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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this penit laY be subject to 'deed restrictions' which laY be lOre restrictive than City
<br />regulations. The undersigned assUleS responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner has hired a 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 owner and contractor laY be
<br />cited for a lisdelleaDor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />reguireaents laY apply for the intended 1IOrk, they are advised to contact the City of ZepbyrhiUs Building Departlent, (813)
<br />788-6611. - .,
<br />
<br />FurtherlOre, if the owner bas hired a contractor or contractors, he is advised to have 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 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 he 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, have been provided with a copy of 'Florida's Construction Lien Law - HOIIeOWJler's Protection
<br />Guide' prepared by the Florida DepartJent of Agriculture and Conslller Affairs. If the applicant is SOJeODe other than the
<br />'owner', I certify that I have obtained a copy of the above described docuIent and prOJise in good faith to deliver it to the
<br />'owner' prior to CQIIBDceaent.
<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 deveJoplent.
<br />
<br />Application is hereby lade to obtain a peIlit to do wort and installation as indicated. I certify that no wort or
<br />installation has ~ced prior to issuance of a penit and that all wort will be perf OM to .et standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIDIeDtal agencies lilY apply to the intended wort, and that it is
<br />IY responsibility to identify what actions I lust take to be in c08pliance. Such agencies include but are not lilited to:
<br />t DepartJent of Envirolll8lltal Regulation - Cypress Bayheads, Vetland Areas and Envirolll8lltally Sensitive Lands,
<br />Vater/Vastewater Treatlent
<br />t Southwest Florida Vater Hanageaent District - VeIls, Cypress Bayheads, Vetland Areas, Altering Vatercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Ifavigable Vaterways
<br />t Departlent of Health & Rehabilitative Services, EnvirODlental Health Unit - VeIls, Vastewater Treatlent, Septic 'anks
<br />t US EnviroDlental Protection Agency - Asbestos abatl!lent
<br />I also certify that, if fill laterial is to be used in Flood Zone 'A' or 'A,etc.', it is understood that a drainage plan
<br />addressing a 'COIpensating volute' will be sublitted 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 shall issuance of a peIlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bverr penit issued shall beCOle invalid
<br />unless the work authoriled by such penit is COII8IlCed within sillOnths of issuance, or if wort authoriled by the perait is
<br />suspended or abandoned for a period of sillODths after the tile the wort is cOlleDced. One 90 day atension of tile, lilY be
<br />allowed for the perait with fee charge of $15.00. Tbe atension 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 />VAIUIIIG to OIlIER: YOUR FIILURI '0 RECORD I 1I0llCE OF COIIHDCEIIIIft' MAY RESULt II YOUR PlYING !VICE FOR IHPROVBHmS to YOUR
<br />PROPERTY. IF YOU IIIUIID !O OBfIIJI FIIWICIKG, COJISULt VI!H YOOR LBKDER OR lIf AnolUlBY BBFORE RBCORDIIG YOUR 1000ICI OF
<br />
<br />
<br />aDPcrwn.~::~.nmm~mum m A ;pz;;t
<br />
<br />SIGJlAtURI: OR IGm SIGJlAtURf: COH1'RAC'lOR_
<br />
<br />STATB OF FLORIDA
<br />COUNty OF Pl-l5 C-V
<br />The foregoing instrument was acknowledged
<br />before me this b!7p}J& 1, 19~ by
<br />
<br />If t- B 2-7Z...; .s I M..s
<br />who is personally known to me or WAO b~&
<br />predth..c!l1
<br />as identifieatiOB and who did/did not
<br />
<br />take~~ g. ~
<br />(Sign ure) _ '
<br />k A 11-1 L e:E A.J oJ. 'i3R () W 10
<br />(Name Typed, Printed or Stamped)
<br />NOTARY P>>~
<br />"," 1- KATHLEEN J BROWN
<br />*." * My Commission CC....9029
<br />Expires Apr. 02.1999
<br />~ ~..
<br />-f,", 0' ,\.o'fo
<br />
<br />StAtB OF FLORIDA
<br />coum OF r H::SC--O
<br />The foregoing instrument was acknowledged
<br />before me this ~~ ~, 19~ by
<br />
<br />A L &7<-/- S I H-.S
<br />who is personally known to me or who h6&
<br />.produeel!
<br />-aM 1duht-;fir:atieB and who '"*Idid not
<br />
<br />take W~J~ Ii ~
<br />(Signature)
<br />kATl-lLEEAJ J. J3RiJ'WN
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />"..,,~ PUll
<br />..~ fi "1-
<br />~.;
<br />
<br />of,", IIF ,\.~
<br />
<br />KATHLEEN J BROWN
<br />My Commislllon CC449029
<br />Expires Apr. 02,1999
<br />
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