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<br />COND~T~ONS OF PERMIT AFFIDAVIT
<br />A.nOTICE OF DEED RESTRICTIONS'
<br />!be uDiii~rsigned UDderltaDds ttiat tbiapera1t lilY be subject to 'deed reatrictiOlli'wch lilY be .ore reatricUve tban City
<br />regubt:iOD&. lie \1IlderIigDeC1 illJUlelRlpoIIIibUitl for COIPl~ ,ith i111. applicable deed reatrictiOlli. '
<br />
<br />B. UNLICENSEDCONTRAC'l'ORS AND CONTRACTOR RESPONSIBILI,TIES .
<br />If the ~)d8t baa bired a l;lOIltractor or c:ootractora to UDdertike IIOtk, they lilY be required to be 11ceqe4 1A acc:o(c1iQce ..ith
<br />state a11d local regu!atiCl!l:l.;'. If tbeCOPtnctor ia DOt liC8D8ed ill required bylu, both ~e"m,mer andCQll~tor lily be
<br />cited fill a aiack!lWQl.,iOlitioo UDder ltate 111I. If the ower or intew1e4 COIltractor are'WiCertaiD as to wt lic8D8ug
<br />requiIellenta iii apply for theinteDdec1 IOfk, they are advised to COIltact the Cit! of Zepbyrbi11s Building De~~,. (813)
<br />188-6Hl.' .. -'. i., .
<br />
<br />, ,
<br />FurtberJlOre, if the ower baa bifed a contractor or CODtractors, be is advised to bave the CODtractor(S) sign porUooa of the -
<br />IConb alctor SecUoosI of Ws applicatioo for wch' they ,ill be reapooaible. If JOU, as the o.mer sign as. the ~tfactor,
<br />YOIl ilIe iDdicatiDg tbit,JOIl, ratller tbaD tile contractor, are responsible for the at. If the COIltractor wiahealOll to'.ign
<br />as COltcactor tbat U, ,be ill iDtUcatioo tbat be is DOt properly licenaedand ia DOt entitled to pemittiDg privileges ill the'
<br />City cf Zepbyrbilla.' . \ ' .' ..,' ,.
<br />
<br />C. ~L'RANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. !::ONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS )umNPED) .
<br />I certify tbat 1, the applicaot, bive been provicled vith a copy of IFloril14l'1 COIIitruCtiDll Lien LaI - JIoIecMDer'.'rotectiOll
<br />Guide" :prepared br tbe Florida DepirtleDt of Agriculture and COIIiWIU Affairs. If tbe applicaot is IIOIIeOIUl other thi.D the
<br />'OW8J'., 1 certifrtJait 1 biva obtoiDed i copy of the above deacribed doculIent and prOIiae in good faith to deliver it to the
<br />'owneJ:1 prior to ~"CfIMU!t. '. .. .'
<br />
<br />, ; I,
<br />
<br />E. !::ONTRACTOR · S/OWHER' S ' AFFIDAVIT
<br />1 cerLify tJait all tile .iDforaaUoil,Ja W..,applieaUOIl ia accurate and tbataJ,l alOlt "ill .be _ 'in eo.pliance wUJl'all
<br />applil:able 1_ regulating CODStruc~JODiDg,and land tlevelopleAt. .'. . .
<br />
<br />." ''':~'r;'''',,'''''' .,....~.,.,.". .' .,' . ..
<br />
<br />Applkation is ,Ilereby _to ob~ aperait to do 10ft awl iDatallaUOIl iIIiD4icate4. 1 certify tbat IIOtIOl't or'
<br />iDataUatioD baa torellaldprior~'J"*c,' Qfa;pemt and tbit all_t ,111 beperfQlJed to lilt ataDllarda of ill u.s '
<br />reguhting COBItrucUoa, C1ty.f"~JegulatiOlll, aDd lilld de'alopeeatrequlaUODI'in the juriadicUoa. I also' .. ,-
<br />eartHy tbat I UDderataD4 tbat tberegUlitiODi. of other go.eruental agenciu lal apply to the 1AteD4e4 uk, and that it 11
<br />IY rl!1;ponaibilitJ to itleIltifywt aetiOna Il\18t tab to be' in coapliaice., Such agencies' include bllt are DOt liaited to:
<br />* ~~!tJent of BDvirooaental Rectulation - Cypreaa Blybeada, Wetland Areas and InvuOIlII8Iltally _itive Landa,
<br />. '. "ater/"aatewatet lreataeAt ..
<br />t SoUi]lIIeat Plorida Mater llaDaQeMIlt. District - "elll, . Cypreaa Baybea4a, "etland Areas, Altering "atercouraea
<br />t !f!i Corps of Engineers - S...l1l, Docks, lav~giJble Waterways
<br />t ~~~tJent of Health , Bebabilitative Senicea. BDviIOIlIeDtal Health Unit - "ells, "illtewa~ TreataeDt, Septic 'IiDb
<br />t ~;~.vi(OIUIeDtal ProtectiOllleJency - labeatoa ibatuent. '
<br />1 alai) certify tbat, ifUU Iilterij! il to be used in Flood ZODe III or Il,ete.', it il understood that a drainage plan
<br />addre.i~iling a ICQIPtDIilting voluel will be subllitted which is prepared by a profeaaiODal engineer registered in the State of
<br />Plori-ie, prior to pmit ialUiDCl." .."."., .
<br />
<br />1 ptp:lit iaaued &ball be coaatrue4 to be a' UceD&e to proceecl with tile at aDd DOt as authority to violate, caocel alter, or
<br />6et ~ si.de any PCOVWOQI of the tecbnical c:odea, DOr aball iaalliDCl of a perait prevent the Building Official fro. thereafter
<br />requiring il correctiQQof mora ~plaD1, COIlOtructiOll, or vWatiODl of anJ code. Ivery perlit iaaued Jball becoIe invalid
<br />Wll~,1iI tbe IIOrk autborbld)Y such penit ia ~""ed -.itbiD SUlODtba of iaa\IanC:e, or if...k authoriled by the peiait is
<br />&USpuMled or abalVloPeel for i period. of aU IDIltba after the tile tbe uk ia ~,ced. ' (me 90' day ateAaion of tile, Iill be
<br />allo.leCl for the peQit "ith fee ~e of $15.00. Ibe ateAaloo aball be requested in vritiDg to the Building Official. An
<br />appl(fYOO iDapectioD lUSt be logged dur1Dg each aU IODtb period, 01' tbt project "ill. be conaitlered abaPdoned.
<br />WARJUM(; TO OWDB: YOUi FnWIlK TO PCOBD A 10llCK 0' .aItMIICIKBO' KAY RBSULT II YOUR PAYIHG nUCK POi lHPllOVlllEl'tS TO YOWl
<br />PIlOPUrtY. 11 YOU 111110 TO QBlW 'WIICl1G, COISULf ,.IUIH ,YOUR LDDBI OR AI lffORllY WORK BiCOBDlJiG YOWl 10fICK 01 ,
<br />ClIlItIlIOiIlIlIl'l. _1IIIIlIII~,~~.~ IIIl BOr _10 pClRU AlDPOSI1'BOr?Zd
<br />
<br />
<br />Sli;w~1UB1: oma OR AGm SlGIIAf~~-
<br />
<br />S'Ilfli OF PLOIUIlA . I .:
<br />COUJl'Irf OP
<br />'l'he foregoing instrument was acknowledged
<br />beflJI'B lie this ,19_ by ,
<br />
<br />. S'IlTI 0' FLWDA
<br />coum OP
<br />The foregoing instrument was acknowledged
<br />before lie this , 19 by
<br />
<br />",' ~.1' .
<br />
<br />whe? 1s per~onally known to lie or who has
<br />'produced
<br />as identification and who did/did not
<br />take an oQ.th.
<br />
<br />(Signature)
<br />
<br />(Name .typed, Printed or Stamped)
<br />~O'rARY PUBLIC
<br />
<br />who "1.s personally mown to .e or who. has
<br />produced -
<br />il8 .i(]len~ification and 1lI~ .4.i.d/diq ~ot
<br />taklj an oath.
<br />.' , '~ . < '. " ,
<br />
<br />(Si~iii,ilture )
<br />(NaJOEl 'l'yped, PJ"iD:ted orStuped)
<br />~i~:Y PUBLIC '" ..,. ,
<br />
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