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<br />1\. [JUT ICE; OF DEED RESTRICTIOllS
<br />['lie ulldels.i<;jlled Ilnderstands that tllis permit mall be subject to "deed resLricll')ll'," \-Ilil(:h
<br />!lldY be !l101e restricl-.iIJE: than ':ity reyuJat-.Lnns, The undelsiqnec:l aSSllliles Lt::Sl)[!llsihi l),l.)' 1'1J1
<br />cOll\p.lianf:e 1'/Jth allY aphJLlcalJle deed lest;ict.iofis,
<br />B. lJi'l!']CF~11SEI) 'I:UIITR1ICTOHS Alii) CCJll'l'RN"l't)R RESPOllSlBlLI'I'IES
<br />.I f tile (J\'1l181 lias hi.red a contlacto:c (n conlracl.ors 10 undertake vlork, tlley may be u;Cjlli red
<br />1'u he I Jcellsed in acc(jl'dance 11.lI:h sl.al>= allcllocal regulal.ions, Jf Ule cOldlaclor is 11U\'
<br />Jicellsed as requi.red by lal'I, buth lh.;: O\'lIler and cOlltractor Illay be cil.ed for a misdemearllll'
<br />violati.ull unclel sLate la\!, If the (\I'mer or Intended cont.ractor are uncerl.alll as lu \-Ilia I
<br />Jic~!lsillg requirements Illay apply fer the inteJlcJed 1'01'1;, Lhey are advised lc, ,:ontac\ lhe
<br />City of Zepllyrl1Jlis Building DeparMnent., 8L:J-78CJ-0020,
<br />fUrUJerllli)r~, i f th~ U\'J[ler has IILred a contractor or contractors, he is advised to Ilal/e the
<br />t;O!ltral;t.or(s) sJ(Jn port jUriS of tile "Contractor 8e,.:;1:ions" of tills appJJcal:lntl fur \cihich they
<br />1/11.1 be re::;pollslbJe, If yuu, as tile olmer signs as the cuntractJJl', VOIl ale iw.licdl:IIlCj !(lat
<br />}fr.,u, laUler' 111611 the ,~r:Jrli:taCLor, ale responsible for the \'lOrk. 1 f Ule conlracl')j I.lislles
<br />}lCJIl t:() si'jll at> contractor that lliay be all illdica~ion t113l: he is !lot: properly I icenserl alld is
<br />110t cml.H led I:e, p8111lHtiny pdl1ile~lesin I.he City of Zepllyrl1i Us,
<br />(, 'J'R!\.tlSPORJ'ill [UII H'jPl\CT FEES I\UD [J'j'l f,I'l'Y ('UIII1Et''I J OIl f8E:S
<br />[), l'UIIS'j'RIIC'I'lIlUtl LIE.II LA\'J (CHAPTE:R 713, FLORIDA STNI'UT8S, AS l\HF.IJ[)ED)
<br />r '.:ertif'y' Lhal: I, i.he appLicant, ha'!e been provided vlith a cupy of "F']orlda's ('onst:rllction
<br />lien La\'! Hrjll\eoll1ler's Protection Guide" jJrepared by t.he Florida Department of !\gdcllitIlJB
<br />and C'onslllller l\ftalrs. if tlle applicant is someone other that. the' "ol^mer", I ,:er\fy t.hat J
<br />have ohtained a copy of the above descri.bed document. and p-cornise in IJClod faith 1:0 dellvel
<br />i I: to tile ",)v'lller." prien to commencenlent,
<br />F.;-, CUll1'Rl\C'j'UR' S/U\tHlE:R' S AFFlDAVIT
<br />1 certify Ihat all. Ihe lnfcJlmat.Lun in this application is aCCIJral:e and Illat all l.JOcl; 11ill
<br />he dOlle in cOll1pliallce vli.t_1i all ap[Jlicable lal'is reglllat.ing constructiclil, zonillY, and land
<br />developlIlE:iil ,
<br />l\F'plicarioJI ]S herehy made to obtain a peIlllir 1_0 do \'Iork and installaLion as ] IlCIlcal:ecl.
<br />'cerlify that no \'!()r!; 01 instaJlation has commenced prior 1:0 issuance of i:l pennlt: and I'hat
<br />aU 1'lOrk I'lill he perfoufled to meet standards of all la\'ls regulating construcl:ion, t'] ty
<br />codes, zOlllng reg\lJatiollS, and land rJeveloprnellt regulations ill t.he juri.sdict:iUll, J alsu
<br />certify that: I understand I'hat tlte regulations of other government.al agtJlI(,~les 1I1ay apply to
<br />tlle illtended vlork, alld l:hat it is my responsibility to idelll:ify 1'll1at actions I Hlllst I:ake to
<br />be ill ,;olTtplLance, SIICI1 aqencies include but are not I lllll ted to: *\lepart:menl ()f
<br />ElIV.l.l.'t)llmell l'a 1 Re(Jl.llal i nIl-Cypress Bayheacls, Hetland l\r eas altd E:nvirolllllelil a Lly ~,ens I t ive
<br />lands, \tJat:er/v'vasl:el'later 'J'r'eatrnent
<br />"'SOLlthllest F'Jocida i.IJater l'13nagement District-I'Jells, (~'ypress Bayheads, I'J811and !\leas,
<br />AI I er lilY VJa I. e rCiJlll ses
<br />*ArrllY Corps uf E.nyll18els-Sea\'laJ 1s, [jocks, 1'~avigablE:: Watel\'Iays
<br />*\.JepartfLlen1. oJ: fleaJ.Lh [, Hel1ah.i.lit3tive Services, Environmental Healt.h IJnLl.\'lells,
<br />\IJast:ellal er Trealmenl, Septic Tallks
<br />Ill, S, Ellvll ollmellLa i Prot.ection Agency-Asbestos abatement
<br />1 also certify t1lal:, if fillinaterial is to be used in E'luI)cl ZCJl'le "A" or "il,el'(' it is
<br />under-sl'ood ttlat a c.!lalllage plan addressing a "compensating vulullie" Iii 1.1 l)e snhmil.hecl llIli.cll
<br />is prepared hy' a prnfessional engineer registered in l:l1e StaLe of fil,'rida pri')L hJ peulii I.
<br />j s s uaJ](':e ,
<br />1\ pennl\:. issued sllalJ be l~Ollstrl1ed to be a licelise 1_0 proceed \,,jl:h t.ile \'Iork dllll Ilot as
<br />authority 1:0 violate, canuel, alter, OJ: set aside any provislollS of tile \'eclllli(;aL ,;udes,
<br />nOl shall issnance ('.if a permit prevent tlle Bui1cHng Official from l:lleJeafter re(jlllrlng a
<br />correcctiol1 uf errCllS in plans, construction, or '!.lolations of allY t'~ocle, F~\j8JY perm]1
<br />issued shal I become invalid Ilnless thE: \'IOlk authorized by sllch permit is COltllllencecl 111,Lilill
<br />S.1:: lliontlls of issuance, or i.f \'lOrk authorized by the pernti t is suspended or ahandoned for a
<br />pe):ioll DE six lliontl1s aJ'ter the time the 1'lOrk is commenced. OIlS 90 day extensiOll of l.illlS
<br />lIlay be aLloI'led for I.lIe permil I,ith fee cnarge of $15.00, The 8::tensioll silall he 18Cj\lested
<br />in V;r-1L:illg to tJle Building Official, An approved ills[1ection must: l,e J()(Jf.Jed d1l1111q each sj):
<br />liIl)f1th pe1'i ud, or [he p:coj ACt: I,d 11 be considered abandonee!,
<br />l'I!\RlllIH; Tn l.>\^lI1ER: YUIJR FJ\ILllRE TO HECORU A tl(lTI(~E UF (:(JI\1I'1EllCEll~~I1'l' [,ll\Y HF:SUl,'j III YOIIR
<br />!:'flill.)I; '!'VneE FlIP H1PR()\!E/'lEJ1TS 'l'f) '{I)IJB PROPERTY, lF 'fOil ItI'J'Etml'(} OB'j'I\111 F IWIIJCIII(." ('()I<ISIIL'I'
<br />iHTll YlIlJP. LF:lllJER OR i\IJ Nj"]'CIRI1E'( BEEORE RECORIlIIIC; YOIIR lIU'1'ICF, OF C:orl[JElICE:rlE;llT, ,lfiLlS IIIIIJEP
<br />$:2, suo 1 II V!\LlJE: Dr I IlllT IJEEll TO RECORD l\tlD POST A "ll0TICE: tlF ("UI"1l'lI~IJCI;:t'IF,II'l"',
<br />
<br />S 1 (;IlNI'UHE::
<br />
<br />t)vIJIlER 1m l\GEIlT
<br />
<br />SIGlJATlJRE;: CotITRA(:'['OR
<br />
<br />S'I'lI,TE OF FLORI llA
<br />COIlN'!'Y ()E' .~. .___.____.___..__ ____.________
<br />The to 1'e fJO i.11] illS l. r Lll1lent .\1 a s a,~ );no,,1 edged
<br />Before Ille t-lIis _____._ day of _____________, 2IL.__
<br />
<br />))y .--.".----. ---- ---....------.. ..-------.--- ,.- ."..-..-------.
<br />(Ilalne of person acknol'!ledgecl)
<br />[J \/110 is personally klJOI1Jl t.0 Ine, or
<br />
<br />ST!\TF~ OF F'L!)RI D!\
<br />r-; 0 lJ l1'1' Y () E'___._____ ________
<br />The foregoing JnstrlHlleJlt \'Ias acJ:!lo\.lIedged
<br />Before me this ._ ___day of---------------.., 211
<br />
<br />by __ _______________..._._____...._ ______m_..__ ___.
<br />(name of pS'rsoil itc:!;l1oVlledged)
<br />[llho is persoila.n.y kno\lI\ l:o me, or
<br />
<br />[J l'lllo has pIodllced___._________.________
<br />(lype of identificati.on)
<br />d II d \-1110 Ll did [] did II 0 t: t a j; e an 0 a t h ,
<br />
<br />[] \'iho 11 asp H)d II ced ____..______.__..__.__ __..____._.
<br />(Lyj:)8 of lrhmUf.i':al:iol1)
<br />ami "Ihe []did L}-J.1d !lol I al:e 2i1l oatil
<br />
<br />S.1'Jlla1'llre ot persun ta!:inq acl:nO\lleucJement
<br />
<br />,si',j1\at\lre uf person Loki/I(.J ackllCiHled':;l1l18Jlt
<br />
<br />[Jawe l. yped, pi ill t e' I or stamped
<br />
<br />lJame I.ypeel, iH i nl.:ed or sl:alll[)ed
<br />
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