HomeMy WebLinkAbout117 Bent Oak Ct; 17-2262; CONCRETE SLABtil; 3T9
Job Address:
Ecslve- CITY OF SANFORD
BUILDING & FIRE PREVENTION
JUL 2 5 2017 PERMIT APPLICATION
Application No: M
q,eox
Documented Construction Value: $ ,?,00 — AM -5114,
7710 92ZZY Historic District: Yes No [9
Parcel ID: //- _/)Q -_Y0-`56Z_5--0000 - 15 3ab Residential Commercial
Type of Work: New Addition Alteration El Repair Reppair El Demo El Change of Use ElMove
Description of Work: 2p/ a X'/ 511 t0/l lr Sle/'a9 uhi'
Plan Review Contact Person:
Phone: LOB Jd:/--, , Ya9 Fax:
Title: ijt-iz
Email: eW1 X,, L'0,4t
Property Owner Information
Name e// Phone: L 7/ 10 0 9
Street- %&7' C/i C77 Resident of property? : c°
City, State Zip: Sot 17 A4ZZ /'7 W23
Contractor Information
Name _Syhe t Phone:
Street:
City, State Zip:
Name: -
Street:
City, St, Zip:
Bonding Company:
Address:
Fax:
State License No.:
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender: i r.sf 2 %%%fo,
Address: /J'( ,&
r9r(
DQ/,as. TV
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. v
0
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 4
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 permits required frort%rother 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.
04 1-7
Sign ure cl Owner/Agent Date
Print Owmef/Agent's
Date
LISA ANTONINI
Notary Public - State of Florida
Y My Comm. Expires May 21, 2018
Commission u FF 125242
Produced ID Type of ID
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
or 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: 2 17UTILITIES:
ENGINEERING: FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
COMMENTS: UK 1xji-'k l (,,, 'etkMefjt C %'VVW
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:•\-\
Revised: June 30, 2015 Permit Application
ParcelInfo Page 1 of 1
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PlatViewer ? Documents i AbstrartDoc HxDocsAPR®p
Parcel Detail Sheet Range ( Parcel Detail Sheet Trim Notice
SEMINOLE COUNTY, FLORIOA
Parcel Info 11-20-30-505-0000-0320
Bulld6 { Le6ONoteslStatus ``Land 'Sales t aira FeatureI = I ' !` I Permits Simon Search
Taxroll Year: 200117—vI i Taxes ( New Const Ovr-d-) I DR501 Fo ms i Fdit P— rr-I natal F,r RProtntl
I
Owner Info Property Address
Name: POWELL JOYCE S Addr: 117 BENT OAK CT
Addrl: City/Zip: SANFORD 32773-5626
Addr2: 117 BENT OAK CT
FlagsCity: SANFORD
State/Zip: FL 32773-5626 I Ag ElDEMO ElInc Ind Inc Ltr Den:
Codes Values
DOR: 01 SINGLE FAMILY Nbad Factor: 1.10
TD: S1 SANFORD Adj Ag:
Market Area: 01 RES CPI: 2.1
IND: Amd 10 Cap: 3
Hx Removal: Tax Bill: 1,667.32
NBHD
Pre File ExemptionsComm:
Facility:
Ownership:
Hx Granted:
Code Description
00 HOMESTEAD
E&I Number: Pet #: 01 ADDITIONAL HOMESTEAD
Exemptions
Code Description Granted
No Exempt.
Summary
2016 Re Appraised Re Appr % Addition Value Total Appraised Total %
Land Value 21,000 25,000 19.00 25,000 19.00
Extra Features 0
Building Value 65,835 75,124 14.10 75,124 14.10
Cost/Market Just Value 86,835 100,124 15.30 100,124 15.30
Income Just Value
Correct Assd/Admin Value
Classified Value
SOH Adjustment 0 0 p
Non-HX Adjustment 5,872 11,065 11,065
P&G Adjustment 0 0 0
Total Assessed Value 80,963 89,059. 10.00 0 89,059 10.00
Taxable Values
Millage Code Millage Desc Assessment Value Exempt Values Taxable Values
0100 COUNTY GENERAL FUND 89,059 01 89,059
0400 SCHL SCHOOL 100,124 0. 100,124
1000 CITY SANFORD 89,059 0 89,059
1200 SJWM 89,059 0 89,059
9800 COUNTY BONDS 89,0590 89,059 Parcel
I Building I Le-gal/Notes/Status I Land I Sales I Extra Feature I Permits I Simon I Search http://
scpaias 1 x64/Relnquiry/faces/Setup2.j spx?cparcel=11203050500000320&ctry=2017... 7/25/2017
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
v 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
OJ 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 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
4
Services, and the Florida Department of Revenue. I also understand that I may contact the Florida, 77 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 J 7»
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.
Sigr}afure,6f Owner -Builder
Form of Identification cc
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
City of Sanford
Slab Permit Application Checklist
All permit application packages must be complete prior to acceptance. You must check each box to the
left or indicate n/a on this submittal. A complete application package shall include the following:
C;,,"' Building Permit Application completed, signed and notarized. Application must include correct address
and complete parcel I.D. number.
A4Copy of a contract, signed by the contractor and the property owner, indicating the documented
construction value of the project.
Copy of applicable contractor's license issued by the State of Florida (if contractor is
applicant).
VIA- A site specific notarized power of attorney shall be required from the licensed contractor if
he/she appoints an employee of his/her company to sign the permit application as the contractor.
A- Certificate of insurance indicating worker's compensation insurance coverage and naming the City of
Sanford as certificate holder, or a copy of a worker's compensation exemption issued by the State of
Florida (must be submitted with each application if contractor is the applicant).
Completed and signed Owner Builder Statement / Affidavit (if owner is applicant).
nl TWO (2) site plans indicating proposed location and distances to property line(s).
These guidelines were compiled to assist the applicant in preparing a slab permit application and may not be
complete. The applicant is required to meet all City of Sanford, state, andfederal code requirements.
Revised: February 2015
RECORD COPY
PLAT OF SURVEY
DESCRIPTION
LOT 32, 14IDDEN LAKE PHASE ill UNIT 1, AS RECORDED 1N PLAT BOOK 27, PAGES 44 THROUGH
47, PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA.
LOT 39
LOT 38 FND. 5/8" IR
o LS# 5381
PLS# 3422 `— • E 73 27' PLAT w
S 37 52 30 wF
LEAS fie. c3 ----
V5' CLF
6' wF
LOT 33
1.y
QQ
J
a
w
N
7'
Lai 41
V
h
2
SW CORNER LOT 34
FND 3/4" IP
NO # FND. 5/8" IR
LS# 4243
150.00' PLAT
150.05' MEAS
1
S 37054114' E 73.42
2.3'
DE & UE
FND. I" IP
PLS# 3422
1
LOT 32
V
as W
WA
1I7 16' Wca
t;
CONC
e 21.5'
c 1 STORY BLOCK
N ADDRESS #117
SP.65'
9, iu
cc
10'
5' CLF
3 ' CW
CONC
DW
vi
v
FND. 58' IR
LS# 5 81
W N 32'41
w
2.5'
C3 CURVE DATA
A 00°45'28'
R 155,00'
L 2.05'
CHORD
S 37023'22' E
y 2.05' PLAT
Q Q S 39'28'16' E
a 2,15' MEAS
0Q
4 pay
3 3 LOT 31
N•
i 2.3' oh SYMBOLS LEGEND
CO - CLEAN OUT
EB - ELECTRICAL BOX
InFHin FIRE HYDRANT
5' CLF GUY WIRE ANCHOR
f/j y TR - TELEPHONE RISER
m - TRANSFORMER
12 2'
TV - CABLE TV RISER
WATER METER
WATER VALVE
ELECTRIC METER
Al- DOT MANHOLE
4 - LIGHT POLE
IR
L9# 4596
L Cl CURVE DATA
a 48011'23'
I' W 31,31' PAT R 25.00'
W 3L35' MEAS L 21.03'
CONCAPRON CHORD
20.5' N 56'41'42' W
20.41' PLAT
ElP N 56'47'51' W
BENT DAK COURT 20,36' MEAS
C50' R/ ) _
REVIEWED POR .CODE COMPLIANCE
PLANS EXAMINER
T
DATE
a
C2 ,CURVE DATA
6 = 34.02'37'
R = 50.00'
L = 29.71'
CHORD
N 63'45'40' W
29.27' PLAT
N 63°56'00' W
29.12' ; ME
ILCINc
SANFORD
Lk '_ 7 - 2 2 6 F'q RTM9
MCCORMICK, TICOR TITLE INSURANCE, ABN AMRO GROUP
Ild141100111, ANNITI
of Orlando Inc., LB 4475
2012 E. Robinson St.
Orlando, Florida 32803
PHONE (407) 894-6314 FAY (407) 897-3777
Jr-WES D. BRAY PSM 6507
NOT VAUD WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED
SEAL OF THIS FLORJDA LJCENSED SURVEYOR AND MAPPER.'
NOTES:
1. BEARING STRUCTURE BASED ON: NORTHERLY RIW
LINE OF BENT OAK COURT BEING N32'35'40'W.
2. THIS BUILDING/LOT IS NOT IN A FLOOD PRONE
AREA, ZONE X, BASED ON FLOOD INSURANCE RATE
MAP, NO. 120294 0045 E, CITY OF SANFORD,
SEMINOLE COUNTY, FLORIDA.
J. THIS SURVEY REFLECTS ONLY MATTERS OF
RECORD AS PROVIDED BY CLIENT.
4. UNDERGROUND IMPROVEMENTS HAVE NOT BEEN
LOCATED.
5. BUILDING TIES SHOWN ON THIS SURVEY SHOULD
NOT BE USED TO RECONSTRUCT PROPERTY LINES.
LEGEND
CENTERLINE ARC LENGTH
CBW CONCRETE BLOCK WALL LSA LANDSCAPE AREA
CC COVERED CONCRETE MEAS - MEASURED
CLF CHAIN LINK FENCE MS METAL SHED
CM CONCRETE MONUMENT N&D NAIL & DISK
CONC - CONCRETE OW OVERHEAD WIRE
COVO - COVERED ORB OFFICIAL RECORDS BC
CP CONCRETE PAD P&M PUT & MEASURED
CW CONCRETE WALKWAY PB PUT BOOK
b CENTRAL ANGLE PC POINT OF CURVATURE
D&M DESCRIBED & MEASURED PC PAGE
DE DRAINAGE EASEMENT POS POINT OF BEGINNING
DESC - DESCRIPTION POC POINT OF COMMENCEM
DW DRIVEWAY R RADIUS
EIP EDGE OF PAVEMENT R/W RIGHT OF WAY
ESMT EASEMENT TYP TYPICAL
FFE FINISHED FLOOR ELEVATION UE UTILITY EASEMENT
FIRM FLOOD INSURANCE UP UTILITY POLE
RATE MAP WF WOOD FENCE
FNDIP FOUNDIRONPIPE INS WOOD SHED
R IRON ROD NUMBER
REQUIRED INSPECTION SEQUENCE
BUILDING PERMIT
Min Max Inspection Description
Footer / Setback
Stemwall Foundation /
Form Board Survey Slab /
Mono Slab Prepour Lintel /
Tie Beam / Fill / Down Cell Sheathing —
Walls Sheathing —
Roof Roof
Dry In Frame
Insulation
Rough In Firewall
Screw Pattern Drywall /
Sheetrock Lath
Inspection Final
Solar Final
Firewall Final
Roof Final
Stucco / Siding Insulation
Final Final
Utility Building Final
Door Final
Window Final
Screen Room Final
Pool Screen Enclosure Final
Single Family Residence Final
Building (Other) Address:
117 oN-C ELECTRI
CA'.L .P.ERMiIT Min
Marc I(ns ection Descri tion Electric
Underground Footer /
Slab Steel Bond Electric
Rough T.
U.G. Pre -
Power Final Electric
Final goKR'
a£C{#iA . i»..ra.$ka.a1 Geiilr.*b.ii 4i+"' Min
Maas Ins ection Descri tion Plumbing
Underground Plumbing
Sewer Plumbing
Tub Set Plumbing
Final MECHANICAl,
1PE:RMIT Min
Mays Ins ecti®n Descri tion Mechanical
Rough Mechanical
Final Min
Mays Insi2ection Descri tion Gas
Underground Gas
Rough Gas
Final REVISEID:
June 2014