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<br />CONb:ttl10N*t.\tP..I~d~FFIDAVI'r
<br />A. MaTtes OF DJWI~1!11"'r~1~?l~r~"';'" '....,
<br />'he IlOder_I9ft" IItI1tntt*...taa. hi. ......=...,~..."......', ,:...!ltiloi!....;nebldlons. whleb lay be lOre restrictive than City
<br />regulatlontt. tilt UIII1er.l....fc.....i ' " .. ,lftrtOf".11Mtt _llll t1f,.Ucable deed resUictions.
<br />, . ....,:. '-':';
<br />
<br />B. UNLICBNS.IW co AND COM It RESPONSIBILITIES
<br />If the OWIK!r W'h t ..... .'.4 .' ". .... ...... .~.. "...,btteqUlred to be Ueensed In accordance with
<br />Btatt! aOO loe" ttgttllU.~..If: u.......tot.t ',llOtUtMltdll.ttttalrt4 byla1t, bolb the owner .JOd contractor JaY be
<br />cited tor a .tedMednltt flol.UOd _tlttte.d. ttU...f tit liltinc1tc1 contractor are uncertain as t01lhat licensing
<br />rl!gulrdiRU II' appl, tctt. UII.1nl..... .., t.be, It. .....,lotollUcl lbe eu, of JephrrbUls Building Depart.lent, (813)
<br />188-6611. '. '" .
<br />
<br />Furthertote, If the oMntr has hired a conlraelor or conlractdtl.be tsid,IBed to ha,e the contractor(s) sign portions of the
<br />.conhllttor heU..' .tUtI. ",Utlll... for tthlclt t.her .Ul be t'l!spclI:Ilible. If you, as the owner sign as the eonlnclor,
<br />you arl! 1~lc.Un!i that JOO. t.tlllr th... the eonttatlot, ate t..ilblt! tor the worl. if the contractor wishes you to sign
<br />88 c:ontrllctor that ta, be en lnalcaU..tltat bill not propulr:lIcwl!l1 and 1. nol enUtled to perlllUng privileges in the
<br />City of Zeph,thlll..
<br />
<br />c. TRANSPORTAtION IMPACT FEES AND UT1LITt CONNECTION FEES
<br />
<br />D. CONSTItUCTION t.IEN.{jAW ' (CIlAPTEIt 113. FLORIDA STATUTES, AS AMENDED)
<br />I c@rtlf, that I, the appllclnt. blfl'bllnprotlaea ,Itb a tOpf of -'10rlaa'8 Construction tlen Law . HoIeoNner's Protection
<br />Guide" prepared br tht 'ltJrla'lepitUMt!of 19r1cultut.lnc1 toaUMr Affair.. If the appUcant i8 sOleone otber tban tbe
<br />.00mer", 1 cerUt, that 1 ltatt.obtaiHCt a topt of the abot. c1eaerlbt!t1 c10tuIent and prOllae In good faith to deliver it to the
<br />"owner" prior to tOIIInc:ellnt. Ii.;; .. ·
<br />
<br />,.;,,'i i
<br />
<br />E. CONTRACTOR'S/OWNSR'S AFFIDAVIT
<br />I c@rtif, thalall the lnfor.llon In tll..ppHcaUon I. accuratl! and lhat all wort "nl be done in cOlpliance with all
<br />appllc:ablt! la". tlgUllUIIlI tCIIIltntUOd, ..lng, anc1lantl....lop1eDt.
<br />
<br />
<br />::::~;::r..l::= =:-~~t:t,.:ti=:;~jt::.':Jf:::i~.~I~?:~:~l.~' all la..
<br />
<br />regulating conetrueUCJni tltt...,.;~,...:.,tAeMi~ .....;'....' ....l..t, r....laUoo.ln)be juriadiction. 'I'also
<br />cl!rtUr that t tndtnlenc1 that, the' tIfIl.U.'bfoUtet ..W_...tll _1....' appl, to Us . Intended vort, and tbat it is
<br />If rl!8po1illbHUr to I.Uff.whlt .cu~t~~':!";~!:IItJl_'~UInCt. Buch agenc:111 Include bllt are not HIUed to:
<br />. DepartBt of ....lr.-W ..laU.'" et.t.....,IIRdI, wUlna Ar@a8 and BndronHnlallr Sensitive Lands,
<br />, . . . ..... ...1 ,IM./lMtn.ltttt.lJtenl
<br />. SouUnreat 'lorla. ..lU=tD=ct..-........,....I..l...".'.."C..'. p.tttI........ 1hd4.' Wetland AreaB, Altering watercour. ses
<br />. IIrl' Corpa of' IMlneerl";; ., ~tB t~l__l'''tlda''
<br />. De artBt of lIed~d'; . . lUUt.:~8triltd....>lftt1tOlllltUl...ltb Unit - Ve1l8, lIaslewater 1reallent, Septic 'Ianks
<br />. us Iodr_tal' '.'~f\ ..b.~ tMenl; . . . I
<br />I aha certlfr , .... al"t.ti::betthc1 'III' tll:lOl1'lCIII~t 'A' ot 'A,fJtc.., It is understood that a drainage plan
<br />addrl!8Blng a 'c:otpMIIUntt'ol,,',_UI be....Uted .hlell.... preparl!l1 bf a professional engineer registered in the state of
<br />Florida pdor to perIU.lmalltt.
<br />
<br />. "pel.it iSlued .hall be con.trued to be:. lltena. lo prOtted 11th the work and not as authority to violate, cancel alter, or
<br />Bet allldY IInl pmllloM ofjtllet...let1....'lIDr ...U......IIlCI of a pet.1t prevent the Building Official frol tbereafter
<br />requldng I cot~tlOd o. emtt 11..1.~f"lriitUOll/Clf'lbl.Uon. of an; toc1e. B.erylltnlt 18suec1'ahaU.'beCOl8 III,aUd
<br />unleBII the ItOt. .u~d...'br~,....1....~."r~.lInWl.l~:,.llilOOt.b8 ofl..uance, or Uvork authoriled by the penit is
<br />lIullpenc1ed or abanc1onea' fot . ,.rJlMllJf,~I.~:".tttt>1h1'tJiI"o.e' IfOrl ili ceJllii!nced. On8 90 day eltension of U.~, lay be
<br />IIl10wed for the \It!fllt tflth'M chargeef tl i~;;~~~" *"'11 \Jt requested in wdUng lo the Building OffiCial. IIn
<br />avpro,ed Intlpl!ct1b1t lU.t~logg,,"altdng '. . .JltJ6d'ttf the project erill be con81aelec1 abancloned.
<br />1IIIR"IIIC to _At. IOOItAl...,1O,:R~'A;,M" .., ... MAY IlBsUt,r III YOUR PAYl"G I1IICK FOR IHPROVEHRRTS TO YOUR
<br />PROI'IRTt. l' 10U 1_1tI.ld'tl_i~"",'_RORlIf AttORlfBYBB RDING YOUR ICOTI~ OP
<br />CONfIJltf ' " ' '.' ;~t' .. . POI OF ClMSNI
<br />
<br />
<br />
<br />, ,
<br />
<br />STAlK OF FLORIDA ., , 8tAT' U, FLORiDA
<br />count OF f)AsCq . . .. mum OF j)A:se D
<br />The tort!guing in8ttuJl8l1t WII . ,"knOWledged !\., 'rh~ foregoing instrument was acknowledged
<br />before lite thi" $:;-pr ~ . 19JiL. ..bt " ".I.",belore lie this .,Si:::'7r..23 , 19 98 by
<br />
<br />~'/ JJA;..) IELS .... .'.... ?i1 Y I?JA JJ I t=LS
<br />who is personally known to .e -er whe has . Mho is personallY known to me SF 11119 biU;
<br />p.csdtleetl r},J, t, "ittoAIt(,H
<br />as ideHtlfieet:i811 end trbeJ-fitlldid ,taot , ,* ", '.... itleHUf:l oatis.... and wbo tHd-/did not
<br />take art oalh.. . , ' '," ." ':,.,:.t.ke 8Il0Qth.~d.1e~ 4J ~j,~~
<br />
<br />(Signature) . tI 'f
<br />( Signature, /GIll '-'= . '" "... I::'A-nIt BEN ~ 131<0 W J
<br />-(Hame Typed, Prilltedor stllllPl!d) ., (Ihllfte Typed, Printed or S amped)
<br />. · ~ 'MOTARY. PUBLIC
<br />NOTARY PUBLIC ~'\"6.e(;.. KAT;I'::~N'I BROWN .. , ." ,.
<br />*.. * My Cc. '"'!ssion CC40480111
<br />". ~ expire" Apr. 02, 1~
<br />~~ ~
<br />~ Df ,~o'lf.
<br />
<br />
<br />""I'~ Pile
<br />."" n (;.. KATHLEEN J BROWN
<br />* 'IiiJ! * My Commission CC4490~
<br />'" ~,!It explr.. Apr, oa, 1888
<br />~~ ~~
<br />I DF f~\)
<br />
<br />".,.-.._"----_..,..~',.-,
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<br />,-~"''''---"---'''"..,.'"'.,.-,.,.
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