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<br />...1 UL-~.::.JL' C;d~! JIIU, 1o:::..1c:,. ,--I~ J. LJ ~
<br />
<br />ILL 111-,-
<br />
<br />. CONDITIONS OF PERMIT AFFIDAVIT
<br />A ~ NOTICE OF DEB>> RK8TRICTIONB
<br />. fire umlereiglll4 uadantlDc1l fhat tbl. pel'llt .Y be 8ubject to 'd88d rettrietlonal wblch ., be IOn rntrlcUYI tbID Cit,
<br />regul.tlOlll. flte UDderllped UIUIII rUpoJlJlbllJtf for mlpliante lith IIlJ applicable deed rutrlcUCIlI.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If tbll 0IIIH!l' IIu lUred I eontractor or Contractors to Wl4ertuI .or., the, la, be rlCJuirtd to be lIC8111ea In .cc:onucI with
<br />.tatl IDd local ngulatiOQl. If the contractor il not licenleo .. reQUired brII', botll t)Je GIller Pel rmtr.ator II, be
<br />cited for a IlldMlllOr "olatlon WIder Itate Ialf. If the owner or intended COIluactor are uncertain II to ....t lIclDllag
<br />requifIMDu IIJ IPltlr for the Intuc1ed IOrk, the, are telvbed to I!OIltact tbl City of !epJlyrhUla Building DlparUent~ (813)
<br />788-1611.
<br />
<br />FurtbeI'lOre, if the GIller bat birec1 a contractor or contractors, he II advised to ban tile contractor(a) Ilgn portions of the
<br />lCOOtractor 8ecUODI' of W. applicaUon for vblch tbe, will be reapooaible. If JOll, u the VlDllr alVD u tbe contnctor,
<br />rou are ln41catlng that JOU, rlther tIIan tbe contractor, are tlBpolllible for the work. If the c;ontrllctor .1.... lOll to .lgn
<br />u coatractor that ., be 1ft lmUcatioa tbat be Is DOt properly HClDleel ana 1& not entltllll1 to pen.ltt.lag prid1.. In tile
<br />'City of IePbJrbllla.
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILI'l'Y CONNBCTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certif, that 1, tile appllcUt, he.. been prO'fidlll ,itlla copy of 'Florllla'. CCmltructfon LIID LaIr - B.uaer'. Protection
<br />Guidel preputll br the Florida DeplttleDt of Agriculture and ConsDler Affaire. If tile appl1cilllt I, IGIIOIII otlaer thin the
<br />'OIlIer', I tlrtifr tbat I lIP, obtained I copy of the above dB8Cllbed dDCUHDt IDa prOliBe In goo4 faitlt to Gelher it to the
<br />'owner' prior to ~ceMDt"
<br />
<br />E. CONTRACTOR'S/OWNER1S AFFIDAVIT
<br />I certifr that all the infotlltion In this application ia accurate and tbat all work ,ill be done iD eQlplllDCI with all
<br />applicable 1_ regulatlag c:outructloa, lonibg, ID4 Iud a".JOpItIlt.
<br />
<br />Application 18 hereby lade to obtain a pettit to do work and InltallatioD u indIcated. I clrUf, that no wort or
<br />. lutallaticm bu ~cBc1 prior to 188uence of . perJit anl1 tllat all vorl vIII be perlo_ to .et 1Wdm11 of IllliNl
<br />regulating conatrueUon, Cltr COlIn, loning regulations, and land dev810pllllt regulations In the juri14Ic:Uaa. I 1110
<br />certl!, tbat I underatana that tlle regulations of otber goY8tDl8DtllI agenci81 .J .ppl, to the lat_1ll! IOrk, ua tbat It II
<br />If ruponaibiUtr to identlf, what actlonl 1 IUlt tlke to be in ~llance. Such aglDda Include but ate not llalt14 to:
<br />· DepartllDt of Iadtoll8tal Rl!IIIlatlOll - Cyprul Batbeada, Wetland Iteu and BndtonllDtallr 8wlthe r.ao4I,
<br />MaterfVl8t..ater trlatleDt
<br />· Soutbwut Floria Vater NanaG8IIDt Diltrict - WeUe, Cypress Baybea4., VaUand Ireas, Iltulng lfaterc:aur8.
<br />· Any COl'Pl of lD11uen . 8U1111't Docks, IlrJgabllllatlna,e
<br />t DeJtlfUeDt of ....U j RlbabUltaU" Services, BDdrQIII8Dtal lultll UI1it - 1.111, la_ter Ir..bent, Septic flDl:.
<br />· DB 1Il,~ta1 PratIet1I1l IaeDCI - l8butol abat_t I
<br />I also cartlf, that, if fill IItltlal 1. to be used in Plood Ion. III or IA,lte.w, it I. understood tbat I drainage plan
<br />ldd1'uling I lCOIP8IIIItfng 101.' ,UI be 1w.IUel! wbieb II preparlcl by a professional eDglnaer ",lltered III tha state of
<br />Plorl<1a prior to peOllt illUlftce.
<br />
<br />A pel1Iit IssUICI ,ball be eoutrued to be a 11cenle to proceed with the work and Dot aa autborltr to ,lolita, c:ucel .lter, or
<br />set aalde anr provllloaa of the technical codee, DOt lhall issuance of a pII1lt prlJent the Building Official fa tbullfter
<br />requirift9 I correctlCIJ of errorl it pIa, COIlIUuction, or v!olatloDl of &Dr coae. huy perllt 1"IIe1 ....11 .... malia
<br />Wll... the work ...tJlorilld br aum pe.ralt 18 co.enced within sil .ntbl of issuance, or If vorl autIIorile5 bf till plrtlt Is
<br />BuspeDC1ed or abubec1 for a periCM1 of 811 IODtbs after t)Je U. till work 11 ~clll. 0118 90 llar IItalon bf tilt, .J be
<br />1110184 for tM penlt wiU. fee cllarge of .15.00. the utwlon 11II11 be f8IJUUt84 In wrlUng to tile 81114109 Official. In
<br />approved illfpectJou IUIt be lOfted duriog .ach ablOllth period, or the project ,ill bl couillend abIDdoIlt4.
<br />IWlIIIIfG ro c.u: YOOR FAILURI YO RICORD . IOfiCK or CNlCIIfII! MlY RlSUL1' II YOUR PAlllG rllCS POI IJIPROYJlUlllld 10 YOOR
<br />PJIOPlRfY. If 1m II!IID ro OBtAII JIIUCIIfG, COISOLT WITH YWR LUDIR OR II AIIORm 11_ IlIaIIDllfG YOOII IOtICl OF
<br />CDlllllCIIIDf. JOBS UIDIR U, 500 lor mD YO RIC01m AKD POS! A .1000ICI OF C(JIIJfCIlIIIIIr'.
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<br />f~a1LU--
<br />
<br />
<br />
<br />811ft OF J' fl
<br />coomor oe as
<br />Tbe foreqolnq ~~t~ft waB acknowledged
<br />before.. this - l , 19 qs bl"
<br />
<br />t 0
<br />o Ite or who bas
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<br />,,',W.;:'f~O:" JOYCE D. GUTHRIE
<br />f:~\"rA) "'~l MY COMMISSION # CC 207363
<br />~~:'~7.,:'rf EXPiRES: July 19. 1996
<br />~~:lK:~~~~"" Bonded Thru Notal)' PubHc Underwriters
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