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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned understands that this perait laY be subject to 'deed restrictions" wbicb laY be lOre restrictive than City
<br />regulations. The undersigned assUles responsibility for cOlpliance with any applicable deed restrictions.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake work, they lay be required to he 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 lisdeaeanor violation under state law. If the owner or intended contractor are uncertain as to wbat licensing
<br />requireaents lay 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 wbieb 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 the 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 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 - HOJeOWDer's Protection
<br />Guide" prepared by the Florida Departlent of Agriculture and ConsDler Affairs. If the applicant is sOJeQne other than the
<br />'owner", I certify that I bave obtained a copy of the above described docUleDt and prOlise in good faith to deliver it to the
<br />"owner" prior to cOllenceJeDt.
<br />
<br />E. CONTRACTOR'SjOWNER'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, zoning, and land deve,loplent.
<br />
<br />Application is bereby lade to obtain a perlit to do work and installation as indicated. I certify that no work or
<br />installation bas cOllenced prior to issuance of a perait and that all work will be perf oIled to leet 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 goverDIental agencies aay apply to the intended wort, and that it is
<br />IY responsibility to identify wbat actions I lust take to be in cOlpliance. Such agencies include but are not lilited to:
<br />* DepartJent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater Treatlent
<br />* Southwest Florida Water Hanageaent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t Aray Corps of Engineers - Seawalls, Docks, Mavigable Waterways
<br />t DepartJent of Health & Rehabilitative Services, EnvironJeDtal Health Unit - Wells, Wastewater Treatlent, Septic Tanks
<br />t US EnvirODlental 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 that a drainage plan
<br />addressing a "cOlpensating volUle" will be subtitted whieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit_ issuance.
<br />
<br />A perlit issued shall 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 is~uance of a perlit prevent the Building Official frol thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every perait issued sball becOle invalid
<br />unless tbe work authorized by sucb perlit is cOlleDced within Sil IOnths of issuance, or if work authorized by the perait is
<br />suspended or abandoned for a period of sillOntbs after the tie the work is co.enced. One 90 day extension of tile, laY be
<br />allowed for tbe perait with fee charge of tlS.OO.Tbe extension sball be requested in writing to the Building Official. An
<br />approved inspection lUst be logged during eacb sillOnth period, or the project will be considered abandoned.
<br />WARMIMG TO OWMER: YOUR FAILURE TO RECORD A MOTICEOF CQMHBRCEIlBtIt' MAY RESULT 1M YOUR PAYlMG TWICE FOR IHPROVBllEll'S TO YOUR
<br />PROPERTY. IF YOU ItIt'BHD TO OB'l'AIM FIMAMCIMG, COMSULT WITH YOUR LEIDER OR AM AftORIEY BEFORE RECORDIMG YOUR MOTICE OF
<br />ClIlIIDC J()IIS 1IIIlIII12,SOO H VALUE DO HlJ! HEIlD 10 IIICOIlIl ~~~
<br />
<br />
<br />
<br />ArtJRE: COtlt'RAClOR
<br />
<br />
<br />STATE OF FLO~
<br />COUtIt'Y OF ' J-~
<br />The foregoing instrument was acknowledged
<br />before me this r::2 - .::2~- , 192..2. by
<br />
<br />STATE OF FLORIDA
<br />COUtlt'Y OF
<br />The foregoing instrument was aCknowledged
<br />before me this , 19_____ by
<br />
<br />-aJ\...
<br />who is
<br />produ
<br />as identification and who did/did not
<br />
<br />~L<O~~ () YJ1 ~-~.
<br />(Signature Ai -<i Jj- J1 /
<br />Q. n. c~ t3D ci- V
<br />(Name Typed, Print d or Stamped) I
<br />NOTARY PUBLIC
<br />
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an o~th.
<br />
<br />(Signature)
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />."~'~~";:"'" Nancy A u-.
<br />:~F~;""~'!:i~~ . muvuJ
<br />:'. 'Ji."'~:~ ~w COMMISSION * CC534806 EXPIRES
<br />'~',\>" FebIU8lY 21, 2000
<br />, :":\~9" ilONDED THRlJ TROY FAIN INSURANCE. lNG,
<br />
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