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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to "deed restrictions" whicb lay be lOre restrictive than City
<br />regulations, tbe undersigned assUles responsibility for cOlpliance witb 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 witb
<br />state and local regulations, If the contractor is not licensed as required by law, both the owner and contractor lilY be
<br />cited for a lisdeteanor violation under state law, If the owner or intended contractor are uncertain as to what licensing
<br />requirelents lay apply for the intended work, tbey are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611,
<br />
<br />FurtberlOre, if the owner bas bired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for which they will be responsible, If you, as tbe 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 tbat be is not properly licensed and is not entitled to perlitting privileges in tbe
<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 tbat I, the applicant, bave been provided witb a copy of "Florida's Construction Lien Law - HOIeOWDer's Protection
<br />Guide" prepared by the Florida Deparllent of Agriculture and ConsUler Affairs, If the applicant is sOleDne other tban the
<br />"owner", I certify tbat I bave obtained a copy of the above described docUleDt and prolise in good faith to deliver it to the
<br />"owner" prior to cOllencelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforliltion in this application is accurate and that all work will be done in cOlpliance witb all
<br />applicable laws regulating construction, zoning, and land developlent,
<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 has cOllenced prior to issuance of a perlit and that all work will be perforJed to leet 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 govefDlental agencies lilY apply to tbe intended work, and tbat it is
<br />IY responsibility to identify what actions I lust take to be in cOlpliance, Sucb agencies include but are not lilited to:
<br />· Departlent of EnviroDleDtal Regulation - Cypress Bayheads, Vetland Areas and EnviroDlentally Sensitive Lands,
<br />Vater/Wastewater Treallent
<br />· Southwest Florida Vater Managelent District - Wells, Cypress Bayheads, Wetland Areas, Altering Vatercourses
<br />I ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />· Departlent of Health & Rehabilitative Services, BnvirORlental Health Unit - VeIls, Wastewater Treatlent, Septic tanks
<br />I US RnviroDlental Protection Agency - Asbestos abatelent
<br />I also certify that, if fill laterial is to be used in Flood ZOne "A" or "A,etc,", it is understood tbat a drainage plan
<br />addressing a "colpensating volUle" will be sublitted which 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 witb tbe work and not as authority to violate, cancel alter, or
<br />set aside any provisions of tbe technical codes, nor shall issuance of a perlit prevent the Building Official frOl,thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery perlit issued sball beCOle invalid
<br />unless the work authorized by such perlit is cOll8nced witbin six IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of six IOnths after tbe tie the work is cOMenced. One 90 day utension of tile, lilY be
<br />allowed for the perlit with fee charge of $15,00, The extension shall be requested in writing to tbe Building Official, An
<br />approved inspection lust be logged during each six IOnth period, or the project will be considered abandoned.
<br />WARNING TO OVNRR: YOUR FAILURK TO RKCORD A NOTICK OF COMHKNCHMBNT HAY RESULT IN YOUR PAYING nllCK FOR IMPROVBItBB!S TO YOUR
<br />PROPBRTY. IF YOU INTBND TO OBTAIN FINANCING, CONSULT VITH YOUR LKNDBR OR AN AUORlBY BKFORE RECORDING YOUR NOTICK OF
<br />COMMKNCEKKNT, JOBS UNDER $2,500 IN VALUE DO NOT NKED TO RKCORD AND POST A "NOTICE OF COHMBNCBHBNT",
<br />
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<br />SIGlA~ · ei
<br />
<br />_-9:-:jJ
<br />SIG/" OIINER OR NT
<br />
<br />"
<br />
<br />~
<br />
<br />STATE OF FLOR~
<br />COUNTY OF . ~
<br />The foregoing instrument was acknowledged
<br />before me this 10 -:1 r , 19 96 by
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19_____ by
<br />
<br />who is personally known to me or who has
<br />produced l)L IfS(JD- 'iS7J-0>-:S-~ Vb> - 0
<br />as identification and who did/did not
<br />take an oath.~ A ~L <717-~ .
<br />
<br />(Signature) /!I~ A fijA
<br />_&.h LV~ElodT
<br />(Name Typed, Printed oP/Stamped)
<br />NOTARY PUBLIC
<br />
<br />';N~~'~" NInoY A, Moody
<br />.~' "-~,.% ~ COMMISSION' CC534806 EXPIRES
<br />. \.:. ?Jj FebruarY 21. 2000
<br />''(9f.:f.i s~ 8ONDEDntIll"AOH~ItlIllSllRANCE.INC
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath,
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
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