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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. . NOTICE OF DEED RESTRICTIONS
<br />'I'he undersigned understands tbat this peIlit laY be subject to "deed restrictions" wbich lay be lOre restrictive than City
<br />regulations. !be undersigned assUJes responsibility for COIIpliance with any applicable.'deed restrictions.
<br />
<br />. .
<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 lisdeieanor violation under state law. If the owner or intended contractor are uncertain as to what licensing
<br />requireleDts lay apply for the intended work, they 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, be is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections" of this application for wbich 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 wisbes you to sign
<br />as contractor that lay be an indication that be is not properly licensed and is not entitled to peIlitting 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 - HOIl!OWDer's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and ConsUlleI' Affairs. If the applicant is SOIIeODe other than the
<br />"owner", I certify that I have obtained a copy of the above described docUlent and prOlise in good faith to deliver it to the
<br />"owner" prior to coaencl!Jlent.
<br />
<br />E. CONTRACTOR'SjOWNER'S AFFIDAVIT
<br />I certify that all the inforlation in this application is accurate and that all work will be done in cOlpliance with all
<br />applicable laws regulating construction, loning, and land developlent.
<br />
<br />Application is berehy lade to obtain a peIlit to do work and installation as indicated. I certify that no work or
<br />installation bas cOllenced prior to issuance of a petlit and that all work will be perfoIJed to leet standards of all laws
<br />regulating construction, City codes, loning regulations, and land developlll!Dt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other govl!11lleDtal agencies laY 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 li.ited to:
<br />t Departlent of EnviroDleDtal Regulation - Cypress Baybeads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater 'I'reatlent
<br />t Soutbwest Florida Water Hanagl!Jlent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />* Departlent of Health & Rehabilitative Services, Environtental Health Unit - Wells, Vastewater 'I'reatlent, Septic ranks
<br />* US EnviroDleDtal Protection Agency - Asbestos abatl!Jlent
<br />I also certify that, if fill laterial is to be used in Flood Zone "AU or "A,etc.", it is understood that a drainage plan
<br />addressing a UcOlpeDSating voluteN will be sublitted wbich is prepared by a professional engineer registered in the State of
<br />Florida prior to per.it issuance.
<br />
<br />A peIlit 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 petlit prevent the Building Official frOl thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Every petlit issued sball beCOle invalid
<br />unless the work authorized by such peIlit is COIIenced within sil IOnths of issuance, or if work authoriled by the peIlit is
<br />suspended or abandoned for a period of sil IOnths after the tile the work is co.enced. One 90 day eJtension of tile, lilY be
<br />allowed for the peIlit with fee charge of $15.00. !be eJtension sball be requested in writing to the Building Official. An
<br />approved inspection lust be logged during each sil IODth period, or the project will be considered abandoned.
<br />WARlUIIG '1'0 OWNER: YOUR FAILURE '1'0 RECORD A 1I0!lCE OF COMMDCEIIBM! MAY RESUL! III YOUR PAYIIIG !VICE FOR IMPROVBIIBIft'S '1'0 YOUR
<br />PROPER'lY. IF YOU III'I'EIID '1'0 OB!IIII FIIWICIIIG, COIISUL'I' WI'I'H YOUR LODER OR All AftORRIY BEFORE RECORDIIIG YOUR lfOfICE OF
<br />COHHENCEHEII'I'. JOBS UNDER $2,500 1M VALUE 00 NOt HEED TO RECORD AIID POS! A "NOtICE OF COMHEIICBIIEII!".
<br />
<br />SIGIIAfURB: om:R OR AGEII'I'
<br />
<br />
<br />SIGIIA'I'URE: COII'I'RAC'I'OR
<br />
<br />SrA'I'E OF FLORIDA
<br />COUII'I'Y OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19____ by
<br />
<br />S'I'A'I'E OF FLORIDA 0
<br />COUII'I'Y OF '( '-^ e..U. ^ )
<br />The foregoing instrument was acknowledged
<br />before me this 3.. \ ~ , 19~ by
<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 oath.
<br />
<br />who is
<br />produce
<br />as identification
<br />take an oath.
<br />
<br />
<br />and who did1d1'Q n~
<br />
<br />~
<br />
<br />(Signature)
<br />
<br />(Signature)
<br />
<br />~'" ~S~
<br />Printed or At '( lEAL
<br />lJ KEVIN KRUSE
<br />0"'" 8(", coMtAl"'Otl MU.-IER
<br />~ ~l'" CC548891
<br />;., , . 'jJ ti CQMl.\\SSION EXPIRES
<br />11... ~ MY APR. 28,2000
<br />f' OF r"-O
<br />
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />(Name Typed,
<br />NOTARY PUBL
<br />
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