HomeMy WebLinkAbout112 E 1st St 12-1238 Install Fence and trellisCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $ . 2Ct ''
Job Address: i E /yy 5 Historic District: Yes ❑ No ❑
Parcel ID:
Description of Work:
Plan Review Contact Person:
Phone:
Name
Street:
City, State Zip:
Zoning:
Title:
Fax: E-mail:
Property Owner Information
Phone:
Resident of property?
Contractor Information
Name Phone: S��l'= %f3__ MIW
Street: 2 cfi Gam! ;o Fax:
City, State Zip: Sf411zl' if/ State License No.: a, e
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E -mail:
Bonding Company:
Address:
Mortgage Lender:
Address:
PERMIT INFORMATION
Building Permit ❑
Square Footage: Construction Type: No. of Stories:
No. of Dwelling Units: Flood Zone:
Electrical ❑ Plumbing ❑
New Service — No. of AMPS: New Construction - No. of Fixtures:
Mechanical ❑ (Duct layout required for new systems) Fire Sprinkler /Alarm ❑ No. of heads:
OWNER BUILDER STATEMENT /AFFIDAVIT
Altamonte Springs, Casselberry, Lake Mary, Longwood, Oviedo, Sanford,
Seminole County, Winter Springs
Florida Statutes are quoted here in part for your information to indicate the authority for exemptions for
homeowners from qualifying as contractors and to express any applicable restrictions and responsibilities.
OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DIVISION TO SIGN THIS DOCUMENT
BY SIGNING THIS STATEMENT, I ATTEST THAT: (Initial to the left of each statement)
Rev. 9.14.2009
I understand that state law requires construction to be done by a licensed contractor and have applied for
an owner - builder permit under an exemption from the law. The exemption specifies that I, as the owner of
the property listed, may act as my own contractor with certain restrictions even though I do not have a
license.
I understand that building permits are not required to be signed by a property owner unless he or she is
responsible for the construction and is not hiring a licensed contractor to assume responsibility.
I understand that, as an owner- builder, I am the responsible party of record on a permit. I understand that I
may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed
in his or her name instead of my own name. I also understand that a contractor is required by law to be
1 }
licensed in Florida and to list his or her license numbers on all permit and contracts.
I understand that I may build or improve a one - family or two- family residence or a farm outbuilding. I
may also build or improve a commercial building if the costs do not exceed $75,000. The building or
residence must be for my own use or occupancy. It may not be built or substantially improved for sale or
lease. If a building or residence that I have built or substantially improved myself is sold or leased within
7
in 1 year after the construction is complete, the law will presume that I built or substantially improved it
for sale or lease, which violates this exemption.
I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction.
I understand that I may not hire an unlicensed individual person to act as my contractor or to supervise
persons working on my building or residence. It is my responsibility to ensure that the persons whom I
S11
employ have the licenses required by law and by city ordinance.
I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an
owner - builder permit that erroneously implies that the property owner is providing his or her own labor
and materials. I, as an owner- builder, may be held liable and subjected to serious financial risk for any
injuries sustained by an unlicensed person or his or her employees while working on my property. My
//
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner-
injuries my
tJ
builder and am aware of the limits of my insurance coverage for to workers on property.
I understand that I may not delegate the responsibility for supervising work to a licensed contractor who is
not licensed to perform the work being done. Any person working on my building who Is not licensed
must work under my direct supervision and must be employed by me, which means that I must
comply with laws requiring the withholding of federal income tax and social security contributions
under the Federal Insurance Contributions Act (FICA) and must provide workers' compensation
for the employee. I understand that my failure to follow these laws may subject me to serious financial
risk.
Rev. 9.14.2009
1 Application For a Certificate of Appropriateness
t ICiRilj City of Sanford Historic Preservation Board
1877— P.O. Box 1788
Sanford. Florida 32772 -1788
Phone: 407.688.5145 Faz:407.688.5141 Email: www.sanfordfl.gov
Answer all the questions on this form and submit all required attachments. Incomplete applications will not be reviewed.
If you have questions about application requirements contact the Historic Preservation Officer at407.688.5145 to ensure
your application is complete. A building permit may be required for the activity detailed below. Please contact the Building
Department at 407.688.5150 for more information. Failure to obtain a building permit may result in fines and/or double permit
fees.
1. General Information
Downtown Commercial Historic District 0-"Residential Historic District ❑ Is this a retroactive request? ❑ Yes ❑ No
Is this application filed in response to a Notice of Violation from the Code Enforcement Department? ❑ Yes eNo
Property Address: 1 i Z F 1 &} :S� ee T
Property Owner Information
Print Name: W P C, K LL }'
Mailing Address: fC 1 �� �' lif nke r L 3 a� a
Phone: ,/ r - nax:.7/1 Email:
Sig I tun�tl/n
ApplicantIA rmation ` �7 1 I
Print Name: sa mafv � c_ Sam f � / S�e y'e 1� �c �1Gt -G S
Mailing Address: —420-4` S Savjoc-d L 30- 7-1
Phone: -"IOZ Fax: Email: the b(- ee.Z_e,.f&4 ir-es4 aff Citl�C V0.�no
Signature� —
I certify that all inforhiAtion contaTqi
Applicant/Owner Signature:
®°Would you like to receive emails
and accurate to the best of my knowledge.
ZD
Historic Qservation and Community Planning within your community?
2. Application Category (check all that apply)
Proposed improvements will affect the following elevations: ❑ North
K South ❑ East ❑ West
X Site Improvements /Driveway/Walkway ❑ Storage Shed
❑ Replacement Siding /Floor /Porch
❑ Replacement Windows or Doors ❑ Underskirting
Signs /Awnings
❑ New Construction /Additions )W Paint
Fences /Gates /Pergolas
❑ Roofs /Gutters /Downspouts )R�AC /Mechanical
❑ Other
3. Description of proposed work
Completely describe the entire scope of work, including changes in material
and color, and methods that will be used to
accomplish the proposed work. For large projects an itemized list is required. Use the reverse side if necessary.
AQID<a401 ko �C46 -m an Crc4����cE�f -.1
e, v
* * ** This certificate must be pro-minently displayed on the site when work is in progress. * * **
Co M
.a
i
I
a� .
F
LLj
E
LU
CD,=4
IL
X=s