|
<br />CONDITIONS OF PERMIT AFFIDAVIT
<br />It - NcnICB OF nlED RBSTRICTIONS
<br />!be undersign" aerltaDda that tbie pel'lit IlIf. be subject to 'deed restrlctlonsw wbleb laY be "rt restrictive than City
<br />regulatJODI. !be UDdersJgned ...ute. responsibility for COIpllance with any applicable deed restrlctlOD1.
<br />
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />It the CInar baa blred a contractor or contractors to undertake work, they lay be required to be licensed in accordance with
<br />state and local regulations. If tbe contractor 18 not licensed 88 rlQUired by 1., both the ovne.r and COI'1tr~ ., be
<br />cited for a lildueanor violation under ltabllaw, If the owner or intended contractor are uncertain as to what liC8J18ing
<br />require.utJ ., apply for the intended IfOrk, they lire advlse~ to contact tbe City of Zepbyrbll18 BullrUDg DtpIrtIeDt, (813)
<br />788..6611.
<br />
<br />FurthBmore, If tbt owner bls bired a controctor or contractors, he 18 advised to ha'e tbe contractor(l) lign portiOll8 of the
<br />'Contractor Sectional of this application for vhicb they will be responIible. If you, as the OlDer lign II the amtractor,
<br />you ue indlcatlog tJaat fOu, rather than the contractor, are responaible for tbe vort. If the contractor ,i'beI you to 8ign
<br />ill amtlllctor tbat la' be an indication that be is not properly licensed and 1I not entitled to per.!tUng privilll9u in the
<br />Cit, of ZepbJrbllll.
<br />
<br />C. TRANSPORTATION I~PACT FEES AND UTILITY CONNECTION FEES
<br />
<br />o. CONSTRUCTION LIEN LA" (CHAPTER 713, FLORIDA STATUTES, AS AMBNDED)
<br />I certif1 that I, the appliCant, baYe'been prOVided with a copy of .Plorida's COnatruction Lten taw . HoIeoMDart. Protection
<br />Guide. prepared by the Plorida Depattlant of Agriculture and ConsUler Affain. If the appUClllt 1I1011Oft1 other than the
<br />-OMner-, 1 certif, that I bave obtained a cOP1 of the abo~e ~.acribed docUlent and prOllse in good faith to deliver it to the
<br />-owner- prior to ~C8ll8nt.
<br />
<br />E. CONTRACTORtS/OWNBR'S AFFIDAVIT
<br />1 certify that all tbe InfoIlltlon In this application 18 accurate and that all wort viII be done in COIpliance with all
<br />applicable 1... regulating conatruction, laning, and land developlellt.
<br />
<br />Application fa betUy Rde to obtain a parlit to do work IIId installation as indicated. I certify that DO vort or
<br />installation baa cc.IeIlcecl prior to issuance of a perlit and that all work will be perfoIHd to leet 81'.1Ddard1 of all laws
<br />re;ulating CODItruction, City codes, loning regulationa, and land developlent regulation. in the jurisdiction. I allO
<br />certifl that I understand that tbe regulations of other goyeIDIeDtal agencies Jal apply to the 1n~1d work, an4 tbat it il
<br />~ reapc:ulbll1tr to identify wbat action. I lust tate to be in co.pliance. Such agenciu includa but are not lilited to:
<br />t DepartJent of !nvlrOflleJltal Regulation - Cypress BaYbea~, Wetland Aroas and BnYirOllleJltally Senait1ve L_,
<br />WaterlWilt..ater rreatlent
<br />t Soutbwut Florida Water HanaQlleftt District - Wells, Cypreas Baybeads, Wetland Areae, Altering Watarcouraea
<br />· ArJf Cortll of blaen . 8.a1l8, Docks, lIavlgable Watenlays
<br />I Depui:llDt of BeaJth , RebabUiutbe BeniCBI, InvlrOlll8Dtal Health Unit - lfe11l, Wutbater Tn.tleDt, Septic tanka
<br />t US lDvi~tal Protectilll Ja8llCY - A8butoa abatuent I
<br />I allO certlfr that, if fill.terial is to be used in 'load Zone IAI or 'A,ete.., it 18 underatooc1 that a drainage plan
<br />acldreulng I 'COIIIpeIIsaUng '01.' .ill be lublit.ted whicb il prepared by is plofeSlfood engineer f89i.tered in the State of
<br />Florida prior to petlit i.sUlftce.
<br />
<br />A pettit ielUed sball be construed to be a license to proceed with tile work and not as authority to violate, cancel altlr, or
<br />aet Slide any provisions of tbe technical codes, nor ahall issuance of a petitt prevent tbe Building Official frol thereafter
<br />requiriDg a correction of error. in plus, con8trucUon, or dolations of lUll code. 1Y8IJ pmlt luued allall becaIe malid
<br />\IlllllBS the vor. hthorhed by 8uch penit is COIIenCed within s1l IOntba of issuance, or if IOrk lutborlJed by the penlt 18
<br />sU8peDC1ed or abaDdoD84, for a period Of 8il IOlIths after the till the wod 18 CDIIIlced. One 90 day ateuion of tile, lilY be
<br />allowed for the peqit ,ith fee cbarge of '15.00. fbe extension sball be requested in writing to the Building Official. An
<br />approved lnapectioo ut be logged during each 811 .:mth period, or the project will be COQidere4 aHnbed,
<br />WllIG to (MIl: YOOR PAILIJRI to RECORD A NOfICI OF Cl.>>OIIlCB'MIJI! MAY RESULI IN YOUR PlYING NICI FOR IMPROVIHIIrs ro YOUR
<br />PROPDn'. IF YOO IJIJDD to OBfID FIIIIICIIG, CO.SOL! WIr8 YOUR LBJfDIR OR II I",ORXIY BlrDRI RICORDIlfG YOUJIIfOIICI OF
<br />CC>>III1fCDIm. JOBS UIDIR '2,500 I. VALUI DO Nor MIllO fa RECORD A -NotICE OF ~
<br />
<br />
<br />~~
<br />
<br />
<br />r2...
<br />who i
<br />produced
<br />as ident
<br />take atI
<br />
<br />
<br />~r who has
<br />
<br />SlGQTURB: CONmCfOR
<br />N, ~~~M~~-~M~~~Y(
<br />~ ~s'~ --:r;:
<br />SfA'1 01 FLORIDl/) ~
<br />COOIfY OF f"A 5'( 0
<br />The foregoing 1~trum8DtMa.aCkDOWIGd98d
<br />before me this tJ o-e , 19 9/, by
<br />
<br />C; (l€ C rJ2, 'n,I'Y1-t' r
<br />who 1s pers lllli-..Jmcncn;to. IIIe or who has
<br />produced ,'LJ r L f c..-
<br />as idant cation and who did/did not
<br />take an 4th. ~.
<br />~1
<br />
<br />,t~ (' (It) / U-
<br />(Hame Typed, Printed or Sta.,ped)
<br />NOTARY PUBLIC ....
<br />..;:;~ ~" OFFICIA~ SEAL
<br />l ~ \ SUS/'J A. MC>COLLUM
<br />ill ~ ~ ~. .. .
<br />: ~'~1"' . r"J C:>mmlsslon Expires
<br />\ ' ; A;HiI 16, 1997
<br />'''~OF~'' Comm. No. CC 268679
<br />.........
<br />
<br />
<br />StIB or ~
<br />coom OF {\~c ()
<br />The foregOiDg instrument was acknowledged
<br />before me this d- 0 , 19 Cj f., by
<br />
<br />I
<br />
<br />cation and who did
<br />tho /J1 ('
<br />
<br />IlJ t!.J ((61 /~
<br />(Nue , Printed or Stamped)
<br />NOTARY PUBLIC
<br />.........
<br />.....~~ ~~" OFFICIAL SEAL
<br />
<br />I ~ \ SUS".N A. McCOLLUM
<br />: . Jt. : r,ly Corn mission Expires
<br />\~ _; A )rf116, 1997
<br />.. ....
<br />.... OFFISJIl..- COm!.I. No., CC 268679
<br />*........
<br />
|