HomeMy WebLinkAbout520 Valencia St; 17-2649; FENCECITY OF
Building & Fire Prevention Division
a . RESIDENTIAL FENCE PERMIT APPLICATION
L FIRE OEPARTMENj':;'AUGf± 2017 1
Application No:
o
BYDocumented"Construction Value: $ 01-000
Job Address: Vaj.Ick'. Sk - JW ! Historic District: Yes No
Parcel ID:
Plan Review Contact Person: Title:
Phone: Fax: Email:
Residential Fence Information
Type of Fence: Wood t' Metal PVC/Vinyl Iron Other
Fence Height:
I
Feet # Gates: I Total Linear Feet:
Additional Information:
SZ
Fences with a height of over 6 feet will require signed & sealed structural engineering"
i ` l` n Property Owner Information
P l Q n
Name Ln11e_ lA)"t zo arnp"m Phone: q- q y2
Street: JZD &l'f-'6C ZL. a -
City, State Zip: S (>r 1p ai rL 37,11 I
Name
Street:
City, State Zip:
Resident of property? :
Fence Contractor Information
Phone:
Fax:
Please Note: The Building Department does not perform site inspections on Residential Fence
permits. A signed and notarized Fence Affidavit is required to be submitted along with this
permit application. Please see the attached Fence Permit Submittal Guidelines.
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.
Effective: August 1, 2017
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: 5'h Edition (2014) Florida Building Code
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.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will
be done in compliant with all applicable laws regulating construction and zoning.
g Ognatureof /Agent Date Signature of Contractor/Agent Date
OAA2' n0.
Print Owner/Agent's Name Print Contractor/Agent's Name
qa . 3 /, J
Signature t gl nh!?Gtdivv
MY CUM:IiSSIUN t 8648
Feb.earj 25, c^19
e 3
EXPIRES:
Bonded Thru tJctar; Public Un;!erWrite--s
Owner/Agent is Personally K own to Me or
Produced ID Type of ID I l ,
ev,p- c I3 1cY
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
PLAN REVIEWAPPROVAL: PLANNING: ( HISTORIC:
10
COMMENTS:. Ok to install approx. 15t linear feet of 6' high
privacy fence and ja gate(s) as shown on
plan. Fence shall be constructed with
finished side facing outward.
Effective: August 1. 2017
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 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. 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
0rX 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
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: 5 U)
I, Le_ lI' OAX\ l(J-i+` do hereby state that I am qualified
and capable of performing the requested construction involved with the permit application filed and agree to the
cond'tions specified above.
D S31117
Signature of Owner -Build Date
Form of Identification
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
331588
PLAT OF LAND SURVEY FOR and/or CERTIFIED TO: Louis A. & Leslie J. Campagna
American Realty Title Agency, Industrial Valley Title
Countrywide Funding Corporation
DESCRIPTION AS FOLLOWS: Lots 18 & 19 and the West 1/2 of Lot 20, Block 8, SAN LANTA, asrecordedinPlatBook3, Page 80, Public Records of Seminole County, Florida.
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to install approx._ 1 j_linear feet of 6' high privacy
fence and _Xgate(s) as shown on plan.
Fence shall be constructed with finished
side facing outward. RUSE
MEdER-SCVl._1 & bOC.' I Va LAN® SUR® `ORS LEGENU P PLAT NOTES
IFP -
FIEID IRONPIPE 1.
THE UNDERSIGNEDDOES HEREBY CERTIFY THAT THIS SURVEY MEETS THE MINIMUM TECHNICAL IRON ROD ROD STANDARDS
SET FORTHBY THE FLORIDA BOARD OF PROFESSIONAL LAND SURVEYORS IN CHAPTER CM COI 21 HH-6 FLORIDA ADMINISTRATIVE CODE PURSUANT TO CHAPTER 472-027. FLORIDA STATUTES. RR LMONUMENT E .sssSETIqREIRRECOVEREDRECRECOVERED2. UNLESSEMBOSSEDWITH SURVEYOR'S SEAL, THIS SURVEY IS NOT VALID AND IS PRESENTED FOR PO.B POINT ofBEGINNINGINFORMATIONALPURPOSESONLY. aOC POINT OF COMMENCEMENT
LINE 3. THIS SURVEY
WAS PREPARED FROM TITLE INFORMATION FURNISHED TO THE SURVEYOR. THERE AIL & D. NAU NAIL {
DISC MAYBEOTHERRESTRICTIONS OR EASEMENTS THAT AFFECT THIS PROPERTY. A gIGHTOFWAY ESMT EASEMENTNORTHt
P.) 4. NO UNDERGROUND IMPROVEMENTS HAVE BEEN LOCATED UNLESS OTHERWISE SHOWN, DRAIN . DRAINAGE T- UTILITY
5. THIS.
SURVEY IS PREPARED FOR THE SOLE BENEFIT OF THOSE CERTIFIED TO AND SHOULD NOT BE C L FC CHAIN
LINK FENCE ORLANDO OFFICE RELIED UPON BY ANY OTHER ENTITY. WD.FC WOOD FENCE
CIS . CONCRETE BLOCK 5400
E. COLONIAL DR. 6. DIMENSIONS SHOWN FOR THE LOCATION OF IMPROVEMENTS HEREON SHOULD NOT BE USED TO ORLANDO, FL 32807 0DESCRIPTIONPT . POINTOFCURVATURE
RECONSTRUCT BOUNDARY LINES. 232
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ELEVATIONS,
IF SHOWN. ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM OF 1929, UNLESS OCALA OFFICE L ENTRAGANCENTRALANGLEOTHERWISE
NOTED. 12200 N.
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32686 C tl . CHORD BEARING
PC POINTONLINE TYP TYPICAL
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PRc POINT OF REVERSE
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FIELD DATE
ORDERNo.
THIS BUILDING/PROPERTY DES'
40T 8&-n Ory OI.2o•93 D-254l. LIE WITHIN THE ESTABLISHED
DATESIGNED: 100 YEAR FLOOD PLANE AS
PER "FIRM". ZONE '•C•• TOM
C. GRUSENMEYER, R.L.S. No. 1542 PAUL L. DEATER, R.L.S. No. 4610 TOM X. GRUSENMEYER, R.L.
S. No. 4714 RICHARD E. FISCHER, R.L.S. No. 4616 PANEL M i2'0294. Oo10
S C 9_ \7. JAMES W. SCOTT, R.L.S. No.4801 E.R. BROWN, R.L.S. No.3894 DRAWN BY: "—= J CHECKED BY:
CITY OF
SXKFORD
FIRE DEPARTMENT
Building & Fire Prevention Division
RESIDENTIAL FENCE AFFIDAVIT
6 FEET OR LESS IN HEIGHT)
PERMIT #: CO 7 9 ADDRESS:
Jn oyd-) FL-- 31-;1 11
I to J6) ` 1' `j " lV . HEREBY AFFIRM THAT ALL OF THE FOREGOING
INFORMATION IS TRUE AND ACCURATE. THE FENCE WILL BE INSTALLED IN THE APPROVED LOCATION AS SHOWN ON THE APPROVED SITE
PLAN. THE FENCE WILL BE NO HIGHER THAN 6 FEEr, MEASURED FROM GRADE. THE FINISHED SIDE OF THE FENCE IS REQUIRED TO FACE
OUT. IT IS THE HOMEOWNER'S RESPONSIBILITY TO VERIFY THE FENCE IS PLACED WITHIN THE PROPERTY LINES AND ANY DISPUTES
BETWEEN ADJACENT HOMEOWNERS WILL BE A CIVIL MATTER. I UNDERSTAND THAT FAILURE TO PROPERLY FOLLOW THESE GUIDELINES
AND ADHERE TO ALL CITY CODES (SANFORD LAND DEVELOPMENT REGULATIONS, SCHEDULE F) COULD RESULT IN THE FENCE HAVING
TO BE REPLACED, RELOCATED OR REMOVED AT THE OWNER'S EXPENSE.
FENCE CONTRACTOR
BY SIGNING THIS AFFIDAVIT, YOU ARE ACKNOWLEDGING YOU HAVE MADE THE HOMEOWNER AWARE OF THE FENCE AFFIDAVIT
STIPULATIONS AS STATED ON THIS DOCUMENT.
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE: DATE:
Dq"HOMEOWNER (OWNER/BUILDER)
OWNERUILDER NAME l e- B
OWNER / BUILDER SIGNATURE: DATE:
PLEASE NOTE"
THE BUILDING DEPARTMENT WILL NOT CONDUCT ANY INSPECTIONS ON RESIDENTIAL FENCES. THIS
AFFIDAVIT MUST BE PROVIDED, SIGNED AND NOTARIZED, AT THE TIME OF PERMIT SUBMITTAL AND WILL
SUFFICE AS THE FINAL INSPECTION APPROVAL FOR THE FENCE.
STATE OF FLORIDA COUNTY OF
ru to and Subscribed before me this Z!day of 20/a by:
Who is Personally Known to me or hasProduced (type of 4dentification)
atureofNotary Public State
of Florida Print/
Type/Stamp Name of
Notary Public as
identification. E-*
iDEBSIE
6LANTo"MY
COiiP.1iS510N fF 178G48EXPIRES: February25, 2019, Bondzd
Th Notary Fub .. Undenv;i:ers Effective:
August 1.2017