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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />Tbe undersigned uncler8tanc1a that this perIIit lilY be subject to Ideed restrictionsl wbieb lilY be lOre restrictive than City
<br />regulations. Ihe undersigned aaaUIeB responsibility for COIpliance with any applicable deed restrictions.
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<br />B. UNLICENSED. CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the GlIDer bai' bired a contractor or contractors to undertake IIOrk, they lilY be required to be llcensed in accordance with
<br />state and local regulations. If the contractor is not licensed.as required by la, both the 0IIleI and contractor UJ be
<br />cited for. a lisdeieinol vioiation under state law. If the mmer or intended contractor are uncertain as to "bat lic8D8ing
<br />requireaents lilY apply for the in~ec1l1Ork, they are advi~ to contact.the"Citr of lePbyrbills Building Departlent, (813)
<br />788-6611. ., ""., '. . ..
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<br />Furthenore, if the 0IIDeI bas bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />IContractor Sectional of this application for wbieb they lIill be responsible. If JOU, as the 0IIJleI sign as the contractor,
<br />you are indicating that JOU, rather than the contractor, are responsible for the IIOrt. If the contractor wisbes fOIl to sign
<br />as contractor that lilY be an indication that be is not properly lic8D8ed and is not entitled to perIIitting privilegu in tbe
<br />City of Zepbyrbills.
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<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNBCTION FEES
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<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of IFlorida's Conatruction Lien Law - lIcIIeoImer's protection
<br />Guidel prepared by the Florida Departlent of Agriculture and COnsUIeI Affairs. If the applicant i8 BOII!OIl& other than tbe
<br />10000erl, I certify that I bave obtained a copy of the above described c10cuIent and promse in good faitb to deliver it to tbe
<br />lOII1erl prior to COIIBIlceaent.
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<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforliltion in tbis application is accurate and tbat all IIOrt will be done in COIPliance with all
<br />applicable laws regulating construction, loning, and land develoPElt.
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<br />Application is hereby Be to obtain a perlit to do IOrk and installation as indicated. I certify that no work or
<br />installation bas ~ced prior to issuance of a perlit and that allllOrk will be perfomec1 to _t ataDllarc1s of all laws
<br />regulating construction, City coeles, loning regulations, and land developaent regulations in tbe jurisdictiOD. I also
<br />certify that I understand that the regulations of other govemaental agencies lilY apply to the intended work, and that it is
<br />If responsibility to identify wbat actions I lust take to be in COIpliance. Sueb agencies include but are not lilited to:
<br />. Departlent of Environaental Regulation - Cypress Baybeau, WetlancllIeas and EnviroDMlltally Sensitive Lands,
<br />Water/Wastewater Treatlent .'.
<br />. Soutlnlest Florida Water Hanageaent District - Wells, Cypress Baybeau, Wetland Areas, Altering WatercoUrses
<br />. III' Corps of Engineers - Seawalls, Docks, lIavigable Watenays
<br />t Departaent of Healtb i Rebabilitative Services, Environaental Health Unit - Wells, Wastewater 'reatlent, Septic 'anks
<br />t US EnvirOllllel1tal Protection Agency - Aabeatoa abatelent
<br />I also certify that, if filllilterial is to be used in Flood ZOne III or II, etc. I, it is understood tbat a drainage plan
<br />addressing a Icmpensating voluael ,ill be sw.1tted ,bieb is prepared by a professional engineer registered in the State of
<br />Florida prior to peIlit issuance.
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<br />I perait issued &ball be construed to be a license to proceed ,ith tbe IIOrt and not as autbority to violate, cancel alter, or
<br />set aside any provisions of the technical coeles, nor shall iBBuance of a peIlit prevent tbe Building Official fIOl thereafter
<br />reguiring a correction of errors in plans, construction, or violations of any coele. Ivery perIIit issued shall beaIIe invalid
<br />unless the work autboriled by sUeb perait is ~ced within sillODtbs of issuance, or if !IOrk authoriled by the perlit is
<br />suspended or abandoned for a period of sillODtbs after the tile the IIOrk is co.enced. One 90 day atension of tile, aay be
<br />allOlfed for tbe perIIit witb fee charge of $15.00. Tbe atension shall be requested in writing to the Building Official. An
<br />approved inspection nst be logged during eaeb sillODth period, or the project will be considered abaDI1oned.
<br />WARIIUG TO <IIIJR: ~ FAlLURI '0 RECORD A IOfICE OF CCIIIIIICIIIBH! HAY RISUL' II YOOR PAYIIG !VICE FOR DIPROVIIIBI!8 '0 YOOK
<br />PROPEIl'lY. IF YOO .uilllD 10- 0Bf1Il F IIG, COIISUL' utH YOOR LIIDBR OR All IftORRIY BIFORB RICOBDIIG YOOK JIO'fICE OF
<br />~ 2.!iIlIl UIIlIlO IOf BiD 10 RllClllllIIII POST~~'. .
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<br />~1f- CJ ~
<br />SIGlII!URI: COIIRICIOR
<br />
<br />
<br />S'lID OF FLORIDA P ~ /"
<br />coum OF A I7L 0
<br />The foregoing i,t~was 2knOWledged
<br />before ~e this - , 1t4. OOt>>y
<br />FA U l.,.. ......1 M ^
<br />who is personally known to me or who has
<br />produce(("""'
<br />as ideotif~ "~J.90~i~id Dot
<br />take an oa ,.. ~ y~
<br />
<br />~~UM)A(2..~ IN l ~
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />~O~F FLORIDA t' A seo
<br />The foregoing inJtt~t was acknowledged
<br />before me this -'2 ., , 1!J"'2Do I by
<br />_F(ZA N a <; .M .. t..-. N .etZ-
<br />who is personally known to me or who has
<br />producer -'
<br />as identifi 1ion...-J..,an.,. d.'iih21 d~d.id not
<br />take an 0 ., /~~......- y~
<br />
<br />~eA~lL~l.(-
<br />(Name Typed, Printed or Sta.ped)
<br />NOTARY PUBLIC
<br />~, R. MaTkWi1le\t
<br />f~r. \ MY COMMISSION # CC880695 08
<br />;*: :*~ December 8, 2003
<br />\:~......;;'"f BQNOeDlHIl\J1I!0Y FAlNINS\lRH4C1I1C
<br />:,f:fn\~'"
<br />
<br />~-"""""'" R. Mark WIIett
<br />f:~A.~:-. MY COMMISSION # CC880695 EXPIRES
<br />",;,~':"i December 8, 2003
<br />\:~'.....:0' BQNOEDlltlUOOYFAIN INlIURANCf.lNC.
<br />'.Rf..~~'
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