HomeMy WebLinkAbout300 W 5 St 17-138; fenceECEIVE
JAN 10 2017
By-_W_z>_
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
Documented Construction Value: $
00
CU'ob Address: Historic District: Yes No
Parcel ID: ZJ q--3o -- !(,s--O aD(o -'DD Residential Commercial
Type of Work: New Addition Alteration R Repair Demo Change of Use Move
Description of Work: REPLa--e 4tmD Ri;M 2 RD?) h'I)IiF/Z F:67A/C-G
I"
1 Plan ReviewContactPerson: Fig ltf [. "AA-) -- Title: cal, A2W Phone:
7- 4M^/ ax: Email:co, 1' _ _
Property40wner Informations Name
n/LYYl /i/ I la n_- Phone: ZO;Z_41OQ- S972 1
Street: (A), :5T - Resident of property? City,
State Zip: 04-A/iZD F1- Contractor
Information Name
Street:
City,
State Zip: Name:
Street:
City,
St, Zip: Bonding
Company: Address:
Phone:
Fax:
State
License No.: Architect/
Engineer Information Phone:
Fax:
E-
mail: Mortgage
Lender: Address:
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.
Application
is hereby made to obtain a permit to do the work 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. FBC
105.3 Shall be inscribed with the date of application and the code in effect as of that date: 51h Edition (2014) Florida Building Code Revised:
June 30, 2015 Permit Application
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 pers required from other governmental entities such as water
management districts, state agencies, or federal agencies. 4
mit
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 at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
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.
a,'
l i
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
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
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing[] Gas[] Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONINt6 l' 1b ' 11 UTILITIES:
ENGINEERING:
COMMENTS:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
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)
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 fled
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.
l I understand that I may build or improve a one -family or two-family residence or a farm outbuilding. I
F 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,myseIf is sold or leased within
in 1 year after the construction is complete, the law will presume that I built or substantially improved itftforsaleorlease, which violates this exemption.
F
I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
11
I understand that I may not hire an unlicensed individual person to act as my contractor or to superviseipersonsworkingonmybuildingorresidence. It is my responsibility to ensure that the persons whom I
employ have the licenses required bylaw and by city ordinance.
r
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. 1, 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 contributionsPY9gg
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
51
I
I
I agree that, as the party legally and financially responsible for this proposed construction activity, I will
II abide by 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, 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
j
i
more information about licensed contractors.
J` I am aware of, and consent to, an owner -builder building permit applied for in my name and understand
J 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.
ropertr?Address:
a Peablof p erfc conditions-
hied ignature
of Owner -Builder Form
of Identificatio do
hereby state that I am qualified the
requested construction involved with the permit application filed and agree to the Must
be Photo ID) 1 //
6 h 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
THIS DOCUMENT MUST BE POSTED AT ALL TIMES UNTIL
PROJECT IS COMPLETED.
ISSUED TO: DATE ISSUED:
Firmin Emanuel January 10,, 2017
for
300 W. 51h Street DATE EXPIRES:
Sanford, FL 32771 July 10, 2017
y 4 BP#17-133
Approved to install new k wood picket fence and 6' privacy fence, location depicted,
in Figure 1. Approved to install a new shed (not.plastic), sized below 100 square feet
in location depicted in Figure 1.
o l
APPLICATION #
FOR A CERTIFICATE OF
1-7.
APPROPRIATENESS
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 at
407.688.5145 to ensure your application is complete.
General Information
Downtown Commercial Historic District 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[] No
Proposed improvements will affect the following elevations: North South East West
Property Address: 3 0 fit/ 5TK 'ffVREF_ %%/_
Property Owner Information
Print Name: ll/%l11/ 1(/(L
Mailing Address: S • ' 7Ty S ! R. -P> 02% 7
Phone: '!% mail:/Yf.OIGI Z •Cpis Signature.—
Applicant/Agent Information
Print Name: 1-21q//I/1
Mailinc
Phone
BY SIGNING BELOW YOU ACKNOWLEDGE THAT A BUILDING PERMIT MAY BE REQUIRED FOR THE
SCOPE OF WORK LISTED BELOW. YOU MUST CONTACT THE BUILDING DEPARTMENT TO
DETERMINE IF A BUILDING PERMIT IS REQUIRED. FAILURE TO OBTAIN A BUILDING PERMIT WILL
RESULT IN A STOP WORK ORDER, DOUBLE PERMIT FEES, AND POTENTIAL FINES. BY SIGNING
BELOW, YOU ALSO ACKNOWLEDGE THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS
TRUE AND ACCURATE TO THE BEST OF YOUR KNOWLEDGE.
Signature: Date:
Would you like to receive emails regarding Historic Preservation and Community Planning within your community?
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.
HISTORIC PRESERVATION BOARD • 300 S. Park Avenue • Sanford, Florida 32771 •407.688.5145 • www.sanfordfl.gov/HP
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