|
<br />:y,
<br />
<br />05/15/1g% '14: 00 - H:H.'34t:HJt,2
<br />
<br />~,Ut'jF: I :=E CiJt6TF:UCT I ON
<br />
<br />PAGE 02
<br />
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS"
<br />The undersigned understands that this pertlt tay be subject to 'deed restrictions I wbleb JaY be lOre restrictive than City
<br />regulations. !he und~r8igned aS8utes responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas hired a contractor or contractors to undertake vark, tbey lay be required to be licensed in accordance with
<br />state and local regulationll. If the contractor iA not licensed as required by law, both the Olftler ~d contractor lay be
<br />cited for a lisdeaeanor violation under aLate law. If the owner or intended contractor are uncertain a8 to wbat licensing
<br />requir8lents lay apply for the intended work, they are adviSed to contact the City of ZepbyrbIl18 Building Departtent, (8I3)
<br />788-6611.
<br />
<br />FurtberlOre, if the owner has hired a contractor or contractors, be is advised to have the contractor(s) sign portiODS ot the
<br />aContractor Sections I of this applIcation for which they will be responsible. If you, ~ the OIrrIer sign at the contractor,
<br />you are indicating that you, rather than the contractor, are respoll8ible for the work. If tlIe contractor wisbea you to siqn
<br />as contractor that aay be an indication that be is not properly licensed and is not entitled to peraitting privilegu 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 - BoIeowner's Protectinn
<br />Guide' pr~pared by the Florida Oepartlent of Agriculture and Con8utet Affairs. If the applIcant is 801e0ne other than the
<br />"owner", I certify that I have obtained a Copy of the above described docUJent and prOliae in good faith to deliver it to the
<br />"owner" prior to coaenceaent.
<br />
<br />E. CONTRACTOR'S/OWNER~~ AFFIDAVIT
<br />I certify that all the inCoraation in tbis application is accurate and that all work will be done in cOIpliance .itb all
<br />applicable laws regulating construction, loning, and land developaent.
<br />
<br />Application is hereby .ade to obtain a per.it to dQ work and installation as indicated. r certify that no work or
<br />installation bas cOIIeDCed prior to iSluance of a per.it and that all IOrk viII be perfotled to teet standards of all laws
<br />regulating con8truction, City code&, loning regulations, and land developeent regulations in the jurisdiction. I also
<br />certify that 1 understand that the regulations of other governaental agencies laY apply to the intended worl, and that it is
<br />Jy responsibility to identify what actions I .ust take to be in cOJpliance. Such agencies include but are not li,ited to:
<br />· Departlent of BnvirOnlent~1 Regulation - Cypress Baybeads, Wetland Areas and Kn.ironlentally San8i~ive Lands,
<br />Ifater/llast.wllter freebtent
<br />· Soutbwest Florida Water Han!~t District - VeIls, Cypress Bayheade, Wetland Areas, Altering Watercourses
<br />· ArlY Corps of Engineers - Seallall8, Docks, Ravigable Waterways
<br />t Dtparttent of Health i Rehabilitative Services, HnvirontentAl Health Unit - Wells, Vastewater !reatJent, Septic tanks
<br />· US Environaental Protection Agency ~ Asbestos abateaent
<br />I also certify that, if fill Illterial is to be used in Flood ~one 'A" or MA,etc.', it is understood that a drainage plan
<br />addleBsing a .cOlpensating voluael will be snbtitted whicb is prepared by a professional engineer registered in the State of
<br />Florida p'rior to per.it. issuance.
<br />
<br />A perait issued sball be construed to be a license to proceed witb the work and not as authority to violate, cancaI alter, or
<br />set aside any provisions of the technIcal codes, nor shall issuance of a petlit prevent the Building Official frel tber~after
<br />requiring a correction ot errorl in plans, construction, or violations of any code. Ivery petlit issued Iball beCD18 invalid
<br />unless the work autborlsed by sucb perait i8 cOII8nced within 8il IOnths of issuance, or if work autboriled by the pertit is
<br />8u8p&I1ded or abandoned for a period of sil JOnths a.fter the Ute the work is co.encod. One 90 clay utensJon of till, tal be
<br />allowed for the petlit with fee charge of ns.oo. The extension sball be reql1eated in .riting to the Building Official. An
<br />approved inspection lUSt be logged during each Sil IOOtb period, or the project will be coftBiaered abandoned.
<br />WARNING to 0IfImI: YOUR FAItORS fO RECORD A NOTIC! OF c:o.afKRBCBHm MAY RKSULT IN YOOR PUlIS nICE FOR IMPROVEIImS TO YOUR
<br />PROPERTY. IF YOU ImlfD ro OBfAIK F'IKBCING, CONSULT WI'fB YOOR LODER OR AK AftORnY BEFORE RlCOflDlJrG YOUR HOTICI OP
<br />ctMIlEIIC J~S UIlIlIlJl ~'D IJiI) POS! A 'NO!ICR or _ /_---=>
<br />
<br />
<br />
<br />R RAGEHI' .--
<br />
<br />STATE OF FLORIDA . ::=)
<br />coum Of (/~-,r~
<br />The foregoing 1n8trument was acknowledged
<br />before me this rq,",; /)( , 19~ by
<br />
<br />6~~A1) L:?~X'~ ?~) .
<br />who is ps~p,al1y Jrnown/ 0 me or who has
<br />produced ~~~!.s ~ aJ.<j.,_t:i..9-.
<br />as . iflcation and _ho' -
<br />.... ... , ....~
<br />t~ke ~.n ~~~~__'.." /~,'_ .
<br />
<br />1Y a. \l1ra) ---... /-
<br />. ~if; ;.e-:'.
<br />(Name Typed, Printed or tamped)
<br />NOTARY PUB~
<br />"I~", 8Wblt S. Swwtlant!
<br />t.:, ::i MY COMMISSION' celi';"""
<br />. . . l
<br />,,;. 'if,. r:.bn,.ary 2% :'u,
<br />"'~;,~;,f:.: ,\. BONO.O THffl.I T1l.>\ -'I~ 'N''''
<br />
<br />
<br />L.:~
<br />
<br />
<br />
<br />
|