HomeMy WebLinkAbout2415 Key Ave 17-1670; ELECTRICALJUN 0 6 2017
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CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / 1- /(70
Documented Construction Value:,-$= 3360.00
CJob Address: 0l4ice, K<<c-v Ayt% 6ArjFbto 34--n Historic District: Yes No
Parcel ID: Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
cD:es.cription of Work: up ""Ta pf1-iVCZs
Plan Review Contact Person: Title:
Phone: Fax: Email:
P_ro.pe,rt.y=0 ner4nfor:mation
Name ('14 12 i .S /) / GK Z ,_ Phone: 330 , 6776 Street:
0-mb Kola A-VE Resident of property? City,
State Zip: 3,77 / Contractor
Information Name
Phone: Street:
Fax: City,
State Zip: State License No.: Architect/
Engineer Information Name:
Phone: Street:
Fax: City,
St, Zip: E-mail: Bonding
Company: Mortgage Lender: Address:
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. 1 understand that a separate permit must be secured for electrical work, plumbing, signs, wells, pools, furnaces,
boilers, heaters, tanks, and air conditioners, etc. 5
OJ
FBC105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5,h Edition (2014) Florida Building Code Revised:
June 30, 2015 Permit Application 6' V\
I
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 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.
Signature o wner/Agent Date
Print Owner/Agent's Name
Bl td7t4j Aw
Signature of Notary -State of Florida Date
DEBBIE BLANTONY'
MY COMMISSION i# FF 178648
EXPIRES: February 25, 2019
a t °.• Bonded Thru Notary Public Underwriters J
Owner/Agent is
Produced ID Type of ID L
6-F-191 1
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
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: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
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/AFFI DAVIT
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 1, 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.
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 I must
comply with laws requiring the withholding of federal income tax and social security contributions
N 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 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 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
fin coverage.
Property Address: o l 5 %
GI!/ 04,2i s Ali ac tli,- , 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 %Decified above.
er-Builder
Form of Identification
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
SCPA Parcel View: 31-19-31-524-1000-0080 Page 1 of 2
Property Record Card
roMd,
a=W,cra
Parcel: 31-19-31-524-1000-0080
7l fMR Owner: NICKLE CHRIS E
SCnva0.@ CSOlrrrv,t.prtun Property Address: 2415 KEY AVE SANFORD, FL 32771
Parcel Information Value Summary
Parcel 31-19-31-524-1000-0080
Owner NICKLE CHRIS E
Property Address 2415 KEY AVE SANFORD, FL 32771
Mailing 2415 KEY AVE SANFORD, FL 32771-4647
Subdivision Name WYNNEWOOD
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(2000)
e
C'7
Seminole Coun y GIS
Legal Description
S44FTOFLOT 8+N39FT OF
LOT 9 BILK 10 WYNNEWOOD
PB
4 PG 93 Taxes
2017
Working 2016 Certified Values
Values Valuation
Method Cost/Market Cost/Market Number
of Buildings 1 1 Depreciated
Bldg Value 60,432 M
M55,
596 Depreciated
EXFT Value Land
Value (Market) 16,102 14,894 Land
Value Ag Just/
Market Value ** 76,534 70,490 Portability
Adj Save
Our Homes Ad/ 7,838 3,207 Amendment
1 Adj P&
G Adj 0 0 Assessed
Value 68,696 67,283 Tax
Amount without SOH: $656.00 2016
Tax Bill Amount $632.00 Tax
Estimator Save
Our Homes Savings: $24.00 Taxing
Authority Assessment Value Exempt Values Taxable Value County
General Fund City
Sanford Schools - --
68,
696 68,
696 68,
696 43,
696 43,
696 25,
000 25,
000 25,
000 43,
696 SJWM(
Saint Johns Water Management) 68,696 43,696 25,000 County
Bonds 68,696 43,696 25,000 Sales
Description
Date Book Page Amount Qualified Vac/Imp QUIT
CLAIM DEED 9/1/2003 05089 1997 100 No Improved FINAL
JUDGEMENT 10/1/2000 03938 0658 100 I No Improved WARRANTY
DEED 5/1/1999 03664 1915 78 000 1 Yes Improved WARRANTY
DEED 11/1/1995 02991 0553 65,000 Yes 1 Improved WARRANTY
DEED 6/1/1992 02440 1707 45,000 Yes Improved Find
Comparable Sales Land
Method ]
E,tag: Depth Units Units Price Lan$16,
102 FRONTFOOT & DEPTH 83.001 135.00 0 200.00 Building
Information Is
Bed/Bath count incorrect? Click Here. Description
Fixtures Bed Bath Base Area Total SF Living SF Ext Wall Adj Value Rapt Value Appendages http://
parceldetail. scpafl.org/ParcelDetailInfo.aspx?PID=31193152410000080 6/6/2017
THIS INSTRUMENT PREPARED0 Z. i iilill Ilili lii i liiil iliil ilifi Ilii 111i
Name:
Address: GRANT MALOYr SEMINOLE COUNTY
CLERK, OF CIRCUIT COURT h COMPTROLLER
BK 8926 P3 1! i64 (Wss )
NOTICE OF COMMENCEMENT CLERK'S T 2017055990
RECORDED 06/06/2017 01:39:35 P11
State of Florida
RECORDING FEES `Ii10.00
RECORDED BY .ier_kenro
County of Seminole
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Permit Number: / l / --/ v Parcel ID Number: ' 3 'J—LLA - COWW
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
rESCRIPTION OF PROPERTY: (Legal descri tion of the property and street address if available)
a' f IS A I-N/aa Gc 3 a-77i
GENERAL DESCRIPTION OF IMPROVEMENT:
R-6-C'ad!A 4 C DQOVE 2
OWNER -INFORMATION:-'
Name: e S (L.
Address: 9-ik5 KkCt AWE 6eWkizo FC S 77 %
Fee Simple Title Holder (if other than owner) Name:
Address:
CONTRACTOR:
r /1
mName: i:]IA CD/),S1IZu., 'C-1 l_bw y
Address: q (G 1if,0ILDMAT )2 " ! , de E 1+1 t?_5 DI: 8"d-14
Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served
as provided by Section 713.13(1)(b), Florida Statutes.
Name:
Address:
In addition to himself, Owner Designates of
To receive a copy of the Lienor's Notice as Provided in
Section 713.13(1)(b), Florida Statutes.
Expiration Date of Notice of Commencement (The expiration date is 1 year from date of recording unless a 1`
different date is specified) '— O
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
cl i
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, CC
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A O
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 Z
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true
to the best of m knowledge and belief. rP -', !,Z
ir`
Owner's Signature Owner's Printed Name( —
Florida Statute 713.13 1 The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead." >
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State of County of v _
The fore oin instrument was cknowledged before me this 22day of , 20/ O `
Um1 by e
d C/'
Who is rsonally known to me o u",, Name of
person making statemen O Z(D) OR who
has produced identification type of identification produced: --- cc u,'M o Hr•°;:
DEBBIEBUINTON 2` MYCOMMISSION #
I'
F 178648 Notary Signature
EXPIRES: February
25, 2019 Bonded Thru
Not Public Underwriters