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<br />, II 'I "-"~- -"....' ".... .,.'.
<br />
<br />. . CONDITIONS OF PERMIT AFFIDAVIT
<br />A. IfOTICB OF DJtm RKSTRIC'l'IONS . .
<br />fbe uader.lgaed-UDdIrttaD4t thitiEbfl pi'tllt lay be subject to 'deed re8trittlone" wbleb lat be tore reatrlctlvl than eitr
<br />regulltlaol. rbe uDder.lgntd aSIUltI responsIbility for cOIplfance with any appliclhl1 4eed :cltfletiODl.
<br />
<br />8. UNLICBNSBD CONTRAC~ORS AND CONT~CTOR RESPONSIBILITIBS
<br />If till CMltf bu blrH'~i- contractor or contractors to undertake wOrk, they Ii, be r84uirec1 to he lie_lid In ICC:Or4uce 11th
<br />ttate - local regul'UDDI. If the contractor te not licensed u require" by In, both the owner ana contractor ., be
<br />clt8cl for I l11de1eanor violation unaet alate law. If the owner or Intended contractor .r8 WlcertalD as to wbat lIeHling
<br />requirellOts II' appl, for thu intended work, they are advieed to contact tbe City of lepbft~illl BulldiDg Depertleot, (813)
<br />788-6611.
<br />
<br />FurtheflOre, If the owner baa blred a contractor or contractore, be 18 advised to bay. tbe contractor(l} aiga portiGal of tbe
<br />'Cootr.ctor Secti_, of this application for .bleb tlley "ill be IlUJponsible. If you, u the OImBI .ign as tbe CDIItllctor,
<br />Joo It. Indicating that you, rather than tbe contractor, are responsible for tbe work. If the contractor Illb.. JOI1 to lip
<br />U COIltrlctor that lilY be an indicltion tbat be 18 not properly Heenaed and Is not entitled to penittlD9 prbU. iD the
<br />City of ZepbJrbll11.
<br />
<br />c.
<br />
<br />TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />~'~._--~~.'---'------"'--"--_._-- !
<br />
<br />D. ~OU!TRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMBRDED)
<br />I certl , t I, tbe Ippllcant, baye been provided with a copy of 'Florida's COn8tructlon Lien Law - BoIeoMDer'. Protection
<br />Guide' prepmc1 by the Florida DepertJent of Agriculture and Conllu'~r Affaire. If the applicant I. IClMIORe otller tbln the
<br />lOIftlr', I cartlf, thlt I hay. obtained a copy of the above described docuaent and prOlise 10 good filth to da11,er it to the
<br />'owner' prior to COIIIftCBllRt.
<br />
<br />E. CONTRACTOR'S/O~S:R'_~..AFFIJ)AVIT
<br />1 certif, tblt all tbI infOrJation In thil application i. accurate and lbat all work viII be done in COIpliaaCl _ltb .11
<br />epplieabll I... regulating construction, loning, and land developllnt,
<br />
<br />Application II berebr lade to obtain a perlit to do vork and in.tallatlon as indicated. I certlfr that no work or
<br />lutaU.tloa has u.enced prior to issuance of a per.it IIId tbat alllfOrk wUI be perfoned to .et It_ra. of ell III.
<br />regulating COIlItruCtion, Cltr codu, loning regulations, and land daveloptent regulationa in tile judlC11ctloo. 1 allO
<br />cerUf, that I und.r.tand that the rIIg\11ations Df other 9OY'tnIeI1tal agenet.s HJ apply to the Int_1Id IOI't, _ lUt It i.
<br />fI1 r8lponaibilltr to identif, "bat actions 1 lUst take to be in co.pHanell. Sucll agenda incluc1e but UI DOt U.ited to:
<br />t DDJrt.lent 9f InvlrOlllefttal Requlatiof! - Cyprus Barheads, lIetland AUS8 and InvirolllMullr S_lthe LaDeJ.,
<br />: Water/Wastewater 'reltJp~t
<br />I !QiatJllelt 'Iod. "aur Jlaoag~t Diltrlct - WeUI, Cypress Barheads, Wetland Area8, Altering lIatercolIf8eI
<br />· IrIr CorDI of IDrIDtItI . SeawallS, Docks, NavJgable Waterway.
<br />t ~t Df IIIltII , hbilbllltati,. Seniels, Ba,irouental Health Unit - We1l8, Wastewater 1'r8ltl8nt, Septic lanb
<br />· US Inl~tal Protect1~ 1Q1ftc.Y . Albtstos lbatuent
<br />I .lso cartl'r that, It fill llterial is to be ueed in Flood Zone -A' or MAretc.', It 18 underltood that a dralnege plan
<br />Iddrllllng a 'eDIpID,.ting volU18. will be eubllttea whiCh is prepared by a professiODal engineer registered In tbI State of
<br />Plorlda prior to peIllt illuance.
<br />
<br />I pIlItt 10u14 lball be COIIfItrued to be I license to proceed tilth the !fOrt and not al authorltf to dolete, CIIICIl alter. or
<br />let I.ide anI provlalODI of the tecbnical codes, nor shall issuance of 8 ptrtit prevent tbe Building Offlci.l frol tbarllfter
<br />requlrill9 I correction of error. in plenl, COII8UucUon, or Ylolations of InY code. I.eq ptl'lit i8luad ebill beCOII1Dfalid
<br />unIe.. tile 110ft autborlled bJ 8um penit is COIIence4 within sillOntbs of issuance, or if IOrk lutboriled b, till panlit 18
<br />IUlpended Dr abiw1oDe4 tor a pedoc1 of eillOntbs after tbe U. the work is ~cet1. 0ft8 10 ...., eatlllllaG bf t., .r be
<br />allowed for tilt pm,Jt 11tb fee eIIarge of '15.00. tbe ut8l\81oJl sball be requeated In wdting to tile BuUtlag Offle1al. An
<br />IpptOYlClIupecUan IUllt be. 100014 during eacb oil IOBtll period, or u., project wUI be C01IIit1ere(J lbaDaoned.
<br />_IIG to 0InIIR; YOUR PAl CORD A MICE or mtmlCIJIBMI MAY RESUL' I. TOUR P ICI POll DIPROVIIIIIII 10 lOUR
<br />PIOPUff. IP!OO IIUID raIl f1 CIIfG, COR8ULI IIlIH YOUR LIJIDIR OR All A IFORI JIG YOOJIIOrICI 0'
<br />CDIDCIIIIIft'. J '2,500 1 UK DO lot QED 10 RICORD UD posr A III
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<br />
<br />StiR 0' MIDi
<br />coom 0' S? ~ _,
<br />The foregoiDg iD.t~ent was acknOwledged
<br />before .. this ~( ~ ~, 19 t:t It, by
<br />
<br />wbft.~il!~~ Dr iiliOiia.
<br />
<br />produced i-...l PI-... ~ ___
<br />al identification and who d1d/d~t
<br />
<br />~~r<_.~,
<br />(9Ilature) ~~ -.---
<br />
<br />
<br />srATI OF p~
<br />COUNTY OF "-Y ~)
<br />The foregoing in8trument wal acknOWledged
<br />before me this '01.f ;2. 3. , 19~ by
<br />
<br />~4~~~~
<br />who 1s personally known to .. or who bas
<br />produced ~ ~
<br />as identification and wbo did/did Dot
<br />
<br />t8~~.~~~~~
<br />~
<br />
<br />(Mae Typed, p .- ~~t8iipedI- - (Naie Typed, Printed or Stuped)
<br />RO'I'ARY PUBLIC NOT~RY PUBLIC _" "",>...
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