|
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. NOTICE OF DEED RESTRICTIONS
<br />!be underaigud WIlIer8taDd8 that thil pmit IlaY be lubject to ldeed rutrlCti0D81 ,bleb IlaY be _e restrictive than City
<br />regulatiClll. !lie lIIIderaigud __ responsibility for CCIIplilDce ,Ith any applicable c1eec1 ratrlctiCll8.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the OlDer baa bired a contractor or contractoR to undertab work, they _y be nQIIlred to be liC8lllld io accordance with
<br />ltate aocJ local regulatiou. If the contractor II lOt liClDl8C1I8 rep.lnd by law, both the OlDer and cmtractor III be
<br />cited for a lime.lDOr violation under state law. If the OlDer or 10teDded cootractor are UIlC81't:I1D 18 to ..t li..iDg
<br />reguir_ta IlaY apply for the intended work, they are advised to COIltact the City of lepbyrbilll Buildlog ~t, (813)
<br />788-6611.
<br />
<br />Furtbenore, if the OlDer baa bired a contractor or contractorl, be is advised to bave the COOtractor(l) lign portioIII of the
<br />lContractor SectiClllI of this applicaUoo for Ibieb they 1111 be responsible. If rou, 18 the OlDer sign 18 the cmtractor,
<br />you are iDllicating that JOU, rather than the contractor, are responsible for the work. If the cmtractor 'iIIIea JOIl to aign
<br />18 contractor that IlaY be an indicatioo that lie is not properl, liC8D8ed and is lOt entitled to penlttiog prililegll in the
<br />City of lepllyrbilla.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY COHNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMBImED)
<br />I certify that I, the applicant, bave been provided ,ith a copy of IFlorida's CCIlItructioo Liea Law - JIclIlI'-.rll Protectioo
<br />Guidel prepared by the Florida Departlent of Agriculture aDd ConIl..r Affairl. If the applicant il .... other than the
<br />lOIIIlIrI, I certify that I bave obtaiD8c1 a copy of the above described aocu.at aDd proliae III good faith to Wi. it to the
<br />10ID81'1 prior to a.eo~t.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify that all the ioforutioo in thil applicatioo il accurate and that all work ,ill be doDe io COIpliaoce with all
<br />applicable 1_ regulating conatructioo, lOlling, and land dml..-nt.
<br />
<br />Ipplicatioo il bereby lade to obtain a penit to do work and iDatallatioo 18 iDdicated. I certify that 110 work or
<br />iDatallaUoo baa CD InKed prior to iuuance of a penit _ that all work ,ill be perforB to _t .tIDI1udI of all 1_
<br />regulating conatruc:tioo, City cocles, lOlling regulati0D8, and lad deYela,..ot regulati0D8 III tile jurladlctial. I allO
<br />certitr that I understand that tile regulatiCllll of other gov_tal -..cia IlaY applr to the lllteoaea at, _ tMt it il
<br />If responsibility to identify "bat acti0D8 I lUSt take to be in CCIIpliaoce. 8ucb ageocia include but are IIOt li1ite4 to:
<br />t DepartleJ1t of IovlrDlllelltal Regulation - Cypr888 Barheac1a, leU_ Areas aocJ lo,irOlllelltallr Seasitive Landa,
<br />Mater/Vlltelater !reat:IeDt
<br />t Soutllle8t Florida later JIaDag_t Diltrlct - 1e111, Cypreaa 81rlleada, wetland 1rea8, Iltering latercouraea
<br />t 1rIy. Corps of lDgineerB - Seaulll, DocU, lavlgable latervars
<br />t DepartJent of Health , Rebabilitative Senlca, IDYIRIII8Dtal Health Unit - lelll, Mastelater lnatleDt, septic I_
<br />t US Ioyj~tal Protect1oo IgeDcy - I8bestoa abau.ot
<br />I also certitr that, if flllllaterial il to be used in Plooc1loDe III or II, etc. I, it il uoderatoocl that a drainage plan
<br />addreaaing a ICIIIpID8Iting vol.1 ,ill be lDittedlbieb is prepared by a profeaaioaal engineer regiltered III the State of
<br />Florida prior to perIIit i88uaDce.
<br />
<br />I penit i88ued sball be c:onatrued to be a liceoae to proceed with the IOrk aDd IIOt as autbority to ,iolate, c:aDCel alter, or
<br />set aside any provlliou of the technical codes, nor sba11 i8l1llDC8 of a pmit pre,eat the Bu11tliDg Official frill tllereafter
<br />requiring a correcUoo of errorl in p1aDS, CCIlItruct100, or ,loIIUC118 of anI colle. bur pemlt 111IIII111II11 __ IDtalld
<br />unl888 the I01't autboriled by lueb perIIit 18 c-.ocec1111Wo III _tha of i8lUaDCe, or if vort authoriJell br the PUJit il
<br />luspeOOecJ or abandoDed for a period of 811 _ths after the t1Ie the work II~. ~ 90 dar ateallll of t1Ie, IIJ be
<br />allond for ths pen1t "ith fee cbarge of .15.00. !be u_IeIlllll11 be reqauted in vrltiDg to the luiltiDg Official. In
<br />approved in8pectioo lUSt be logged during eacb IiI _th periCllJ, or the project ,ill be CCIlIldered ...........
<br />IfIIIUG 10 CIIIII: fOOl FIIWRlIO RIOOIID I DICE OF <ma.'~ ., BSULI II YCDI PIIIIG MCI MIl IIIIIBEII8 10 YCIJI
<br />PIlOPIRIY. IF YOU III'IID 10 OBIm FIDlCIIG, OOISOLI IIIB YOOII ,.. . D IIICIIIY BIfOIIIlall)UG .. DICI OF
<br />
<br />_.~~.IIIDIO_IID_I 'D1aW~~
<br />~ ~
<br />
<br />
<br />SliD OF ~
<br />aun OF ' r'AS'c 0
<br />The foregoing i2stl1ment was acknowledged
<br />before _ this Klt,il dr;:, 19~ by
<br />I
<br />(h "vhA-c-f Corrc /4
<br />wbo is persona 1y known to _ or who bas
<br />prodUCed~..I-(.,Q-fl ~(~ r..~
<br />as 1 t1fica ion and w 0 did/d1 ot
<br />tat an oath. I)fc~
<br />
<br />Si~~)~ A J1t (Co / / (f I'f/
<br />(N...,Typed, Printed or Sta.ped)
<br />NOTARY PUBLIC
<br />
<br />
<br />SlID OF rum~
<br />COOllY OF 'A seD
<br />The foregoing instI'UEllt was acknowledgecl
<br />before _ this JJ.ff,'1 ~5 , 19 9$ by
<br />II1I'vt~( ,Gilt. e,'A-
<br />who 18 per 11y known to .. or! who baa
<br />produced r r1 ~( \
<br />as 1d ification and ho d1d/d1 Dot
<br />tate oeth. j11(~
<br />
<br />i~U.e!~ If mf ~1/U/W1
<br />(N... !yped, Printed or St..,ed)
<br />NOTARY PUBLIC
<br />
<br />..~~... OFFICIAL SEAL
<br />....ofIJ.... ..~..
<br />.. ~" SUSAN A. McCOLLUM
<br />{ . a My Commission Expires
<br />\ ! A)ril16. 1997
<br />".SOF\f\.~.. Comm. No. CC 268679
<br />..........
<br />
<br />....~.~;;._ OFFICIAL SEAL
<br />{~-\ SUSAN A. McCOLLUM
<br />. ",,: My Commission Expires
<br />\ ';~!' ! April 16. 1997
<br />"'~~OFf\.~.. Comm. No. CC 268679
<br />.........
<br />
|