|
<br />t'lAR-11- '96 MON 14: 05 ID :
<br />
<br />TEL NO:
<br />
<br />IH02 P02
<br />
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />A NOTICR OF DEED RESTRICTIONS
<br />fb~ undenlgDtd uDderttanai tbat this perllt Jar be 8ubject to 'deed rt.tdctlw' which II' be lOll rauleUve than City
<br />regulations. !be UDderslgned 8IIUII. responlibility for cOIpliance with ani applicable died reltrictioal.
<br />
<br />B. UHLICBN ED CONT TORS AND CONTRACTOR PONSI ILITIHS .
<br />If the owtIer bu bired a contnctor or contract01'I to undertake JOrt, tlltr ., be r to be UCIJIIIl1l11 accordince With
<br />state and local regulatIonl. If the contractor 18 not l1cena8d I. required bJ I.w, both the CNDU ID4 COlluma.' .J be
<br />cited for a .114M1anor violation UDder .tate law. If the owner or intended contractor are IIDC8rta1n II to llhat licensing
<br />requirlEDtlu, apply for tlle intended work, they are addled to contact tht City of JephrrlalU. Building Departaent, (813)
<br />788-6611.
<br />
<br />FurthetlOre, if tJle OIIler baa bired a contractor or contractore, be is adviled to bay, tbe contractor(l) lip portlona of the
<br />'Contractor SICtiOll8' of tbis application for waich they will be ruponlihll. If IOU, 18 tile 0IfJ18t lip II tile contractor,
<br />you are in4icaUag tbat JOIl, rather than the contractor, Ire responaibl. for the IIOrk. If tbe contractor wllhu you to lign
<br />as contractor that ., be an imUcation that III is not properly Hewed and la DOt entlUed to per.ittillg pddlegu in the
<br />City of Zephfrbll1..
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNBCTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS MINDED)
<br />I certif, that I, tbe Ippl1cant, 11Ift beAD provided .itlla copy of 'Florida'. CODettuctioa Lien La. . ~I. Protection
<br />Guide' prepered by the Florida Deplrtlent of Agriculture and CooaUllf Affair.. If the appllcant 1& IOIIllD8 other than tbl
<br />'owner', I cutifJ that 1 hive obtained It copy of the above ~8Scrlbed 40cuaeDt and prmd.. ill gOOlJ flltb to IlBliYer it to the
<br />'owner- prior to COIIBnC8lent.
<br />
<br />E. CONTRACTOR'S/OWNBR'S AFFIDAVIT
<br />I certify that all tU infoIlaUon In tbll applicatiou is accurate and tbat III wort ,ill be _ in COIPUuCl1Iitb all
<br />appliclble In. regal.tiDg conaUuction, loninv, and land deVllopllllt.
<br />
<br />Application i. bereby Jade to obtain a per.it to do 1IOrt and in8tallation II iadicated. 1 cartifr tilt DO work or
<br />i08t811ltlon bu CDI8ICIc1 prior to !aBuUce of I petlU and that alll10rk .UI be ptrfoflBd to _t ItlD4ardl of all II..
<br />regulating construction, City codes, lOlling regulatiOl1l, ID4 land d.velopleAt tegullUou In till jurlld1ctloD. I also
<br />eertif, that I undtrltaad that the regulaUonl of other vo'e.ruental I9IDClu III epp1r to the iJJtlDl!el1lJOrk, IDd that it 1.
<br />-r respon,eibllitr to fdeutlfy IhIt actions I IUlt take to be in colpliance. Such agenc1a iDe!udI but are DOt UJited to:
<br />* Departlent of InYirOlllelltal Regulation - Cyprus Barhuda, "etlanc1lreu aDd InviroueataU, -Uhl LaD4a,
<br />Ifater/Mutnater freatlent
<br />· Soutbnat Plori4a Ifater IllllaVlIeIlt District - VeIl., Cypress Bayheada, Wetland Itlll, Altering lfat8rcour...
<br />· Arty, CoIlll of Ina'1n8en - BeavaU8, Docks, lavigable Waterways
<br />* DeDlrtleat of IIIltb . Rtbabllltati,. SerriC81, Invironaental Healtb Unit - WIlli, Iflltewater fr.atl8nt, Septic 'anks
<br />* US IndllllllllJtal Protection IGtft.9 - IabQtOl abatllent
<br />I illO certlf, that, if f111 IIterial 11 to be used in Plood loDe "A- or -.,etc.-, It il under.tood that . dra1nlge plan
<br />adeJreasiDg I -~ltlDg VOIIIIe- .IlI be suhlltted Ihleb i. prepared br 1 profeufODlI qinllI reglltared 1D the State of
<br />Florida prior to ptrlit i..uanee.
<br />
<br />
<br />A penit iuued .11 be construed to be a license to proceed .itb tlle IOrk and not u autboritr to dolate, caacaJ. alter, or
<br />Bet aside an, prodliOlll of the tecbnlcaJ codu, Dor ,ball iaauance of . perltt prevent tbe 1ai141lll Offlciallrcll tlttrllfter
<br />requiring a correction of errora in plw, COJ1IUuction, or violatiOl18 of aDY co4t. Itttr pemJt laull1 ..11 becaII maUd
<br />unless tb8 IIOr1 autJloriled by 8uch perllt Is CGalDced within silllOl1tbs of i8luance, or If "Ork lutbor1l1l1 by till penit is
<br />suspended or lhandorJed for a period of .UIODtb8 after the t1ae the vorl1e ~cec1. €m 90 air uteuiaa of u., ., be
<br />allowed for the petlit .ltIa fee cbarqe of '15.00. file e.tlDlion 'b.ll be r:equllte4 in ,dUng to tile Building Official. An
<br />approved iaapectiou _t be logged during eaell ail aoatll period, or the project will be CClUiIlIl'lId abaDc1aat4.
<br />WAIlING fa (11II: YOOR 'I[LORI !O 1 1I0rleR 0' CCIaIDCBNIJf MAY Rl8ULf II 1001 PIYlIG MCI POI IMPIKMIIm8 '0 rOOK
<br />PIIOPIli!J, lP llIIlllllllD 10 IIBI' .1 G, CIIISOLT 1111 , lDDII oa 111_ ~I1IIIlIIlIICJ 01
<br />C cmar. JOBS II '2,5 II VALUI DO lor ffUD fO RICO AID A 'lotIa .
<br />
<br />,
<br />
<br />: COITIACD
<br />
<br />9 Service Ins
<br />~ 770
<br />II OF FLCIItDA b -..n U"Lll.
<br />coum or ~(( ~ (:) Cf) Ll'J ~
<br />The foregoing instrument a8 acknowledged
<br />before 118 this mA.tjc~J!, 19..1..k by
<br />:fa k.(\, A. 1 e..,f '/
<br />who 18 personally knowlV'to IIi or who has
<br />produced' )J A
<br />8S i entification and ~bo did/did not
<br />ta e an oa .
<br />
<br />,NOTARY Exp. 1
<br />PUBLIC ~ d By 5etvice Ins
<br />SrAr! OF FWRJDI 01, f\,Otf N.9. CC334770
<br />COOllY OP \.-L \ \",-b of 0 u... a ~l~'" lJOlherl,o.
<br />The foregoing iDstru.ent waa acknowledged
<br />before .e this ~ Arc...'" \,1 , 19.:lJ:2... by
<br />-
<br />.:rbh^ A. \ ~ fry'
<br />who is pflfSODlIII11y known /to.JIIt! or who has
<br />produced . IV / A
<br />~~tificatiOD ODd wbo did/did not :
<br />tak ~oa~~W 1
<br />~1' ~OY ~
<br />(8i9nature)Vt.-l't~ F". \)6N"AUL
<br />
<br />(Hue Typed, Printed or StlllPed)
<br />NOTARY PUBLIC
<br />
<br />
<br />
<br />(8i~.pture) 1 V
<br />K~\ + ~ r. )...,J-c1Y\ A-L-r--
<br />(Hue Typed, Printed or Stlllllped)
<br />NOTARY PUBLIC
<br />
|