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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />rbe under.lgoed undersland. lbel thl. penoil ..V be .ubJecl 10 'deed r..lrlcli.... vbieb ..V be sore restrlcll.. !has Cily
<br />regul.lion.. rbe uoder.igoed "'Wle. re.pon.ibilily for coopllance vllb any .ppl/cable deed r..tricl/....
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />ff lbe ...er bas blrol · oootr,clor or coolr.clor. 10 uoderlale ..rl. they ..V be reguirel to be Ilceosed 10 accordaoce vlll
<br />.1.le and local regol.I/.... If the contr.ctor I. 001 Ilceo.oI .. regoired by I... both Ibe ....r and onotractor .., be
<br />cfted Cor · .I.d....oor viol.l/on under .lale I.v. IC the ....r or lolended conlr.clor .re ..certalo as to viol II....fng
<br />regolr....l. IO, .pply Cor lbe lolesded vorl. they .re .dvl.ed 10 cool.cl lbe CII, DC Zepbyrblll. Building Deparbossl. (811)
<br />788-6611.
<br />
<br />FurlberSDre. IC lbe Wloer bas bired · conlr'ctor Dr coolr.clor., be I. .d.l.oI 10 10.. the CDotractor(.) .Igo porll... of the
<br />'Coolraclor Secllon.' oC lbl. 'ppllcati.. Cor vblcb they viii be responsible. If roo. as the own" sign .. the cootraclor.
<br />you are indlc.llng lbal YOU. r.ther !ban Ibe CDolr.clor. .re r..ponslble for lbe vorl. ff the contr.ctor vishes you to .ign
<br />.. coolr'clor thel .., be .0 1001c'llon Ib.1 be i. 001 properly Ilc....d and I. 001 enlllled to peraJlliog pei'iloges 10 the
<br />City of Zephyrhil1s.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND U'l'ILI'l'Y CONNECTION FEES ,,~
<br />
<br />D. CONSTRUC'I'ION LIEN M\W (CHAPTER '113, FLORIDA STATUTES, AS AME1fDED)
<br />I cerlif, lbal f. the .pplicanl. ba.e been pro'ided vith . copy oC 'Florlda'. Coo.trucll.. LI.. Law _ BOIeovoer'. Protecllon
<br />Guide' prepared by Ibe Florid. Deparlleul uC Agricullure and Coosover Aff.ir.. IC lb. appllcanl I. ....... otler tban the
<br />.....r.. f cerllCy 1b.1 I be,. obl.loed · copy DC Ibe .10.. d..crlbed do.....1 .od prooi.. 10 good f.llb 10 deliver II to the
<br />"owner" prior to co..encelent.
<br />
<br />E. CONTRACTOR' S/OWNER' S AFFIDAVI'l'
<br />I cerllfy lbel .11 the 10fo,,"1100 10 Ibl. .ppllcalloo I. .ccur.le and lbol .11 ..rl viii be done io COOPllanc. vllb all
<br />applicable laws regulating construction, loning, and land developlent.
<br />I
<br />
<br />Application is hereby lade to obtain a perlit to do wort and instailation as indicated. I certify that no worl or
<br />10.1.11.1100 bo. COIIenced prior 10 i.....c. of . persil and lbal .11 vorl viii be perforoed to 1001 .laodarda of all I...
<br />regulating construction, City codes, loning regulations, and land developlent regulations in the jurisdiction. lalso
<br />certlf, 1b.1 I uoder'l.od lbal the regul'lioo. of olber guv'rnoeolll .genel.. IO, .pply 10 the inleolol VOlt. and 1101 II I.
<br />Iy responsibility to identify what actions I lust tate to be in cOlpliance. Such agencies include but are not liJited to:
<br />· Deportoeol of Eovir.....I.1 Rooul'llon - Cypr... 8aybeads, Kelland Ar... and Ro,lrooooolall, Sonslll.. lands.
<br />Nater/Nastewater Treallent
<br />t Southwest Florida Nater HanageJent District - NeIls, Cypress Bayheads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docts, Navigable Waterways
<br />· De arloonl of Reqllb , Rehabllilali,. Ser,/ces Rovir.....I.1 Health Boil - lell.. IOsI...I" r,,"loonl, Septic ranis
<br />t US InvironJental Protection Agency - Asbestos abatSlent
<br />I .1.. cerllCy thol, If IIII ..leri.1 I. 10 be uooI In Flood Zooe 'A' or 'A.elc.'. II I. underolood 1101 a dreloage plan
<br />addr...iog a 'COIpens.llng ..I.... viii be 'ubaltled vbleb I. prepared by . profession.1 engineer regl.terol Ie 110 Slate of
<br />Florida prior to perlit. issuance.
<br />
<br />. A per.il f..oed shall be conslrued 10 b. · licoo.. to proceed vith tbe vorl ..d nol .. antborll, to 'iolate, COOO!l alter, or
<br />'.1 ..ide ao, pro,l.i... oC tbe lechoical cod", onr .ball i.suonce of . perlil Preveol tbe Building Official fVOl tIoroofter
<br />r.qulring a correction of error. io pI.... coeslruclJoo, or ,ioi'li... of any code. RIOlJ IOCIit Issued shall becooo Ioralld
<br />uol... Ibe vorl authorilOl by sucb POllII I. c.....cod vlthin .1, IOUth. of I......., or If ..rl IOtborlaol by the IOCIiI i.
<br />.- or abaodooed for · periol of .ia IOUlbe .fler th. tile the vorlie .....cod. !me 10 da, OIleeslon of tile, .., be
<br />.11...d Cor tbe perolt vith fee cbarg. of li5.00. Tbe OII...lon sball be reqeOlled 10 vrlllng to 1Io Bolldleg Official. Au
<br />approved inspection lust be logged during each six IOntb period, or the project wiU be considered abandoned.
<br />IlARlIIIIG YO 0I0I1ll: 1001I FAILlJRR YO RRCOIlD A IO'IICB OF CIAIIlBRCBIoln lIAr IIIlSULr II 1001I YAnllG filCH FOR IIIFIiOVIaIms 10 100I
<br />PROPIRTY. IF YOU INTIND TO OBTAIN FlIfANCING, CONSULT NITH YOUR LINDIR OR AN ATTORIIY BIFORl RlCORDING YOUR NorICi OF
<br />COHHIN~HENT. JOBS UNDER << ,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTlCI OF COHMINCIDIINT".
<br />
<br />
<br />-SIGNATURI: CONTRACTOR
<br />
<br />. I
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF -r~, C-O
<br />The foregOing in~ument was acknowledged
<br />before me this \ , 19 -9.B by
<br />
<br />T e ('( L..\ ~,\ ~E(d.\ ~ (" :;-
<br />who is per~onal y known to me or who has
<br />produced V'rrL~ Y'I Th ~
<br />as identification and who did/did not
<br />~e~an 'oath\ \
<br />i. () L-... ;:) \. ,
<br />( S.,igDature) ~
<br />t\ \ep~ l::::>e{~\.,\~~
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC EILEEN W. HERMAN
<br />MY COMMISSION , cc 418846
<br />EXPIRES: AprIl 30. 1999
<br />IlCIlldId Tllnl Nl*IY NIle l)IdrMIIIII
<br />
<br />STATE OF FLORIDA
<br />COUNTY OF
<br />The foregOing instrument
<br />before me this
<br />
<br />was acknowledged
<br />, 19_ by
<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 />
<br />
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