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<br />CONOITIONB OF PERMIT A~FIOAVIT. _
<br />
<br />A. NOTl!;:S: OF DEE:a ~STRII~TIO~~ubJect to 'deed restriCUOl1I' wbleb ~f be II>te f8lUicth'e than t!tV
<br />the .underaigllul \lnderdl~ed t ll_~ ies~lI~IUt'i for COIpHancB with any applicable deed reatdctiooa.
<br />regulationa. ~'18 un ef.lgn U8_ r--
<br />
<br />B UNLIt"ENSED CONTRACTORS AND CONTRACTOR REBPOHSIBILJ1IES .... I .... Ith
<br />. ~ ~: t to d tat work tbey laY be required tl,' be UCeD8w n ICCOLIJance "
<br />II tho -.: L.. hired a "",tractor or contree orl .. . or. '. oil b I.. both lho -. lid alIItra<tot ..r be
<br />state and loc~' regulatiOll8. If the contractor it not hewed as requn '/ , In a. to what Ucenain
<br />"ted for a liRdeJe&nor violation under state law. If the owner or intended contractor Ite uncerta 9
<br />&1 t 1 f .~- intAftd-A work they are advised to contact the City of Zephrrh1118 Building Dapartlent, (813)
<br />requiruen 8 It'll app 'J or ~ _ I:V ,
<br />788-6611.
<br />
<br />FUltbeTlOre Ir the owner bas bired a contractor or contractors, be is advised to hal'l the colltnetor(8) 8ign portions of the
<br />-Contractor' ~;~;t'tion81 of thil application for Ihicll they w111 be rUllOOlible. If you, aa the 0IIDIl lign Q tlIe contractor,
<br />you lU'e incHr:tJng that you, raUler t.haD the contractor, ate relpoMible for the IIOrt. .If the COIltractor wllhu you to algn
<br />as contractor IJlat laY be an indication that he is not properly Hewed and ia not entItled to pu'lUt1l'lg prl'lleges in the
<br />City of leph:r MUs.
<br />
<br />C. TRAHHPOHTATION IMPACT FEES AND UTILITY CONlfBCTION FEES
<br />----. ~u ~
<br />
<br />D. CONS?L'RUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AHB.NDED)
<br />I certify thaFI, tb& applicant, hare been provided with a copy of 'Plorida'. COfIJtrucUon Lie Law _ lIoIecwer'. Protection
<br />Guide" prepi!!e' by the Florida Departaeot at Agriculture and COnBUIU Affairs. If the applicant is 1OIIOn8 other tbn the
<br />-0IIII8r", I cHtify that 1 bave obtained a rop, of the abo~e described docuJent and praltse in good faith to deliver it to the
<br />'owner' prio~- 1,0 COllUcel8nt.
<br />
<br />E. COHTHACTOR'S/OWNBR'S AFFIDAVIT
<br />I certif, thai JII tba infOllitJoo in thi8 application i. accurate and that all wort will be done io co.plianc8 with all
<br />applicable la. /I regulating conatruction, lOlling, and land deyelopleJlt,
<br />
<br />Application in he.rq lade to obtain a PIIIit to do IOr~ and installation at indicated. I eerUf, that 110 IIOrt or
<br />installation :au ~ced prior to iuuance of a penit and that all IOrl will he perfollled to ...t .taoderdt of aU Jaws
<br />regulating C(rllwtruction, Cit, cod., lOllIng regulatiolll, and IllJld de,elop.nt regullUolII in the juriac!icUOII. I 1110
<br />certify that .. l1IldU8tand that the regulations of other 90YBIUeDtal agenciu III' lippI, to the intended 1IIOl1, and that it is
<br />II'J responsibL it, to icl64tifl what actions I wst take to be in COIpliatlc.. Sucb IIgenciu include but Ile not Hltted to:
<br />t De~r~.d InYirOilllelltll RequlaUoo - Cypreu BaYbelda, Wetland Areas and BndrOllle.DtaU, 8enaiUve Landa,
<br />WaterlMutewatilr 'rutlerlt
<br />· Soutblfeat 'h1rJda Ifater HaDaoe.ent Dfatrict - Well., eyplet8 Baybeac18, Wetland Areas, Altering Ifatercoureel
<br />· ArIy Corp, !\,~ lP9ine.ra - Suwall., !loeb, lad gable Waterway.
<br />· Departlellt !~~ Health' Rehabilitative Berficu, BnvirOllleDtal Health 1JD1~ - lieU., Waata.tel Treatlent, Septic !an..
<br />I US Indron'M~!ta] Protection ~~ .. laheatoe abat8leJlt
<br />I also certi~, that, if fill llterial i. to be uaed lu Flood lone 'A' or 'A,ste.', it is UDderatood that a drainage plan
<br />addre.e81ng a "f'\lIP8JIHting yoll1l8- Ifill be sw.itted wbJch i8 pnpared bJ a professional engineer registered In the State of
<br />Florida prior j;" perJit iaauance.
<br />
<br />IlOtIit 1....1 aIlalI be _trued t. be a 11..... t. prot<!ooI oil/l the ..rl and oot II authorltr to .Iolat.. _I aller, or
<br />Bet aaide any : lto,illons of tbe tecJ1alcal codes, nor aball iSluance of a penit prevent tile Building Offici.l trOl tAereafter
<br />requiring a co, 'IecUon of error, in PIIDl, COII8truction, or YiolaU0D8 of any code. B'1lIJ penft S..ued 8Jl4U belDe fDUlJd
<br />unlesl lbe Mlr;; lluthoriJed by sueJI penit is ~ced within ail IODtha of issuance, or jf worlauthodled bl the pemit is
<br />'_001 or I~ed for a petiOlI of III ...tho atur tho tfoo tho IlIrl'l> -..oJ. Qoo 10 day OIteaoloD of tloo, 10' be
<br />allowed for tb penit with tee c1Iatge of tI5.00. !be 81tensiOD shall be requeated in wriUng to tbe Buildlug Orficial. An
<br />approved iOlpr',tJoa lUSt be logged c1uring each at. IOIltll period, or the project will be COIIffdered abandoned.
<br />IfIIIIIIIIC ro 011I. '. n: Y1IIllI rmlll ro IIOJID I IO\'ICS or llIIIIiICIIIIr illY IISILr I' IllDI 'UllIe: NICS P1!I 1IIrIIOVMurI ro Y1IIllI
<br />'BOPIRTY. IF' 00 ImHD 10 OB'J'U' rJIBCUG, 00118&7 WID YOOI LODII OIlIlmIIIIY U10fIB RICOIDIJG YOUI JOrICl 01
<br />OIfHINC . .1088 UIDIR lLUI IUD fO RBCORO UD POSI A IfIOrICl OF crMMbClMln".
<br />
<br />
<br />srw~ quJ~
<br />
<br />SrAn 0' nop 11
<br />COOllY OF~ s;. C 0
<br />Tbe foregO~Dg instru.eot -a8 acknowledged
<br />before lIle this 7 ~ ~ S , 191.i- by
<br />
<br />7e r$~"'-!lk /(Nq 0f1A. I
<br />who 1ft penfl)oally 'JrnOWD to .8 or who bas
<br />prOduced
<br />as 1 tiffcatiOQ and who did/did not
<br />take oat.h.
<br />
<br />BfAD or MIDI
<br />coorrr OF P i (\ E:: \ ~ ct s
<br />The foregoing inst~t was aCknOwledged
<br />before .e this _, /13 , 19~ by
<br />I
<br />11\.'0. ~.R...i.+ce.j
<br />who 1s~8ODlIUy Jr.n~to .. or who has
<br />produced ~
<br />as identification and 1fbo did 1d DO
<br />tllk~(oat~. 0) ()
<br />~.lA ex. L/~..-' R,~LV
<br />('Si'goature) C I ' L l ~ ~
<br />y 'D"", ex... , c CL4..
<br />'(Hue Typed, Printed or Stuped)
<br />HQ'l'DY PUBLIC
<br />1'E OF FLORIDA
<br />HOT AR Y PUBll C ~~~ APR 7. 1995
<br />MV GOMMI~,SIUO~El'lr:RAL INS, UN,),
<br />8r!~~ED TnR -
<br />
<br />
<br />, t'~,p~blc~~r1da
<br />~ MARILYN JANE NELSON
<br />My Comm. Exp. Feb. 25. 1996
<br />Comm, No. CC 183108
<br />
<br />1 ("I (~l ,-,
<br />
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