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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perlit lay be subject to 'deed restrictions' wbicb lay be lOre restrictive than City
<br />regulations. Ibe undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertate 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 o~er and contractor lay be
<br />cited for a lisdeleanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requirelents aay apply for the intended work, they are advised to contact the City of Zepbyrbills Building Departlent, (813)
<br />788-6611.
<br />
<br />FurtherlOre, if the owner bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'Contractor Sections' of this application for wbicb they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, ratber tban the contractor, are responsible for the work. If tbe contractor wisbes 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 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 that I, the applicant, bave been provided with a copy of 'Florida's Construction Lien Law - HoIeowner'a Protection
<br />Guide' prepared by the Florida DepartJent of Agriculture and ConsUler Affairs. If tbe applicant is sOleone other tban 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 cOlIBDcelent.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in tbis application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land develop.lent.
<br />
<br />Application is bereby aade to obtain a perlit to do wort and installation as indicated. I certify that no work or
<br />installation baa COIIenced prior to issuance of a perlit and that all wort will be perforJed to leet 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 goveDII8Dtal agencies JaY apply to tbe intended wort, and that it is
<br />IY responsibility to identify wbat actions I lust tate to be in cOlpliance. Such agencies include but are not lilited to:
<br />A Departient of EnviroDJental Regulation - Cypress Baybeads, Vetland Areas and EnviroDlentally Sensitive Lands,
<br />Vater/Vastewater Ireatlent
<br />t Southwest Florida Vater Hanagelent District - VeIls, Cypress Bayhea4s, Vetland Areas, Altering Watercourses
<br />t ArlY Corps of Bngineers - Seawalls, Docks, Navigable Vaterways
<br />t Departlent of Health , Rebabilitative Services, Environtental Health Unit - Wells, Vastewater IreatJent, Septic lanks
<br />A US BnvirODl8Dtal Protection Agency - Asbestos abateaent
<br />I also certify that, if fill laterial is to be used in Flood ZODe 'A' or 'A,etc.', it is understood tbat a drainage plan
<br />addressing a 'CQlpensating volute' will be subtitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />.s i-f. It'Tt ttUf 6tJ L71t tJ r /tit -rI(O/llUJ Y/ 0101
<br />
<br />PM ~ f/ U{ I( wilt U /lfl.
<br />SIGNA'fURI: OIftIIR OR IGINI
<br />
<br />A pe~lit issued shall be construed to be a license to proceed with tbe wort and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perJit issued sball beCOle invalid
<br />unless the work authoriled by such perlit is cOllenced witbin sil IOnths of issuance, or if work authorized by the perlit is
<br />suspended or abandoned for a period of sillOnths after the tile the wort is cOllenced. One 90 day extension of tile, JaY be
<br />allowed for the perJit with fee charge of $15.00. Ibe extension sball be requested in writing to the Building Official. An
<br />approved inspection lust be logged during eacb sil IOntb period, or the project will be considered abandoned.
<br />WARNING TO OWNER: YOUR FAILURE 10 RECORD I NOTICE OF C(IIMINCIIIBNI lilY RlSULT IN YOOR PAYING "'ICE FOR IHPROVIMINlS TO YOUR
<br />PROPERlY. IF YOU IJIIEND 10 OBIAIN FINAJlCING, CONSULI VI'" YOUR LlNDIR OR AJI IIIORNEY BEFORE RECORDING YOUR NOTICB OF
<br />COHHIlNCIHINI. JOBS UNDER $2,500 IN VALUE 00 NOI NEilD 10 RECORD AND POSI A 'NOIICIl OF COHHIlNCIHINT'.
<br />
<br />
<br />,lJ ill V c./L
<br />SIGNAlURI: CONlRACIOR
<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 />SIAIE OF FLOR~
<br />COUNIY OF
<br />The foregoing in~ent was acknowledged
<br />before me thisd _ /7 ' 19-2Z.. by
<br />
<br />7J1J 11/ I) LJ ;jLt,G ~
<br />who is personally knoWn to me or who has
<br />produced
<br />as identification and who did/~~
<br />.~ks an Oath~ (} 1
<br />
<br />(Signature) tI '
<br />
<br />(Rame Typed, Print. pecijFFICIAL SEAL
<br />ROTARY PUBLIC . Wi Roberta J. Stockslager
<br />My Commission Expires
<br />\, May 29, 2000
<br />): Comm. No. CC548153
<br />
<br />SlATE OF FLORIDA
<br />COUNIY OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />(Signature)
<br />
<br />(Name,Typed, Printed or Stamped)
<br />ROTARY PUBLIC
<br />
<br />
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