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<br />. CONDITIONS OF PERMIT AFFIDAVIT
<br />A'. NOTICE OF DEED RESTRICTIONS
<br />fhe undersigned understands that this pemit lay be Subject to "deed restrictions" wbich Jay 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 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 lisdeteanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireJents 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, he is advised to bave the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for wbich they willbe 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 lilY be an indication that be is not properly licensed and is not entitled to pettitting 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 - H(IIl!OWJler's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUJer Affairs. If the applicant is sOleone other tban the
<br />"owner", I certify that I bave obtained a copy of the above described docUJent and prOlise in good faith to deliver it to the
<br />"owner" prior to cOlleDceJent.
<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 cOlpliance with all
<br />applicable laws regulating construction, zoning, and land developent.
<br />
<br />Application is bereby lade to obtain a pemit to do work and installation as indicated. I certify that no work or
<br />installation bas cOlleDced prior to issuance of a pemit and that all work will be perfoIled to teet standards of all laws
<br />regulating construction, City codes, zoning regulations, and land developlent regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIDJeDtal 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 liJited to:
<br />t DepartJent of EnviroDJeDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDJeDtally Sensitive Lands,
<br />Water/Wastewater freatJent
<br />t Soutbwest Florida Water HanageJent 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, EnvirODJental Health Unit - Wells, Wastewater freatJent, Septic Tanks
<br />t US InviIODlental Protection Agency - Asbestos abateJent
<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 "cQlpensating volute" will be subJitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />~..~h~Y
<br />P'S GJlAfURB: 0WIfK. ,.R.. . Jft!
<br />
<br />A pemit 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 pemit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Ivery pettit issued shall beCOle invalid
<br />unless the work authorized by such pemit is cOJJeJlced within six IOnths of issuance, or if work authorized by the pemit is
<br />suspended or abandoned for a period of six IOnths after the tile the work is COIIeI1ced. One 90 day extension of tite, JaY be
<br />allowed for the pemit with fee charge of $15.00. fbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during each sixlOnth period, or the project will be considered abandoned.
<br />WAIUUNG TO OWNER: YOUR FAILURE '1'0 RECORD A NO'I'ICE OF C(JIIfDCIIIENf HAY RESULT IN YOUR PAYING nICE FOR IHPROVIIIDfS fO YOUR
<br />PROPIRfY. IF YOU IJf!1ND ro OBfIIN FIKAlCING, COBSULf WlrH YOUR LINDO OR AN AnomY BBFORE RECORDING YOUR NO'I'Ie! OF
<br />COHMENCEHEJf!. JOBS UNDER '2,500 IN VALUE 00 10'1' lEBO '1'0 RECORD AND POS'I' A "NO'I'ICE OF COMHDCIHm'".
<br />
<br />~~-;2
<br />
<br />SIGJlATURB: COJmlACfOR
<br />
<br />STATI OF FLORIDt)
<br />coum OF ~5( 0
<br />The foregoing instrument was acknowledged
<br />before me this ..,j,.L Ol'L, 19..ita- by
<br />
<br />~-n\.e S ~'("\1e... \
<br />who is personally known to me or who has
<br />produced
<br />as id "fic did/did not
<br />oC!th
<br />
<br />STATI OF FLORIt:1
<br />coum OF SC ()
<br />The foregoing instrum~as a~owledged
<br />before me this ,3rcL ~. , 1~ by
<br />
<br />Eo k~ c. - t~~01c." .J v
<br />
<br />wh is personally known to me or who has
<br />produced
<br />as identifi
<br />take
<br />
<br />
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLI LARIEJ.JONES-DAVlS
<br />A Notary Pubiic, Slate of Rorida
<br />.;., My Ccr"!n. Expires Jan. 29, 200::>
<br />.. .'0',.1 ~~". C:-;: 528143
<br />...y'. Bunded 11;:\i ~efii~I~1 ~r.nk\tll t)rrlritt
<br />1-(800) 723-0121
<br />
<br />(Name Typed, Printed or S \
<br />NOTARY PUBLIC ^... M=~{~~.,,~fD.~~J
<br />
<br />~ No, CC 528'14-3
<br />~80llded Ti\!li (j!Hc!ll1 !ei'!t;1l ~tnrltt
<br />1-.(300) 723-0121
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