HomeMy WebLinkAbout929 W 11th St 12-2529 replace broken meter box permit applicationSEP 26'',2012
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�,CITY OF SANFORD
BUILDING & FIRE PREVENTION
` PERMIT APPLICATION
Application No:. ' a6aq Documented Construction Value: $ �� F v
Job Address: �� S/_ Historic District: Yes ❑ No ❑
Parcel ID: Zoning:
Description of Work:
Plan Review Contact Person: Title:
Phone:
Fax:
E-mail:
Property Owner Information
Name Afild'
N� Phone: 32-/— 9 y —71W—
Street:''
71 —Street: 9-a% w l% ! Resident of property? : e
City, State Zip:
Contractor Information
Nameb
Street:
City, State Zip:
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Building Permit ❑
Square Footage:
No. of Dwelling Units:
Electrical ❑
New Service - No. of AMPS:
Phone:
Fax:
State License No.:
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address: x
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PERMIT INFORMATION
:+.i.'• -r i+7.� 41*Vl/!'etf.Nvi1�"-:ti41'WNAfJt'.S.?'%.tS'
Construction Type: No. of Stories:
Flood Zone:
Mechanical ❑ (Duct layout required for new systems)
Plumbing ❑
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm 0 No. of heads:
Application is hereby made to obtain a permit to do thework and installations as indicated. I certify that no
work or installation has commenced prior to the issuance of a permit and that all work will be performed 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 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.
2
ignatuurre�off/O n'e eentt
Print Owner/Agent's Name
Si a ure of Notary -State of Florida Date
1tr vy'`,'%
JO ANN M. JOHNSON
*: 7'.- MY COMMISSION # EE 159467
EXPIRES; March 23, 2016
„ Bonded TW Notary Public Ur&wders
Owner/Agent is Personally Kno to or
Produced ID �ype of ID E> -M L,
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Rev 11.08
UTILITIES:
FIRE:
Signature of Contractor/Agent
Print Contractor/Agent's Name
Date
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
SCPA Parcel View: 25-19-30-511-0000-0230
JoFinscrn, CF1 Parcel: 25-19-30-511-0000-0230
CPW*'.4O'Pe
Owner: WYNN KgVIN L
Property Address: 929 W 11TH ST SANFORD, FL 32771
cotxJn Ft,pRIW
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Parcel: 25-19-30-511-0000-0230 1 Value Summary
Property Address: 929 W 11TH ST
Owner: WYNN KEVIN L
Mailing: 929 W 11TH ST
SANFORD, FL 32771 - 2491
Subdivision Name: STENDIFORDS ADD
Tax District: Sl-SANFORD
Exemptions: 00 -HOMESTEAD (2007)
DOR Use Code: 01 -SINGLE FAMILY
i®
W 11TH ST
ffn
s Z O �lhi
138 a a
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W-1 ZrH ST
® nrel0IfE0i1I 1 f rp In 1 13 013
Map I Aerial I Both I Footprint I + Extents Center
Larger Map I Dual Map View - Extemal
Legal Description
LOT 23 STENDIFORDS ADD PB 1 PG 110
Tax Details
Tax Amount without SOH:
2012 Working
2011 Certified
$558
Values
Values
Valuation
Cost/Market
Cost/Market
Method
525,000
$29,542
Number of
1
1
Buildings
SJWM(Saintjohns Water Management)
$54,542
Depreciated
$46,087
$48,381
Bldg Value
529,542
$25,000
Depreciated
$7,000
Improved
EXFT Value
WARRANTY DEED
10/1997
Land Value
581455
$9,345
(Market)
Yes
Find Comparable Sales within this Subdivision
Land Value Ag
Just/Market
$54,542
$57,726
Value **
Portability Adj
Save Our Homes
$0
$0
Adj
Amendment 1
Adj
Assessed Value
554,542
$57,726
Tax Amount without SOH:
$558
2011 Tax Bill Amount
$558
Tax Estimator
TRIM Notice
Save Our Homes Savings:
$0
* Does NOT INCLUDE Non Ad Valorem
Assessments
Taxing Authority
Assessment Value
Exempt Values
Taxable Value
County General Fund
554,542
529,542
$25,000
Schools
554,542
525,000
$29,542
City Sanford
$54,542
529,542
525,000
SJWM(Saintjohns Water Management)
$54,542
529,542
525,000
County Bonds
$54,542
529,542
$25,000
Sales
Deed
Date
Book
Page
Amount
Vac/Imp
Qualified
QUIT CLAIM DEED
11/2008
07097
1383
S100
Improved
No
WARRANTY DEED
12/2007
06892
1371
S29,400
Improved
No
QUIT CLAIM DEED
03/2006
06228
0939
$7,000
Improved
No
WARRANTY DEED
10/1997
0 317
0270
$4,500
Vacant
Yes
Find Comparable Sales within this Subdivision
Land
Method I Frontage I Depth I Units I Unit Price I Land Value
FRONT FOOT & DEPITHI Sol 1171 1 190.001 58,455
Building Information
# Description Year Fixtures Base Total SF Living Ext Wall Adj Repl Appendages
Built Area SF Value Value
n - �
Page 1 of 2
http://www.scpafl.org/ParcelDetails.aspx?PID=25-19-30-511-0000-0230 9/26/2012
SCPA Parcel View: 25-19-30-511-0000-0230
1 SINGLE
FAMILY
1998
6
1,262.00
1,280.00
1,262.001
SIDING
AVG
t
$46,087
$48,513
Description Area
_
OPEN PORCH Y 18
18
FINISHED
Permits
Permit # I Type Agency Amount CO Date Permit Date
01997 New - Residential Sanfordl $47,600 09/28/1998 05/01/1998
00855 New - Residential Sanfordl $41,500 01/01/1998
Extra Features
Description
Year Bit
Units
I Value
Cost New
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Page 2 of 2
http://www.sepafl.org/ParcelDetails.aspx?PID=25-19-30-511-0000-0230 9/26/2012
OWNER BUILDER STATEMENT/AFFIDAVIT
Altamonte Springs, Casselberry; Laky 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.
Y
I understand that building permits are not required to be signed by a property owner unless he or she is
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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
improved it
in 1 year after the construction is complete, the law will presume that I built or substantially
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 I must
comply with laws requiring the withholding of federal income tax and social security contributions
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under the Federal Insurance Contributions Act (FICA) and must provide workers' compensation
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for the employee. I understand that my failure to follow these laws may subject me to serious financial
risk.
Rev. 9.14.2009
Property Addres
'l2 -
I, Mx_ /i tQ , do hereby state that I am qualified
and capable of performing the r quested construction involved with the permit application filed and agree to the
conditions specified above.
nature of Owner -Builder
Form of Identification F—f—, �`---
(Must be Photo ID)
Date
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
I agree that, as the party legally and financially responsible for this proposed construction activity, I will
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abide by all applicable laws and requirements that govern owner -builders as well as employers. I also
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understand that the construction must comply with all applicable laws, ordinances, building codes, and
zoning regulations. 1.
I
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
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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
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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
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whether the contractor is property licensed and the status of the contractor's workers' compensation
coverage.
Property Addres
'l2 -
I, Mx_ /i tQ , do hereby state that I am qualified
and capable of performing the r quested construction involved with the permit application filed and agree to the
conditions specified above.
nature of Owner -Builder
Form of Identification F—f—, �`---
(Must be Photo ID)
Date
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