HomeMy WebLinkAbout2004 Sanford Avei
CITY OF 8,_ ANFORD
_ CITY OF SANFORD
APR 8 2010 BUILDING & FIRE PREVENTION
PERMIT APPLICATION
tion No: 0 t Docu Rd'sructi n Value: $ / 500Applica !
Job Address: oZQOy SANFOM AVC— Historic District: 'Yes ❑ No
Parcel ID:
Description of Work: voilet- StO1,U4
Zoning: /P 511 ed4 a
Plan Review Contact Person: r�vt�el Title: Owv�s
Phone: C4eD) fc21- 33 Fax: E-mail:
Property Owner Information
Name �DQ4el zukowski Phone:
Street: D OM .Sk yArd Aye Resident of property?
City, State Zip:
Contractor Information
Name
Street:
Phone:
Fax:
City, State Zip: State License No.:
Name:
Street:
City, St, Zip:
Bonding Company: -�—
Address:
Building Permit 13"
Square Footage: //
No. of Dwelling Units: 2
Electrical ❑
New Service --No. of AMPS:
Architect/Engineer Information
Phone:
Fax: -
E-mail:
Mortgage Lende" -Y,i,
Address:
PERMIT INFORMATION', , ; ;:•' ;�.'�
... 1,00 .
Construction Type: %&C� Fie . No. of Stories:
Flood Zone: /L/O
Plumbing ❑
New Construction - No. of Fixtures:
Mechanical 0 (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that. Po
work or installation has commenced prior to the issuance of a permit and that all work will be perqormed to
meet standards of all laws regulating construction in this jurisdiction. I understand that a separate permit
must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and
air conditioners, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE,TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE
OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH I YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this
property that may be found in the public records of this county, and there may be additional permits required
from other governmental entities such as water management districts, state agencies, or federal agencies!'
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida
Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
JQ4 yl ? Laoiy
Signature of Owner/Agent Date
ti Ael Zu6L0-<L
Print Owner/Agent's Name ��»Illillllll!/!�
dp��%4W-.4R>-
�/��i,,
J
Signature of Notary -State of Florida c,
ir�O :4"91lienuA
Owner/Agent is Personally Known to Me or
Produced ID Type of ID 1Vr I L
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
1_0i73
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
Rev 11.08
OWNER BUILDER STATEMENT/AFFIDAVIT
h _ ;;i
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)
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
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
jl ) lease. If a building or residence that I have built or subs-tantially improved myself is sold or leased within
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.
9 DO I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
K 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
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 -
builder and am aware of the limits of my insurance coverage for injuries to workers on my 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
I agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide Eby all applicable laws and requirements that govern owner -builders as well as employers. I also
understand that the construction must comply with all applicable laws, ordinances, building codes, and
zoning regulations.
'
I am of aware of construction practices and I have access to the Florida Building Codes.
I understand that I may obtain more information regarding my obligations as an employer from the Internal
Revenue Service, the United States Small Business Administration, the Florida Department of Financial
Services, and the Florida Department of Revenue. I also understand that I may contact the Florida
Construction Industry Licensing Board at 1-850-487-1395 or at www myflorida.com/dbpr/pro/cilb/ for
'
more information about licensed contractors.
I am aware of, and consent to, an owner -builder building permit applied for in my name and understand
that I am the party legally and financially responsible for the proposed construction activity at the address
listed below.
I agree to notify the building department immediately of any additions, deletions, or changes to any of the
information that I have provided on this disclosure or in the permit application package.
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person
who does not have a license, the Construction Industry Licensing Board, the Department of Business and
Professional Regulation and the building department may be unable to assist you with any financial loss
that you sustain as a result of a complaint. Your only remedy against an unlicensed contractor may be in
civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an
individual or firm is injured while working on your property, you may be held liable for damages. If you
obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying
whether the contractor is property licensed and the status of the contractor's workers' compensation
coverage.
Property Address: QaW SAR34
I, U& tw-� J� rh�ej �c%o ws��� , do hereby state that I am qualified
and capable of performing the requested construction involved with the permit application filed and agree to the
conditions specified above.
Signature of Owner -Builder Date
Form of Identification `- f se rtf
(Must be Photo ID)
A violation of this exemption is a misdemeanor of the first degree punishable by a term of imprisonment
not exceeding 1 year and a $1,000.00 fine in addition to any civil penalties. In addition, the local
permitting jurisdiction shall withhold final approval, revoke the permit, or pursue any action or remedy
for unlicensed activity against the owner and any person performing work that requires licensure under
the permit issued.
Rev. 9.14.2009
OWNER BUILDER STATEMENT/AFFID"IT
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)
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 '
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
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
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 -
builder and am aware of the limits of my insurance coverage for injuries to workers on my 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 f 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
Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 1
IFA-RP91K,PI TN1;
DAvm JOHNsoN. CFA. ABA
PROPERTY
APPRAISER
BQdINOLE COUNTY Fl-
1101 E. F1FzsT sT
9ANF010. FL 32771.146E
407-6!$ 756
VALUE
SUMMARY
VALUES
2010
Working
2009
Certified
GENERAL
Value Method
Cost/Market
Cost/Market
Parcel Id: 36-19-30-543-0K00-0100
Number of Buildings
1
1
Owner: ZUKOWSKI DANIEL J
Depreciated Bldg Value
$37,695
$40,930
Mailing Address: 1007 BETHPAGE RD
Depreciated EXFT Value
$0
$0
CIty,State,ZipCode: KANNAPOLIS NC 28081
Land Value (Market)
$28,429
$39,900
Property Address: 2004 SANFORD AVE SANFORD 32771
Land Value Ag
$0
$0
Subdivision Name: GARNERS 2ND ADD TO MARKHAM HEIGHTS
Just/Market Value
$66,124
$80,830
Tax District: S1-SANFORD
Portablity Adj
$0
$0
Exemptions:
Save Our Homes Ad)
$01
$0
Dor: 01-SINGLE FAMILY
Assessed Value (SOH)
$66,124
$878-30
Tax
Estimator
2010 TAXABLE VALUE WORKING ESTIMATE
Taxing Authority
Assessment Value
Exempt Values
Taxable Value
County General Fund
$66,124
$0
$66,124
Schools
$66,124
$0
$66,124
City Sanford
$66,124
$0
$66,124
SJWM(Saint Johns Water Management)
$66,124
$0
$66,124
County Bondsl
$66,124
$0
$66,124
The taxable values and taxes are calculated using the current years working values and the prior years approved millage rates.
SALES
Deed Date Book Page Amount Vac/Imp Qualified
2009 VALUE SUMMARY
WARRANTY DEED 10/1989 02126 1606 $45,500 Improved Yes
2009 Tax Bill Amount:
$1,577
WARRANTY DEED 03/1989 02054 1787 $32,000 Improved Yes
2009 Certified Taxable Value and Taxes
DOES NOT INCLUDE NON -AD VALOREM ASSESSMENTS
WARRANTY DEED 01/1972 00948 0540 $10,000 Improved Yes
Find Comparable Sales within this Subdivision
LEGAL DESCRIPTION
LAND
PLATS: Pick... 11
Land Assess Method Frontage Depth Land Units Unit Price Land Value
LEG LOTS 10 + 12 BLK K N H GARNERS 2ND ADD TO
FRONT FOOT & DEPTH 105 130 .000 285.00 $28,429
MARKHAM HEIGHTS
PB 1 PG 80
BUILDING INFORMATION
Bid Num Bid Type Year Bit Fixtures Base SF Gross SF Living SF Ext Wall Bid Value
Est Cost
New
Buildina 1 SINGLE FAMILY 1925 3 882
Sketch
2,098 1,074 SIDING AVG $37,695
$94,238
Appendage I Sqft UTILITY FINISHED / 64
Appendage / Sgft ENCLOSED PORCH FINISHED / 192
Appendage / Sgft DETACHED GARAGE UNFINISHED / 480
Appendage / Sgft CARPORT UNFINISHED / 480
NOTE: Appendage Codes included in Living Area: Base, Upper Story Base, Upper Story Finished, Apartment, Enclosed Porch Finished,Base
Semi Flashed
NOTE: Assessed values shown are NOT certified values and therefore are subject to change before being finalized for ad valorem tax purposes.
"' if you recently purchased a homesteaded property your next ear's property tax will be based on Just/Market value.
http://www.scpafl.org/web/re—web.seminole—countytitle?parcel=3619305430K000100&cp... 4/9/2010