br />take ~ g:b~
<br />(Signature)
<br />KATl.f~,J ~T. 73Row,J
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />~l\' PilI. WN
<br />s,.... n "....to KATHLEEN J BRa
<br />~.. My Commission CC449029
<br />* * ExpiresApr.02,1999
<br />..~ ;
<br />"E OF f\.O
<br />
<br />Sf ATE OF FLORIDA P
<br />coum OF '4-:5 e...D
<br />The foregoing instrument was acknowledged
<br />before me this ~~~ ~, 19~ by
<br />
<br />IJ L13~T -S/ HS
<br />who is personally known to me v~ nh_ ~UD
<br />pl"sduced
<br />~ id8R~iiieati8B and who lied/did not
<br />take an~h. ) P- '-12
<br />'f'~j~ -' ~
<br />(Signa ure)
<br />KATfJL~ J~ fS{<t!x.J;J
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />,,~l\' Plle(
<br />.," fi....to
<br />~.:
<br />
<br />"'" OF fl.O~
<br />
<br />KATHLEEN J BROWN
<br />My Cornmi5sion CC449029
<br />Expires Apr. 02, 1999
<br />
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