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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />fbe undersigned understands that this perlit laY be subject to "deed restrictions" wbieb laY be lOre restrictive than City
<br />regulations. fbe undersigned asSUles 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 work, they uy 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 lisdeJeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirel8Dts laY apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtheIlOre, if the owner has bired a contractor or contractors, he is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections" 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 "Florida's Construction Lien Law - HOIeOlOler's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsDler Affairs. If the applicant is sOJeOne other than the
<br />"owner", I certify that I bave obtained a copy of the above described dOCUJeDt and prOlise in good faith to deliver it to the
<br />"owner" prior to COll8llCel8Dt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable lad regulating construction, zoning, and land developlellt.
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas ~ed prior to issuance of a perlit and that all work will he perfoIJed 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 governJental agenCies lilY apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lUSt take to be in cDlpliance. Sueb agencies include but are not lilited to:
<br />* DepartJent of BnviroDJeDtal Regulation - Cypress Bayheads, Wetland Areas and BnviroDJeDtally Sensitive Lands,
<br />Water/Wastewater freatlent
<br />I Southwest Florida Water Managel8Dt District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t AIIY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />I DepartJent of Health i Rehabilitative Services, BnvirODJeDtal Health Unit - Wells, Wastewater freatJent, Septic lanks
<br />I US BnvirODleDtal Protection Agency - Asbestos abatl!ll!llt
<br />I also certify that, if fill laterial is to be used in Flood ZOne "A" or nA,etc.", it is understood that a drainage plan
<br />addressing a .cDlP8DSating VOIUlen 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 frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perlit issued shall beCOJe invalid
<br />unless the work authorized by sueb perlit is COIJeIlced within slllOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of, six IOntbs after the tile the work is co.enced. One 90 day extension of tile, laY be
<br />allowed for the perlit with fee ebarge of $15.00. Ibe extension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during eaeb six IODth period, or the project will be considered abandoned.
<br />WARNING fa (MINER: YOUR FAILURE 10 RICORD A NOIICE OF C<llMDCEMElI'I MAY RESULI IN YOUR PAYIKG !VICE FOR IMPROVIJIEKIS 10 YOUR
<br />PROPERlY. IF YOU IHUD !O OB'l'IDf FIIWfCIKG, COKSULI WlfH YOUR LBKDIR OR II AnomY BEFORE RECORDING YOUR KOliCH OF
<br />
<br />
<br />d~;:2'~O IIVM OOD_ro~~si~-"
<br />
<br />SfAfB OF FLORIDA P
<br />COUM!Y OF 0... oS C. 0
<br />The foregoing instrument was acknowledged
<br />before me this Se.vJ' 1..3 , 19q & by .
<br />
<br />60b A. \ ocl~
<br />who IS persona y own m r who has
<br />pro uc
<br />as identification and who did~id no~
<br />
<br />tak'XitoaIllJ () I . ~-
<br />~Afll . 7<f hva
<br />(Si~ture) LJ
<br />\ ~..... ~. r 1 ,'^ "'r.cJ,..s
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />
<br />SIAR OF FLORIDA C'.
<br />coum OF t- o....S c. 0
<br />The foregoing instrument was acknowledged
<br />before me this SfZ..pt. 1 3> , 19 ~ by
<br />
<br />c...~o e.-
<br />who i ersonally known to me or who has
<br />produced
<br />as identification
<br />take an oath..
<br />
<br />
<br />
<br />(S~ature)
<br />-l,J ~t'\"'t..~. H"J\I""c./'5'
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />""Ill "II _
<br />." ,6"'<'t> UENEE J HINRICHS
<br />*W* My ool11ll1inion 00449109
<br />Expir-Mw.28.1999
<br />, ~.. Bonded by HAl
<br />~ IIF f~fI>"" 800-422-1555
<br />
<br />,"" ~,,~ DENee J HfNRICH8
<br />*ji" My Com..........., CC4481C>>
<br />* Expiree Mw. 28, 1~
<br />~ , II" Bonded by HAl
<br />.,~., nO. 800-422-155&
<br />
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