HomeMy WebLinkAbout104 W 10 St; 17-2725; FENCEC3
CITY a
19 SAj4VORD
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FIRE DEPARTMENT
Building & Fire Prevention Division
RESIDENTL4L FENCE PERMIT APPLICATION
Application No: I I _ ( I A
Documented Construction Value: $ qdO
Job Address: ' (4T } . Historic District: Yes)No
t
Parcel ID: 22S - (R -30- 5A,G - ItCq - 0cc3
Plan Review Contact Person: Al tm nd, Y-u' Title:
Phone: 391 - 331- a5 a G Fax: Type
of Fence: od Metal Fence
Height: (o A
Feet
Additional
Information: Ow
ne-,o- Email:
Residential
Fence Information PVC/
Vinyl Iron Other Gates:
1 Total Linear Feet: -S' 7 i -
0 "
Fences
with a height of over 6 feet will require signed & sealed structural engineering" Property
Owner Information Name .
AcF- 4'^ ia„Ao Phone: 3611 -331 - 05 CG Street: '
7 a 1 ' I Resident of property? : Al c City,
State Zip: FL 3a is -a Name
Street:
City,
State Zip: 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 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 compliance with all applicable laws regulating construction and zoning.
Signa repf Owner/Agent
Print Owner/Agent's Name
gk,qf n
Signature of N -State of Florida e
Owner/Agent is Personally Known to Me r
Produced ID
JENNIFER M. 60LLOWAY
PU.` = State of FloriNotaryPublic
da
My Comm. Expires, Now 3, 2017
Commissiosow Iwo*n NrAlry AM
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
PLAN REVIEWAPPROVAL: PLANNING: HISTORIC:
COMMENTS:
Effective: August 1, 2017
NEW FENCING
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APPLICATION #
FOR A CERTIFICATE OF 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 Districts Is this a retroactive request? Yes N
Is this application filed in response to a Notice of Violation from the Code Enforce"t Department? Yes dProposedimprovementswillaffectthefollowingelevations: North South East West
Property Address: 0 i.1 t7 S} Sp a, l 3a -1 Z 1
Property Owner Information
Print Name: ICK4,101<r 6. ld
Mailing Address: -72,1 1,4, 11. L-mswoe a. FL 3)'t5o
Phone: Email: a l & @'tzce Signature:
Applicant/Agent Information
Print -Name ---
Mailing Address:
Phone: Email: Signature:
e.
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 ACCURA O THE BEST OF YOUR KNOWLEDGE.
Signature: G^ L,- Date: 'I -7
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.
3-1' ;' 4-4"1
Scree 64: Wor IL -
HISTORIC PRESERVATION BOARD • 300 S. Park Avenue • Sanford, Florida 32771 •407.688.5145 • www.sanfordfl.gov/HP
N-E-W-F-E-N-Cl-NG
w/ GATE EXISTING FENCING
EXISTING FOOTPRINT
104 W. 1 Oth St.)
L------------- I
EXISTING
CONDITIONS
CITY OF
Building & Fire Prevention Division
FIRE DEPARTMENT
RESIDENTIAL FENCE AFFIDAVIT
6 FEET OR LESS IN HEIGHT)
PERMIT #: / p4 ADDRESS: 1 0q j Q }
I' S
Iecaidtr Eld
Sa"T-,J,, T-L 3a-1`1. 1
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 FEET, 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.
El 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:
HOMEOWNER (OWNER/BUILDER) /
OWNER/BUILDERNAME: 1e5(y, c Fue- -
OWNER / BUILDER SIGNATURE:
PLEASE NOTE"
DATE:
DATE: I
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
Sworn to and Subscribed before me this 1 day of 201 / by:
O---'no is Personally Known to me or hasxoduced (type of
identification) 1-- _ as identification. e
DEBBIE BLP.NTON
Si nature of Notary Public "Y'''94r, MY COMMISSION # Fr 178848
State of Florida I'* EXPIRES: Febtuary 25, 2019
Bonded Thru Noteri Publ,c Underwriters
Print/Type/Stamp Name
of Notary Public
Effective: August 1, 2017