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Attachment 6 <br /> CONTRACTOR <br /> RECONSTRUCTION/IMPROVEMENT AFFIDAVIT <br /> Folio #: Contractor Name: <br /> Address: License #: <br /> Property Address: Phone #: <br /> I hereby attest to the fact that 1, or a member of my staff, personally inspected the <br /> above mentioned property and produced the attached itemized list of repairs, <br /> reconstruction and/or remodeling list which are hereby submitted for a Substantial <br /> Damage/Improvement Review. These damages/improvements are ALL OF THE <br /> DAMAGES/IMPROVEMENTS sustained by this structure, and that all additions, <br /> improvements, or repairs proposed on the subject building are included in this estimate. <br /> I understand that I am subject to enforcement and penalties for violation action and/or <br /> fines if the inspection of the property reveals that I have made repairs or improvements <br /> NOT INCLUDED ON THE ATTACHED LIST OF REPAIRS/IMPROVEMENT to THIS <br /> STRUCTURE or any non-conforming or illegal structures/additions, or repairs is <br /> included to the existing structure without having presented plans for such additions. I <br /> understand that any permit issued by Indian River County or the appropriate <br /> Municipality pursuant to this affidavit does not authorize the reconstruction, repair or <br /> maintenance of any illegal additions, fences, sheds or non-conforming uses or <br /> structures on the subject property. <br /> See Attached Itemized List <br /> Total Labor & Materials $ <br /> Overhead & Profit $ <br /> Total Cost $ <br /> STATE OF <br /> COUNTY OF <br /> Before me this day personally appeared who, being duly <br /> sworn deposes and says that he has read, understand, and agrees to comply with all <br /> the aforementioned conditions. <br /> Contractor's Signature Date <br /> Sworn to and subscribed before me this day of , 20_ <br /> Notary Public <br /> My commission Expires: <br /> Indian River County Comprehensive Emergency Management Plan Annex III - Page 29 <br />