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<br />. CONbITIONS OF PERMIT A~FIOAVIT
<br />A.~rJCE OF DEED ~~STRICTIONS _
<br />Thl underll.1Id Unf.,...ndl thlt this ,erlit .., bf lubJlct to -d"d r,strlctlon,. which IIY b. 'Or. testrictive thin City
<br />tltaSlll'nl, T~. uftd,r.l,ned ..Iu.el responsibility for cD.ptl,nt' with Iny .ppll,.ble dlld reltrl~tlDnl. .
<br />
<br />B. UNLICEN$EQ ~DNTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If th. 'Wfter.bl' hlr,' I contr.ct.r or contrlctor. to und.rt.ke work, they IIY b. r!qulr.d to b, lic,nsl' In Iccer',ne, .Ith
<br />stlte Ind IICII Tfgul.tlons. If thl refttrltt,r is, not licensed as requir!d by I'M, both thl ownlr Ind contr.ctor .ay be
<br />clt.d 'Dr. tlsd.IIIDor .iDlatlon Ind.r Itlt. 1'1. If the oln.r or Intend.d cont~.ctor Ir. unclrtain ., to 'hat JicfRllnv
<br />rfqulr..rntl .ay apply f.r th. Intended IOrk. th.y arl Idvlsed to contact the City Df 2.phyrhlll, Building Depart,ent, (813)
<br />788-6611 .
<br />
<br />.
<br />
<br />Furth.r.orl. If th, otntr hi' hlre~ . contrlctor Dr contrlctor., h. II advised to hlv, the contr.ctor(s) sign portion. of the
<br />"Contrlctor B.ctions" of 'hiS .ppllcltitn for which th.y .ill .t rI5pon!ibl.. . If YDV, II th. owntr lion al the cDntractDr,
<br />you Ir. Iftdie.t1nt th.t you, rlther than lhl con'tactor, are rl'ptnsible fDr tht .ori, If the cDntrlctor IIsbes yov tD s19n
<br />II contrlctor th.t la, be In ladlcallon that h. I. not properly licens.d and 1s not t~titlld to ptralttln, prlvt!egls In lh,
<br />Clt, If Z.,h,rhllll.
<br />
<br />C. TRaNSPORTATION IMPACT .~~~S AND UTILITY CONNECtION FEES
<br />
<br />o. CONSTRUCTION LIEN LA~ (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I cfrtlfy 'hi' J, th. I,pliclnt, hlv. b..n proyid.d 11th. copy Df 'Floridl's Conltruction LI'n Law. HOI.oMnfr'. Prottctlon
<br />BUid'- pr.p.r.d ., 'h, flDrida Departllnt"f Agrlcultur@ and Conlu..r Affairs. If thl .ppliclnt II ""Ont oth.r th,n th.
<br />.Dwnlr', . clrtlf, 'hat I hi" I',ained . cop, of the Ibo,. delcrlbed dotu..nt .nd prolll. In 100' filth to dill,., I' to t~.
<br />"ownet' pri,r t. C"lencllent.
<br />
<br />, E. CONTRACTOa'~(QW~ER'S AFFIDAVIT
<br />r clrtlf, th.t 111 thl Inferlltleft in this ."Ile.tlon II Itclratl Ind thlt III wa'~ _111 b. don. In to'pllant. with III
<br />IppltClb.. I... ,..ul.tlnt construction, zoning. and land dlvllop..nt.
<br />
<br />· ApplJcltltft II h!,.by lad, to obt.ln I p.r.it to do IOrt .nd installatlen .. indlcat.d. I certify thlt no .ork or
<br />instlllltiDn hll cOI.enced prior to ilsuanee of I per'll and thlt It 1 MDrt will bl p.rfarlld to leel st.ftdatds 0' ell llw,
<br />rl9vlaling construction, tit, tOd's. loning "Qullllonl, Ind Ilnd dlYltlpl!nt r!gulations In 'h. jurisdictIon. I 1150
<br />e!rtify th.t I und,rstand thlt th, rlgulltionl Df Dlh.r govern..ntat Iglnei.. Ily Ipply to th, int.nd,d IDrk, Ind th,t it is
<br />IY r'lponslbility to id.ntlf, wha' 'ctlonl t lUll tlk, to b, in cD.plilnce. Such agenci.s lncJud. but .r, nDt ti.it,d tOI
<br />, OeDar...ft' Df ~"YirDn~nl.l RIDulatlon - Cypress alyhllds, Vetland Artal and Envlran..nt.1Iy 9,nllllve llnds,
<br />U.I't/N.steMat,r Trlat~ent
<br />· SDvtb~llt Fllrl'. Vatlt ftl~t.tft'JPllttlct - N,lll, Cvpress B.yheldl, V.ttand Ar.al, Alt.rin, lal.rtaut...
<br />t Ar.' CDrDs of EftGln'lr. - S....lls. JOtta, MI.1o.ble N.terwlYs .
<br />· ~'Dlttl'nt of Hlllth , Rlh.billeltlv, IIfVicll. Envlron'lnt.1 Health Unit - Weill, Wllte"lt.r Trllt..nt, Stptic Tlnks
<br />· US Eny'r'"lental ProtlC'iDn ADentY - A,b"'DI .b".I.nt
<br />t IIII t.rtlfy thlt, If fill 1.'.rl.1 II ,. b. u..d In Flood lon' 'A' or 'A,.tc.", It II undlrltaod thlt I drllnl,1 pl.n
<br />addr'!I!n, . Ico.p,nlll1ng VOlUllI will ., lub.ltlld which II p"plr.d by . profesliDnll Intlnllr r'9ilterld In thl 911tl Df
<br />Florid. prior t. ,.r.'t 1.luane..
<br />
<br />A plr.lt 1.luld Ihlll be eonstru.d to b. I llc.n., to prDclld lith th. Hork and not II lulhDrlty to viol.tt, tlnc,1 'It.r, or
<br />,.t I'id. .ny prDvlllonl of Ih' t.chnlcal codls. ner shill il.ulncl of a p.rllt prevent the Bulld1", Of lie I. I f,o. thlt.aftft
<br />requiring. rorrlCtl.n of ,rrOfS In pl.ns, construetioft, or .iolltiDns of Iny cod,. EVlry p.rlit il.uld shill hICOI. in,alid
<br />unit's thl IDrk luthDrllld by ,uch perlit 11 cDllfncld lithin six .onths of lssuance, or if lork autbori!'d by the ptr.lt is
<br />SUlptndtd Dr Ih.ndDned for I "riDd of Iii .onthl .ft.r th' tile thl ~Drk i. cOII.ne,d. One 90 day tlt.nslon of tl.., "y bt
<br />IIIDI'd fDr thl p.r.lt " f.. chlr,1 0' $15.00. The eltensl.n shill bf reqvested in Iritlng to the Building Officill, An
<br />,pprDv.d inlp'ctl ~.l b. 10 d during lath .1. .onlh ptrio', or 'hi proJ.tt will b, consld,r.d .blndDn.d. .
<br />N~RNJNS TO OU I YOUR F~ILUAE f RECORD A NOlIC' OF CDftftENCERENT RAy RESULT IN YOUR PAYING TWICE FOR I"PROYE~NTS TO YOUR
<br />PROPERTY. Y INTEND TO DB FINANCING, CONSUlT VITH YOUR LENDER OR AN AT E R~CORDIN8 YOUR NOTICE OF
<br />CDMMENtEIIE . O' VALUE DO NOT NEU TO RECORD AM& PO · J "IiNT".
<br />
<br />
<br />
<br />DrAU Of!' FLORIDA D
<br />COUNTY OF 'V ~ L
<br />Th. 10r"901n9 l~~ wa. ac~.n owledged
<br />bltfore Ill. thh , 1?~ by
<br />
<br />~x~~~
<br />
<br />who 1. p.raonal1y known to m~ or who ha.
<br />produced ~
<br />.. ld.ntlfic.tlo~ and who did/did not
<br />
<br />tak~f)1 ~
<br />
<br />(Slgnatur.)
<br />
<br />STATE OF F~ '
<br />tOWIlY O~ ~
<br />The 10regoin9 instrumtpt
<br />bcfc4re Iftlt th i. "Yl
<br />
<br />wa. ac lenow ll!dged
<br />, 19~ by
<br />
<br />
<br />who 15 person,l V fenow" tt;'~ or who h..
<br />produc:ed
<br />as identification and wh~ .~d/dld not
<br />take oath.
<br />
<br />
<br />- ~
<br />
<br />
<br />~.
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