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<br />~.r.' . T.
<br />
<br />CONDITION~~eF PERMIT AFFIDAVIT
<br />"A.. NO:l'ICE OF DEED BESTRICTIONS~r
<br />'I'be"uAdetsJgned underBtanda that tbis.,pemlt lay bi~i~j_{;~it9.~dlMlCl ~estr:ic,t10D81UldFlllli:be lOre restrictive than City
<br />regulations. !be undersigned USU188 'responsibllit.,~._lAMCe..!t.. ~y..applicable deed restrictions.
<br />. ,.-.
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<br />B. UNLICEN ED, CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />. If th~ ower b~' ~ired ,~ cOntr9ctor or contractors to un~ertat. IlU'k, ~ey laY bJ required to licensed in accordance with
<br />..~tatea41ocal ~eaulationa. .If. the conb.:actor is not bCBlUlecll8(8QUlIed by la., beth the 0IID8I aDd-contractor lilY he
<br />, cited " for a lisdel8aDOr violation under state law. If the owner or intended contractor are UDcer~' II to wbat lic8D8ing
<br />requir~ts ~y. 'apply' fot, the in~eIide4'"~k; tbevi)re advised to contact .the City of lephyrbills Building Departlent, (813)
<br />788~66tr.. " ' , . ..... .' . .
<br />. ~ . )0 ~ ,I
<br />, ,
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<br />. .Ii ..
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<br />FurtberJOre, if the owner bu. bired a contractor or contractors, be is advised to bave the contractor(s) sign portions of the
<br />'C~~~c~or:S~c~";of.Y1l,~ ilP'P.l~~UOA for lIbieb they will heJ.esponsible. If you, II the OIfDersign aatheconuactor,
<br />,-au are IndICating t6it you, rather than the contractor, are responsible for the wort. If the contractor wishes you to sign
<br />II contractor that' lay be an indication that be is not properly licensed and is not entitled to pmitting 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 heen provided with a copy of 'Florida's Construction Lien Law ~ BoIeowner's Protection
<br />Guide' prepared by the Florida Departlent of Agriculture and ConsUI8I Affairs. If the applicant III 1018OI1& otberthan the
<br />lowner', I certify that I have obtained a copy of the above described docUleDt and prlaise in good faith to deliver it to the
<br />lownerl prior to co.enC8l8llt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the inforaation in this application "is accurate and that all .ork will be ftone in COIpliaoce with all
<br />applicable laws regulating construction, loning, and land d8Vel9~. .' ' .', ' . . . <,
<br />
<br />Application is hereby lade to obtain a perlit to do work and installation as indi~tec1. I certify that no work or
<br />instal!,atiop bu'.cc.II8Ilced prior to 1~~8Dce of a perlit and that all-.oJ.'k .n.....! be,'*'.. fOlleC1,..., to._t s-.r," da of allla..
<br />regulafing,_trUc~ CUycocJea,ioning regulations, and land developllAt repJ."~0Q8 in the jud"'l~UOD. I also
<br />certify tIaat 1 understand that the .regu1ations .of other goveruental agencies aay apply to the intended wm:t, and that it is
<br />IY r8lpooaIbility to identifywbat actions I lust take to be in co,pllance. Such agencies include but are not lilitecl to:
<br />t Departaent ,of EnviroDlBDtal Regulation ~ Cypress Barbeada, Vetlandlreas and JnviroDl8D~f .a8D8itive Lands,
<br />, " . . Vater/Vastowater !reablent ". . , .
<br />t Southwest Florida Vater Mana!llll8l1tDistrict ~ Vells, Cypress Baybeads, Wet1anc1lreas, Altering Watercourses
<br />t Arl' Corps of Engineers - Seawalls, Docks, Kavigable Waterways . . , , ,~
<br />t Depattlent of Health' Rehabilitative Services, BnvirODleDtal Health Unit ~ Vells, Wastewater '!ieafieDt, Septic fanb
<br />t US BDvirODl8Dtal Protection AgencY ~ Asbestos abatuent
<br />I also certify that, if flU.atetial is to he used' in Flood Zone lA' or RA,etc. I, it is understood that a drainage plan
<br />addressing a lCOIpeD8ating voluu' will he subJitted wbieb is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance. . ,
<br />
<br />A pmit',nsued.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 shall issuance of a pewt pr~vent the BuUdlng OUiclal ~rOltbe.teafter
<br />requiring a correction of errors in plans, construction, or violations of any code. IVeIJ perlit issued shall beCDe invalid
<br />unless the work authoriled by such penit is co.enced within sillODtbs of iss.ee, qr if work autboriled by the penit is
<br />suspended or abandoned for a period of sillODtbs after the tile the IOrk is COIIBDced. One 90 day at8D8ioo of tile, IIY be
<br />allowed for the petlit with fee charge of $15.00. fbe atension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt he logged during each slllODth period, or the' project wUl be considered abandoned.
<br />WARJIMG '1'0 <*KIR:'. YOUll tA1~URB fO. tllCOID A NOIICI, ~F~."CBIIIHI MAY mULf 1M YOUI\ PAYING nla fOR DIPROVBIIm8 fO YOUR
<br />PROPUIY. IF YOU U!un 10 OBtAIH' PlWeIMG, COKSUL! 'lIIfH YOUR LIIDIR OR All AnoRIIY BlFORB RBCORDIJIG'YOUB JOIICI OF
<br />COMMEJICBMBII., 'JOBS, _ $Z,1O.O 111 VALUE DO MOl NBlD ro RBCOID AIID' POSf A 'MOIICI OF aJOIBIlClllD!I.
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<br />Sl~~ tElT~ X-_~ · 'J
<br />
<br />SIAU OF FLORIDA
<br />COODY OF
<br />The foregoing instrument wes acknowledged
<br />before me this , 19 by
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identification and who did/did not
<br />take an oath.
<br />
<br />SfAfE OF FLORIDA 0 ~.'
<br />coum OF LA"":>l 0
<br />The foregoing i:rtr;m~t was aCknowledged
<br />before me this - , "ZOOj1)y
<br />
<br />..~t3ZANG{S .(\It., LANE1<-
<br />who is personally known to me or who has
<br />prod ced
<br />as i tific t'
<br />tak
<br />
<br />(Si
<br />
<br />
<br />(Signature)
<br />(Name Typed, Printed or Stamped)
<br />NOTARY PUBLIC
<br />
<br />J,..~
<br />
<br />.
<br />(Name Typed, Printed or Stallped)
<br />NOTARY PUBLIC
<br />
<br />",,~\I~ R. Mark Willett
<br />$~ .~ MYCOMMISSION# 00262312 EXPIRES
<br />,~~} December 8, 2007
<br />,P,f..f,'$-" BONDED THRU TROY FAIN INSURANCf,1NC.
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