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<br />COND~TlONS OF PERKIT AFFIDAVIT '
<br />A. nOTICE OF DEED RESTRICTIONS' '
<br />!be uiJdersigDed UDderltaDda tliat tbiapuaitay be Abject to 'deed reatric;UOII8', 'whieb ay be lOle, restrictive thaDCity
<br />reguliltiOll8. lbe UlldeBigae4 I8IUIIe8 ,reapoalibUitr for COIPliaIIce 11th lUll applicable c1eed restricUODI. '
<br />
<br />B. UNLICENSED' CON'l'RAC'l"ORS AND CON'l'RACTOR RESPONSIBILI.'l'IES" , '
<br />If the iJiiDet baa laired i QmtriCtoror CODtractora to lIDdertUe IIOrk, they IiY be required to be liceqe4 lA ICCOriuce ..ith
<br />state a1ld local reguli~.;'. If the coatnctor 11 DOt liceD&eC118 reQUired ))r law, ))oth thi:.m.mer aD4C01ll;rictor ~r be
<br />cited fllt i aisdeleaDOr "ioliuOllUD4er ltate law. If the 0lfD8(, orlAteoded COIltractor are' uiiCertaiD as to Mbaf liCllDiillg
<br />requilelleDU ar app1, for the 'inteDdecl MOlk, 'ther are advised to COIltact the Cit! of lepbyrhilla Building De~~f (813)
<br />188-6Ul. . ,," ; .....'.. " "","""d' "
<br />
<br />. ,
<br />FurthullOre, if the 0IlIlIr baa bUed a contractor or contractora, be is adviaed to ban the coDtractor(a) aiga portioDa of the
<br />'CootuiCtor SectiODl' ofWa appliCitiOll for .midi,they ..ill be reapoDiible. If fOU, as the ~ ai!Jll as the CQ,Pt[iC~,
<br />lOll an iAdicatiDg tbat.JOU, rathertball tile CODtriCtor, are rea(lQD8ible for the _k. If the COIltractor .iahea r~' to sigD
<br />~ CQ[lt[actor that lIIll.:be lUl iDdicatiOll that be is oot properly lieeDIed aDd is DOt entitled to peraitUog pdvil~~ ~ th,e
<br />Cltv [If Zenhvrbilla " "".' ' " ' ,. , . ' "::, d', :-:." ,..".
<br />" a-. ., . 0" '. I '
<br />
<br />C. ~rRANSPOR'l'A'l'ION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. !~ONSTRUC'1'ION LIEN LAW (CHAPTER 713, FLOllIDA STATUTES, AS'AHEN)lED1,
<br />1 certify that 1, tbeappliCillt, Jav.1leea provicled lith i copy of "Florida'. CoaatrucUoa Lie.a Law - HoIIeoMDer'.ProtecUcm
<br />Guide" :preparec1 by the Florida Departllent of Agriculture aod CoDa",.r Affairs. If the applicant is ao.eona other tbaDthe
<br />'ower', 1 certify that I tal,. obWDed i copy of the above deacdbec1 docwIeIlt aod prOliae in good faitb to deliver it to the
<br />'olllner' prior to ~l)~_i1t. ..,,' '., ' ,', '"
<br />
<br />, 1 I.,
<br />
<br />E. !::ON'l'RAC'l'OR'S/OWNER'S' AFFIDAVIT
<br />I certify ~t ill tbe'WonaUcm.~~applicaUOII'ia ac:curateaod~tall ak llillbe~'iJfC:olpllance.ith'all
<br />applkable lid regulating CODItruc~fiooiDgiaod 'laod deYelOplleAt. . - " , ",
<br />
<br />. ,"'<".:'.:''-'.~.!;'.','' ',' ".",.,':' .>....,.....~..,I. ~ ,""," . I
<br />
<br />ApplkatiOll 1Iberebr IadetOob~ilpenit todollQrk aD4 iDatallaUon l8iD4ieated.lcertify that 110 ak or.' '
<br />inataUat1011 baa ~eapti9r~']~~~Qfi:P,eWtaD4,tbatall.GJ- ,111i1i perf.to..~ atiDllarda of aU ~.a
<br />reguhting cooatructioa,' CityCodtlai'.~ .'~egu1iP0D8i an4 ,l~ de"elOPI8Dt .r~uliti0D8 in' the iud~ctiOll. I also '" .'..
<br />eerthy that I UDdarttiUlll that tile' rfl9ll1aUOU' of ., other goiUJllelltal agenciu' iiI apply to the intended IlOlk, aD4 that it 1i
<br />IY rellponaibilitr to ideDtify what ~tiOna llI\I8t tale to be' in COIPlialice., SllcJl agencies ioclude bllt are oot liaited to:
<br />* ~jltae.at of IDvirODlelltal Requ1atiOll - CJpreaa IIIrbeada, Wetland Areas aD4 Bn'irODIeDtillr Sensitive LaDda,
<br />. . .'.. ~ter/Ml8teAter !natleAt ' "
<br />t Sou~lIIeat Florida ~ter llanageaeot District - .UI, Cypreaa Baybeadl, MetlaD4 Areas, Altering "atercoUlaea
<br />* An i COrpl of Knqineers - Seawalls, Docks,' 'av~gable "ateEVaYI
<br />. .!!.I!llrtaent of Health' RehabilitaUve Senicaa. IDvirODlellW Bealtb Unit - MeUa, "illite.ilter freatleDt, Septic liUlU
<br />t y!"~vironaenW Protection Agency - Asbeatoa ibatuent, .
<br />1 alai) certifJ that, 1ffUl atetw 11 to be uaed ill Flood lODe "A" or "A,ete.', it is Ulldetatood that a iltaiaage pllUl
<br />addrelliinq a 'CQlpeDlitiDgVolUle' .illlle aublitteclllhicb 11 prepared br a profeaaiooal engineer registered in the State of
<br />fl1otid~L prior to pen1t ialUilACe..'"...". '
<br />
<br />A ~lIlit iaaued aball becoaatrued to be i liceD&e to proc:eecl .ith the tlQrk aDd DOt as authority to ,iolate, caDCel alter, or
<br />6et G side lUll pro"iaioDa of the tecbn1cal codes, DOt &ball iaa\liUlCe of a peIJit prevent the Building Official floa thereafter
<br />requi ring a c:orrec:UoQof eaor. ia .pljIDI, CODItructiOll, or violaUooa of lUll CQI1e. Ivery perait 18Iued Jiball becoIe. iDvali4
<br />unllUi a tbe IIork authori...,br allCb perlit ls COl!N8nctcl tdtJda au IODtba of iaaUitAce, or if.alO(k autbodled by the peBit is
<br />suspuuled or aba_eel for i peri04 of ail atba after the tiM the _t 11 COMInced. (kIe 90' day ute.aaion of tile, JIllr be
<br />alloulil for the ~t lith fee charge of 115.00. !be utension &ball be requested iIllldUng to the BuildiDg Official. An
<br />applllVOO inapectiOD _t be logged cluriDg eacb ail _tit peri04, or the ploject .ill. be COII8idered abiDdoDed.
<br />"AIUIl HG !O OWJIIR: YOWl FULUII !O UCORD A IOJICl 01 'CDHDCIIIUt' lilY USULr 11 YOUR 'AYUG !VICI fOi lHPJlOVIKD'tS !O YOUR
<br />PROPllIl'llY. 11 YOU QrBID !O OBrAIJI ,IWClJIG, COHSDLr .,tlIIH YOUR LIJIDU OR AM lnoRllBY BIPORK RiCOBDDlG YOUR 1I0rICI 01 .
<br />COUUUNIIT. -QIUII~'~QQ:II~ ~ go 101 IUD !O .-0 AID fOS! 1 '~R,
<br />
<br />
<br />Si(;JfJl7URi: OWl OR AGUI SlWfUBK: COftJlAC!OR
<br />
<br />I' : .~. :-
<br />
<br />SU!E OF PLOUDA ' .. .: .
<br />COUKWY 0'
<br />The foregoing iD&tIWIent was acknowledged
<br />befurB me this' , 19 by .
<br />'....,:.,,/\ . ~
<br />
<br />'. surK OP PLOR1DA
<br />coum OF
<br />The foregoing instrument was acknowledged
<br />before me this , 19 by
<br />
<br />\ ;, ~.,., j,. ,." ,
<br />
<br />whq 1s personally known to me or who has
<br />. produced
<br />as identification and who did/did not
<br />take em Oqth.
<br />
<br />(Signature)
<br />
<br />(Name '~ed, Printed or Stamped)
<br />~OTARY PUBLIC
<br />
<br />whol,s personally kAownto _ or who. has
<br />pr~j~ced .
<br />as :i.~lent1ficationand w~' ,4,id/di4, uot
<br />takl3 an' oath.'. " .
<br />. ." , '0.. .. .; ,- ~ . I~ .. ''; " 1 .
<br />
<br />(Si\jDature)
<br />(NalM~ Typed, P~iDted or Stamped)'
<br />~~:Y PUBLI.C
<br />
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