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<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A. Ncn.I~ OF DBBD RB8'1'ftlCTX0N8
<br />Ibe undmlga UDdIrItm!s tllat tJala pera1t lay be subject to 14814 restriction. I .bieb .., be lOre fIIulcUv. thBD City
<br />regulaUCIIlJ. lilt _.mglld ..... .rupoDlllbllltf for ~lbnC8 with aDY applicable 4ee4 rllulctlou.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tile ower b.. blte4 . coatrattor 01' contractors to wtclertake tIOrk, the, lay be rellUite4 to lit l1C8J18ed III accordance "ltb
<br />state and local regu.ltt10111. If the contractor 18 Dot licen8ed as required by law, botll tile 0IIlU aDd c:ontr.elm la, be
<br />cited for a .l~r violation under .tate la.. If the orner or intended contractor are uncertain II to wblt lIC8ll8ing
<br />requlr~tlllIJ apply for tile intent1ed lIOrt, ther ate advised to contact the City of Zepbrrbllla Bu114.lDg ~t, (813)
<br />. 188..6611.
<br />
<br />E. COH'l'RAC'l'OR' S/OWNER '8 AFFIDAVIT
<br />I certlfr that III tbe lntollltJon in tbi8 application ia accurate and that all work viiI be done In COIPllaace .Itb all
<br />IppUcable 1_ regulating CODItr\lction, lOlling, and 1ll1d a"..1o,.lIt.
<br />
<br />ApplicatlOD I, bereby lIde to obtaiD . pmit to do work and installation a. indicated. I cerUfr th4t r-j IOrk 01'
<br />lDltaUaUOIl baa ~cea prior to iuuanee of a perllt and that allllOrk will be perfoned to w:: 1tuaard. of all In.
<br />regulating CCIGItruct.iont eltr codes, lOlling regulations, an4 land de,elOplent regl1latlOlll In the '~td.dictiOl. 1 1180
<br />tertii! tJIIt I unc1tr.UDd that the regulations of other go,elDllDtal Igenele. Ii' apply to tb8 lIlt8D48l1 .It, and that It 1.
<br />If r'lpoII8lbUlt, to id.tif, Ibat actions I lUSt take to be In COIPllancl. Sucb liganei.. include but lrt .1IJt Ibllt84 to:
<br />t DeDar_t of BD'irOlll8Dtal Regulation - Cyprus "yhsada, Wetland Area. anG Ittvirolllentallr Balli'(C it-I
<br />lIateI/1Iutevater IreatleDt
<br />I 8oU.tMat rloridllfatu Jlaua.,.mt District - Welll, Cypress Baybeads, 1letland Areaa, Alterino lfatercourlSl
<br />IItIY COrDI 9f _~"f1 .. a....u., Docb, "'igable Waterways
<br />I ~t of IIIaltb &,1Ibab111tatlJe SmiclI...r. InvlrOJlltlltal Health lblit - Well., 11l8tnater Irll_t, septic !WI
<br />t l!f ,luinllllatal Protectll1lla1DcJ .. A8be8tol abat_t
<br />I also certif, tbat, If fill IIterial i8 to be used in 'load ZODe IAI or IA,.te.l, it is UDder.tood that a 4t.lnege plan
<br />ac1drUllng a .....Uog tOl.' ,ill be euhlitted wbich il preparec1 by a prof_joMl enylDeer regl.terec11a tile State of
<br />Florida prior to petitt illUilftCI.
<br />
<br />A penit iuaed 1hil11 be coDltrued to be a license to proceed lith tile IOrt and not as authority to ,lolate, CIDCIlalter, or
<br />ut ali48 IDJ pmhlQ118 of the technical codes, nor sba1l1sIuance of a pen1t prevent tlIe Building OfUelel fa ther.aUlr
<br />rllJUirlng . correctloa of errora In pIa, construction, or Yiolatiou8 of anJ COde. herr pemlt 1med aba11 beeme iDvalid
<br />001811 thla IOrk autbariled bl IUch petitt Is cc.enced ,dtbln 811 JOIltlll of lUlIIDce, or if IOrk lutharlle4 by the pel'llt 18
<br />8uapeDOed or ebIIII1oIIII1 for a pul04 of .1& Jontha anII' the tile the VOlk 18 cx.eDce4. Ooe 90 tal ut_ldD of tble, ., be
<br />allOMec1 for lbe pmit lith fIe cbarge of $15.00. tbe ealenalOll sball be (8lJIl88ted in "dUno to the Bullting Official. An
<br />approve4 lupect1aa _t be logged duril1g each Iii .nth pBf'iod, or the project wIll be CCDi4erll1 "'Id.
<br />IWUIIIG to MIll: YOOI '11_ to IBCOID I IOIlCl 01" CCIIIICIIIII! MAY RESUL! II YOUR PAYIIG ftflClIlOll UIrIlORUU8 '0 YOOR
<br />PROPIIIY. II YOU IIDlD ro onlll FIIWtCIIIG, COIf8ULIlfIIH fOUR LI1IDI1l 01 AI AnoRQY ..,. RICORDIIG IWR MICI OF
<br />0IfMI~. '2,500 II VILUI 00 1l0l0lD fO RICOllD AID POSI I · OJ: ~..
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<br />81
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<br />BUI. 0' PLCIlDA
<br />coom 0'
<br />Tbe foregoing in8t~t was acknowledged
<br />before.. thi8 , 19_ by
<br />
<br />stlrE OF FLORIDA
<br />COUII't1 or
<br />Tbe foregoing in8t~t was acknowledged
<br />before me thil , 19 by
<br />..
<br />
<br />who i8 perlODaIly known to m. or who has
<br />produced
<br />18 identification and who did/did not ..
<br />take 8ft oath.
<br />
<br />(Signature)
<br />
<br />(Kame TJped, Printed or Stamped)
<br />ROTARY 'UBLIC
<br />
<br />who 11 perlonally kDo.n to .. or who has
<br />produced
<br />a8 identification and who did/did Dot
<br />take au oath.
<br />
<br />(8igneture)
<br />
<br />(R.me Typed, Printed or st88P8d)
<br />NOTARY PUBLIC
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