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<br />CONDITIONS OF PEF].\1IT AFfIDAVIT
<br />
<br />01\- NO'!'ICE OF DEED RES'l'RIC'fIONS
<br />The undersigned understands thijt Lhi~ parmit may be subject ~o "deed restriotionsH wbjc~
<br />may be more restri cti ve than City r:e9uli:ltiol1s. 'I'h,= 1ll1d,=r:si9ned assumes responsibili ty for
<br />CJompliaHce with any applicable deed (.=st:eictions.
<br />B. UNI,ICENSED CON'l'RAC'I'ORS AND CON'l'RI\CTOR RESI:'CJNS lBIl,['l'U:S
<br />I f the o\'>/ner has h.ired a contracto!: or contractors to undertake work, they llIay be requiu:H.l
<br />to be licensed in accordance wi.th state and local reglllati.ons. If the contracl:or is not
<br />licensed as required by lav~, both t.he o\mer- and contractor may be cJted for a lIIi.sdellleanor
<br />violation under state laH. If the ownet' or- .intended Cl.JfltrClctor a!:e uncertain as to vJhat
<br />licensing requirements may apply for the intended work, they an. advi.sed to contact the
<br />City of Zephydlills Building Department, 813-788-'6611.
<br />Furthe.l.'lllore, if the owner has Idr'ed a contractor or contractors, he is advised to have the
<br />contractor(s) sign portions of the "Contractor Sections" of this application for which they
<br />will be responsible. If you, as the owner signs as the contractor, YQ4 are indicating that
<br />you, rather than the contractor, are responsible for the work. If the contractor wishes
<br />you to sign al:l contractor that may be an indication that he is not properly licensed and is
<br />not ellti tled to permitting privileges in the City of Zephyrhi.lls.
<br />c. TRANSPOk'l'A'rION IMPACT FEES AND U'i'ILI'l'Y CONNECTION IfEES
<br />D. CONS'l'RIIC'rUION LIEN I.A~l (CHAPTER 713, FI.ORIDA STATUTES, AS AMENDED)
<br />1 certi.fy that I, the applicant, have been provi.ded with a copy of "Florida's Construction
<br />lien Law - Homeowner's Protection GuideH prepared by the Florida Department of Agriculture
<br />and Consumer Affair's, If the appli.cant is someone other that the "owner", I cerify that I
<br />have obtained a copy of the above described document and promise in good faith to deliver
<br />it to the "owner" prior to conUllencement.
<br />E. CONTRAC'l'OR' a/OWNER'S AFFIDAVl'l'
<br />I certify that all the information in this application is accurate and that all work will
<br />be done in compliance with all applicable laws regulating construction, zoning, and land
<br />development.
<br />Application is hereby made to obtain a permjt to do work and installation as indicated, 1
<br />certify that no Hork or installation has commenced pri.or to issuance of a permit and that
<br />all work will be performed to meet standards of all laws regulati.ng construction, c.ity
<br />codes, zoning regulations, and land development regulat.i.ons in the jurisdiction. I also
<br />certify thatl understand that the regulations of other governmental agencies may apply to
<br />the intended work, and that it is my responsibility to identify what actions I must take to
<br />be in compliance. Such agencies i.nclude but are not limited to: *Department of
<br />Envirollmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
<br />Lands, Water/waste\'>/ater Treatment
<br />*Southwest Inorida Water Management District-Wells, Cypress Bayheads, Wet.1and Areas,
<br />Altering Watercourses
<br />*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
<br />*Department of Health & Rehabllitative Services, Envi.ronmental Health Uni.t-Wel1s,
<br />Wastewater Treatment, Septic Tanks
<br />*U.S. Environmental I?rotection Agency-Asbestos abatement
<br />I also certify that, if fill material i.s to be used in Flood Zone ~AH or "A,etc.H, it is
<br />understood that a drai.nage plan addressing a "compensating volume" 'will be submitted Hhiah
<br />is prepared by a professional engineer registered in the state of Florida prior to permit
<br />issuance,
<br />A permi.t issued shall be construed to be a license to proceed with the work and not as
<br />authority to violate, cancel, alter, or set aside any provisions of the technical codes,
<br />nor slla11 issuance of a permit prevent the Building Ofticial from thereafter requi.ring a
<br />correction of errors ill plans, construction, or violations of any code. Every permit
<br />iStjl1ed shall become invalid unless the work authorized by such permit is cOllullenced within
<br />six months of issuance, or i.f work authorized by the permi.t is suspended or abandol1ed for a
<br />period of si.x months after the time the work is cOllunenced. One 90 day extension of time
<br />may be allowed for the permit with fee charge of $15.00. The extensi.on shall be teques~ed
<br />in writing to the Buildi.ng official. An approved inspection must be logged during each six
<br />month period, or the project will be considered abandoned.
<br />WARNING '1'0 OWNER; YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUI!I' IN YOUR
<br />PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB'I'AIN InNAN(~ING, ~qN~UI:l'
<br />WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEN'I'. .JOBS mHlER
<br />.2,500 IN VALUE DO No~eORU AND POS" A "NOTICE OF COMM Ne""EN'!"'.
<br />
<br />~AA
<br />
<br />SIGNA'l'lJRE; OWNER OR AGEN'I'
<br />
<br />STATE OF FLO~~ .
<br />COUNTY OF _-'-U 51" L) COUNTY OF
<br />'I'he foregoing instrument was acknowledged The foregoing instrument w~
<br />Bef3l1\~hiS -4z....'Y~ d~y of _ ~~., ~tJ~ Befor~II"If:c;-2~s 1a . of ,
<br />by. _~t ~~t'Tt ~ by~'
<br />(name of person acknowledged) (name of person acknowledged)
<br />o who is personally known to me, or D~ho is personally kno~m to me, or
<br />
<br />~WhO has produced...E:L..7).. L. 04:20 -'197-t6- ~I,I..O has producedflD L .!Jfr20'_."79.'7-lf
<br />. JtYp-e of identi.fi cationl?~7-D /.-....__.-~.J: (t:ype~Of i~entifioatien! .
<br />al.19.--wfiOT.,,~d ~i?,no~"",-,.ftake an oath./,,/ and ".h,..O, , [Jd,i.,..cjj ~. id, nrt.t~ an 01t~.?f7. (..
<br />
<br />_! '--7Q~~ ~a~x~~CM7~_..~< l_ / ~2{;~
<br />
<br />signatur'e of person taking acknowledgement Signature of person taking acknowledgment
<br />
<br />\\\111I1', ,....~';i~:rv.:'~ Bobbie Swetland
<br />~'f~ Bobbie Swetland f""f'~\ MY COMMISSION # CC893160 EXPIRES
<br />
<br />{t~~y~~?i~~:~~j~~~6$iXP~~amped -.------ Hame il PfO~6~t~~~;I~~--'-'---"-----'-
<br />"lfp.f.,~~'" BONDED THRU TROY FAIN INSURANCE, INC '. ......... -
<br />
<br />
<br />STA'l'E OF FLORIDA
<br />
<br />CONTRACTOR
<br />
<br />.---.~
<br />2{Jf~
<br />
<br />
<br />S I GNA'J1URE :
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