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<br />,,:2'.; CONDITIONS OF PERMIT AFFIDAVIT
<br />;;,:A. NOTICE OF DEED RESTRICTIONS
<br />~lhe under.igned,under.tandB tbat thie penH ..y be ,ubject to 'deed reetrictions" .bicb lay be lOre reetrictive tban City
<br />:W;reguJatlons, !he underaigeed as...., re,ponsibility for cOlpliaoce .ith any applicable deed restrictioo"
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<br />.'i~. UNLICENSEj) CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />~t !be llWIIet ilas blred ~ contractor or cootracto:, to~ertake NOrk, they..y be required to be IIcen'ed in acoordance .ith
<br />fIltate and local regulatIons, If the contractor 18 oot hcensed as reqlUred by IaN, both the ""er and contractor "y be
<br />~ted for a lisde8eaoor violation under .tate laN, If the ONOer or intended oontractor are uncertain as to .bat licensing
<br />lIlregnire8ents ..y ~Iy for the iotended NOrk, they are advised to oootact the City of Zepbyrbills Building Oepartlent, (BI3)
<br />, '~~88-6611.
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<br />I.....~:~'...',. r u...ore, If the owner bas bired a contractor or oontractor" be ie advi,ed to bave the contractor(s) ,ign portions of the
<br />,; Contractor Sections' of this application for .bieb they .iIl be responsible, If YOU, as the ""er ,Ign as the contractor,
<br />.: ~'ars indicating !bat YOU, rather tbao the contractor, are responsible for the .ork, If the contractor .isb.. you to sign
<br />~contractor !bat "y be an Indicatioo !bat be is not properly licensed and is not entitled to psuitting privilsges in tbs
<br />\~pity of ZephyrhilIs. ,
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<br />;.'t. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
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<br />''P. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />II) certify !bat I, !ba applicant, bave been prbvided .i th a, oopy ~ of "yjorida" Construction Lien LaN _ BOI"woer' s Protection
<br />iJi!Iide' peepared by the Florida Oepartlent of Bgriculture and ConsUler Affairs, jf the applicant is 'OIeone other than the
<br />,1{qwner', I certify !bat I bave obtained a copy of the above described docUlent and proli'e in good faith to deliver it to the
<br /><i-rowner" prior to couenceaent. ,
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<br />;~~ CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />~cartlfy !bat all the Infowtion in this application is accurate and that all work .iIl be done in cOlpHanca with all
<br />..~pplicable laws regulating construction, zoning, and land developlent.
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<br />;~Iication I. bereby lade to obtain a penit to do .ork aod lostallation as indicated, I certify that no work or
<br />,liJitallation bas coaenred prior to issuance of a penH and that all work wm be perfoued to leet standards of ell IaN'
<br />;f~.tlng coostroctioo, City codes, soning regUlations, and land develoP..nt regulationa in the juri'dictioo, I al,o
<br />)~ify !bat I understaod that the regulatiena of other gov,,",ental agenclea lay apply to the intended work, and that it i,
<br />';!rl'SSpansibiIity to Identify wbat actions I lust take to be in COIpllance, Sucb agenclee iuclude but are not lilited to:
<br />jl1D1!orl8eDt of Bnvl~OOIental B"lulatioo - Cypress Baybeads, Vetlaod Areas and Bnvironlentally Sensitive Lands,
<br /><~~i. Water/Wastewater '!'reatJent
<br />:.~{Southwest Florida Nater HanageJent District - Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />,~~Arly Corps of Engineers - Seawalls, Docks, Navigable Waterways
<br />~lOe artIeot of Healtb , Rehabilitative Services Bovir...eotal Health Unit . Veil" Vaste.ater Ireallent, Septic lanks
<br />!lUS Bnvirouental Protection Aqeocy - Asbestos abat..eot ,
<br />i;~", certify !bat, if fill ..terlal is to be esed in Flood Zone "A" or 'A, etc, ", it is neder,tood that a drainage plan
<br />~sing a "COIpensatlng volUle' will be soblitted wbieb i, prepared by a profe,sional engineer registered in the State of
<br />,F~~rida prior to perJit issuance.
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<br />A'PersI t issued sbaIl be cooetrued to be a license to proceed wi th the work and not as autbority to v iOlate, cancel alter, or
<br />set,aeide any provisl", of tbs technical codes, nor ,ball issuance of a perait prevent the Building Official frOl thereafter
<br />rOioiriog a correctloo of errors In plans, construction, or violations of any code, Bvery perlit i,eued ,ball bec..e invalid
<br />WlIese the work authorized by .ueb pe",it is co....ced within 'ix ..nths of issuance, or if .ork authorized by tbs perlit i,
<br />;~pended or abandoned for a period of eis IOfitbs after the tile the work Is c...encad, One 90 day ezten,ioo of tile, "y be
<br /><(lowed for the pellit with fee cbarge of 115.00, lbe "tees ion sball be requested, in writiog to the BUilding Official, An
<br />~ed inspectioo lOst be logged during eaeb .Iz lOath period, or the project will be con,idered abandoned,
<br />NlB!lNG TO OWHKR: lOUR FAILUBB TO RBCOBO A HOlIC! Oy OOKHBHCBKBHI MAY RBSULI IH yOUR PAYIHG IVICB POR IHPBOVBKBHTS TO YOUB
<br />,~&P~BJlrY. IF YOU IHJEHD fO OB!!IN FINANCING, CONSUL'!' NI'l'H YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
<br />cmtHEN . JOBS UNDER IN VALUE DO HOT NEED TO RECORD AND POST II NTII.
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<br />ent was acknowledged
<br />, 19!i:l by
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<br />STATE OF. FLORIDA ~
<br />COUNTY OF ~_\
<br />The foregOing inst ent was aCknOWledged
<br />before me this .s, 19l1 by
<br />
<br />
<br />w~Q s P~onally
<br />prOduced
<br />aSf,ldentification
<br />taxe" an oath.
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<br />and who did/diD nqt
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<br />who is P sonally known to me or who has
<br />produced -
<br />as identification and who did/d~dno~
<br />take an Oath
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<br />(S~gnature
<br />;(~~(~' ~
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<br />(Signa
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<br />(~~~ Typed, P~~~ed 0 St ped)
<br />NOTARY PUBLI~s"\d6(.-... E J BURKE
<br />. . i/l ^---'--Ion CC543871
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<br />,,: * Explr_ Mar. 31,2000
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<br />(Name Typed, Prl
<br />NOTARY PUBLIC *
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