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HomeMy WebLinkAbout1216 W 13 St 02-1256 remodelPERMIT ADDRESS CONTRACTOR ADDRESS PHONE NUMBER 3& Sr. PROPERTY OWNER ADDRESS o, i l, PHONE NUMBER )(401' -,::Z3. 20co ELECTRICAL CONTRACTOR MECHANICAL CONTRACTOR PLUMBING CONTRACTOR MISCELLANEOUS CONTRACTOR PERMIT NUMBER MISCELLANEOUS CONTRACTOR FEE PERMIT NUMBER FEE SUBDIVISION PERMIT # d Z- l 1-S ( DATE S 3 © 2- PERMIT DESCRIPTION < V PERMIT VALUATION v CW SQUARE FOOTAGE l C7 C in cn r Zoo ( FZ r31cE cJ-Cc e CITY OF SANFORD PERMIT APPLICATION Permit No.:y C.S' Date: Job Address: / 02 W • 3 Permit Type: _-__ Building Electrical Mechanical Plumbing Fire Alarm/Sprinkler Description of Work: ( ri r Additional Information for Electrical & Plumbing Permits Electrical: —Addition/Alteration _Change of Service Temporary Pole _New AMP Service (# of AMPS ) Plumbing/Residential: Addition/Alteration New Construction (One Closet Plus Additional) Plumbing/Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines Occupancy Type: _Residential Commercial _ . Industrial Total Sq Ftg: / I -To Value of Work: S 600 Type of Construction: Flood Zone: Number of Stories: Number of Dwelling Units: Parcel No.: T , ok 5 / "Attach Proof of Ownership & L.-eygaal Description) Owner/Address/Phone: l V91 a %! Awe Cr %i o ve ai c 9 /o S. - -d , vunr At- 7r Contractor/Address/Phone: joe State License Number: Contact Person: I? R,r C e A D do Rr Li Phone & Fax Number: r1jo:Z 2.3 -awUo (t o -J7 23 79 $- 2- Title Holder (If other than Owner): A7x Address: Bonding Company: AI QA -e Address: Mortgage Lender: A-r-o Ar-G Address: Architect/ Engineer h iA( ,: e,Q Phone No.: Address: Fax No.: 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. 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. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCWCe, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1 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 tha I ill notify the owner of the property of the requirements of Florida Lien Law, FS 713. Signature of Owner/Agent Date Signature of Contractor/Agent Date Pr' er/A ent' Na ie 5 D2 Signature o ary-State of Florid Date Emily Anne Dilliplane y. * My Commission CC899919 Expires January 05, 2004 Owner/ Agent i Personally Known to Me or Produced ID APPLICATION APPROVED BY: 7 Special Conditions: -2-CDC;, Print Contractor/Agent's Name Signature of Notary -State of Florida Date Contractor/ Agent is Personally Known to Me or Produced ID Date:- 6( t cpe o^oc v I` - F v 6 ti . , l o 6, CITY OF SANFORD BUILDING DIVISION OWNEWBUILDER AFFIDAVIT CONSTRUCTION CONTRACTING O\\'ners of property when acting as their o\wn contractor and providing direct. onsite supervision themselves of all work not performed by licensed contractors. when building or improving farm Outbuildings or one -family or two-fanlil\, residences on such property for the occupancy or use ol such o\wncrs and not offered for sale or lease. or building or improving commercial buildings. at a cost not to exceed $25_000. er. such property- for the occupancy or use of such owners and not offered for sale or lease. In an action Brought under this part. proof of sale or lease, or offering for sale or lease. of any Such structure by the owner -builder within I vicar at -ter completion Of same creates a presumption that the construction \\'as undertaken for purposes of sale or lease. This subsection does not exempt an\' person who is employed by or has a contract with such owner and who acts In the capacity of a contractor. "lThe owner ilia\, not delegate the owner's responsibility to directly supervise all work to any other person unless that person is registered or Certified under this part and the work being performed is within the scope of that persons license. For the purposes of this subsection, the term --owners Of property" includes the owner of a mobile home situated on a leased lot. To qualify for exemption under this subsection. an o\wncr must personally appear and sign the building permit application. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows \you. as the owner of \'our property. to act as ,'our o\wn contractor with certain restrictions CUCII though \'Ou do not have a license. YOU must provide direct. onsite supervision Of the construction \-Ourself. You nlav build or improve a one -family or t\\-o-famil\, residence or a farm outbuilding. YOu Ili \' also build OI' Illlpl'OVe a COI11111C1'CIaI bUllCllllg. provided your costs do not exceed S25.000. The building or residence must be for \'Our o\wn use or occupanC\'. It nla\' not be built Or substantially improved for sale or lease. If you sell or lease a building Vou have built or substantially improved \'ourself within I \-car after the construction is complete. the law \\,III prCSUt»C that Ou built or substantially improved it for sale or lease. which is a violation Of this exemption. You nlaw not hire an unlicensed person to act as your contractor or to Supervise people working on \-our build;'.ng. I IS your responsibility to make sure [hat people employed byyou have licenses required by stale lawand by county or municipal licensing ordinances. You nlay not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. :env person working Oil \'our building who is not licensed must work under \,our direct supervision and must be employed by Ou, which means that you must deduct F.I.C.A. and withholding tax and provide \yorkers' compensation for that employee, all as prescribed by law. four construction must COIllply with all applicable laws. Ordinances; building codes. and zoning regulations. I wS(i.)• on!( /2/ T do hereby state that I nm qualified and capable ol'performing the requested construction involved with the permit application filed. I will assunlC full responsibility as an Owner/Builder Contractor. and \will personally supervise; all work alloyed by law on the permitted structure. Owner/Builder Signature Date / RvssLH /3IZ'C.cs /`10'vcRie.n P'' t O\wncr/Builder Namc r 5 - 02 Emily Anne Dimplam Signattlt'e Notary—State0l 1=10t da Dalc *.' *MyCommissionCC89NI9 Expires January 05.2004 Owner is 4 Personally Known to `-lc or has Produced ID CITY OF SANFORD PERMIT APPLICATION Permit No.: ? 1 Date: - — -- Job Address: _ l /(0 (A). 3 Permit Type: Building Electrical Mechanical _\L Plumbing Fire Alarm/Sprinkler Description of Work: Additional Information for Electrical & Plumbing Permits Electrical: —Addition/Alteration _Change of Service _Temporary Pole _New AMP Service (# of AMPS ) Plumbing/Residential: Addition/Alteration New Construction (One Closet Plus Additional) Plumbing/Commercial: Number of Fixtures 9 Number of Water & Sewer Drainage Lines Number of Gas Lines Occupancy Type: _Residential k Commercial — Industrial Total Sq Ftg: Value of Work: S. Type of Construction: Parcel No.: Own er/Address/Ph on e: Flood Zone: Number of Stories:_ Number of Dwelling Units: Attach Proof of Ownership & Legal Description) S"r7t0 S- 30k-J tfoynF2 Asti _Q2 l % .2432 21,67 ,Z j :L C cr O Contractor/Address/Phone: 3 AfVe State License Number: Contact Person: Re,, e e /i j e 2 , Phone & Fax Number: ((Ay -7 } 523 -- 2-corn Title Holder (If other than Owner): Address Bonding Company: Address: Mortgage Lender: Address: Architect/Engineer Q 6-.;. Are-/2 Phone No.: Address: Fax No.: 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. 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. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCINT, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 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. le L A Signature of Owner/Agent Date Signature of Contractor/Agent Date rent waer/Age t' ame Signature o otary-State of F on a Date Emity Anne Dilliplane My Commission CC899919 Expires January 05, 2004 Owner/Agent is K Personally Known to Me or Produced ID Print Contractor/Agent's Name Signature of Notary -State of Florida Date Contractor/Agent is Personally Known to Me or Produced ID APPLICATION APPROVED BY: /`) G . Date:— Special Conditions: t• CITY OF SANFORD BUILDING DIVISION OWNER/BUILDER AFFIDAVIT CONSTRUCTION CONTRACTING Owners of property when acting as their o\wn contractor and providing direct. onsite supervision themselves of all work not performed bw licensed'contractors, when building or improving farm outbuildings or one -family or two-family residences on such property for the occupancy or use of such owners and not offered for sale or lease, or building or improving commercial buildings, at a cost not to exceed $2 ,000. on such property for the occupancy or use of such owners and not offered for sale or lease. In an action brought under this part. proof of sale or lease, or offering for sale or lease, of any such structure by the owner -builder within I year after completion of same creates a presumption that the construction was undertaken for purposes of sale or lease. This subsection does not exempt any person who is employed by or has a contract with such owner and who acts in the capacity' of a contractor. The owner may not delegate the owner's responsibility to directly supervise all work to any other person unless that person is registered or certified under this part and the \vork being performed is within the scope of that person's license. For the purposes of this subsection, the term `-o\\'ners of property' includes the owner of a mobile home situated on a leased lot. To qualify for exemption under this subsection, an owner must personally appear and sign the building permit application. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows \-ou, as the owner of your property. to act as your own contractor with certain restrictions even though you do not have a license. You must provide direct. onsite supervision of the construction yourself You may build or improve a one -family or t\wo-family residence or a farm outbuilding. You may also build or improve a commercial building. provided your costs do not exceed $2i.000. 'The building or residence must be for your own use or occupancy. It may not be built or substantially improved for sale or lease. If \-oil sell or lease a building Vou have built or substantially improved yourself \within I year after the construction is complete. the la\\- \will presume that you built or substantially improved it for sale or lease. which Is a violation of thus tXCmpilOn. YOU may not hire an unlicensed person to act as \'our contractor or to supervise people working on your building. It is your responsibility to make sure that people employed by \-oil have licenses required by state law and by county or municipal licensing ordinances. You 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 your building who is not licensed must work under your direct supervision and must be employed by ou, which means that you must deduct F.I.C.A. and withholding tax and provide workers compensation for that employee, all as prescribed by law. Your construction must comply with all applicable lays. ordinances,buildingcodes, and zoning regulations. do hereb\' state that I am qualified and capable of performing the requested construction involved with the permit application filed. I will assume full responsibility as an 0\\'ncr/Builder Contractor, and will personally supervise all work allowed by lay on the permitted structure. OwnerBuilder Signature Date RVS%ir I /3R-vco" /`'loNeR/e 4Signaturc der Namc o"N Emily Anne Dilliplane k * MY Commission CC8M9 Expires January 05; 2004 n•—State of FI ida Date ( J Owncr is Pcrsonall\' Known to vtc or his Produced D l 9 C cl N E C— CITY OF SANFORD ELECTRICAL PERMIT APPLICATION Permit Number: Date: The undersigned hereby applies for a permit to install the following electrical: Owner's Name: Address of Job: A.2/l/ /,J. 13 Electrical Contractor: n(,j^je4 Residential: Non -Residential: X Number Amount Addition, Alteration, Repair (Residential & Non -Residential) New Residential: AMP Service New Commercial: AMP Service Change of Service: From _7x_nQ AMP Service to ZAnO AMP Service Manufactured Building Other: Description of Work: e / vi Ce Q R N Application Fee: 10.00 TOTAL DUE: W „P.Q 6z By Signing this application I am stating that I am in compliance with City of Sanford Electrical Code. C/,/ V-a— 6_W A -CA) i Applicants Signature 2 State License Number CITY OF SANFORD BUILDING DIVISION OWNER/BUILDER AFFIDAVIT ELECTRICAL & FIRE ALARM SYSTEMS An owner of property making application for permit, supervising, and doing the work in connection with the construction, maintenance, repair, and alteration of and addition to a single-family or duplex residence for his or her own use and occupancy and not intended for sale or an owner of property when acting as his or her own electrical contractor and providing all material supervision himself or herself, when building or improving a farm outbuilding or a single-family or duplex residence on such property for the occupancy or use of such owner and not offered for sale or lease, or building or improving a commercial building with aggregate construction costs of under $23 00.0 on such property for the occupancy or use of such n.vnPr axtd not offered for sale or lease In an action brought under this subsection, proof of the sale or lease, or offering for sale or lease, of more than one such structure by the owner -builder within I year after completion of same is prima facie evidence that the construction was undertaken for purposes of sale or lease. This subsection does not exempt any person who is employed by such owner and who acts in the capacity of a contractor. For the purpose of this subsection, the term "owner of property" includes the owner of a mobile home situated on a leased lot. To qualiR, for exemption under this subsection, an owner shall personally appear and sign the building permit application. State law requires electrical contracting to be done by licensed electrical contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own electrical contractor even though you do not have a license. You may install electrical wiring for a faun outbuilding or a single-family or duplex residence. You may install electrical wiring in a commercial building the aggregate construction costs of which are under $25,000. The home or building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have wired yourself within I year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your electrical contractor. Your construction shall be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have licenses required by state law andbycounty or municipal licensing ordinances. 1, / wS rcll &-y-e-ar do hereby state that I am qualified and capable of performing the requested construction involved with the permit application filed. will assume full responsibility as an Owner/Builder Contractor, and will personally supervise all work allowed by law on the permitted structure. Owner/ Builder Signature Date V S S f LL ,( j/ZyCCF 1L1,:,n1_C2/, Pr' vner/Builder Name Emily Anne Dilliplane k* My Commission CC899919 ac Expires January 05.20D4 Signature of tary—State of Florid4 Date Owner isX Personally Known to Me or has Produced ID Seminole County Property Appraiser Get Information by Parcel Number Page I of I PARCEL DETAIL 7' remit ¢ a N 12THST O w 0-'--. 3 =.F -, . b n a W. V t I 15 W.1?TR PL Iv, GENERAL Parcel Id: 35-19-30-5AJ-OA00-0050 Tax District: S1-SANFORD MONCRIEF RUSSELL B 01-SINGLE VALUE SUMMARY Owner: & MARY Dor' FAMILY Value Method: Market Address: 3912 S JOHN YOUNG Number of Buildings: 1 PKWY Depreciated Bldg Value: $9,085 City,State,ZipCode: ORLANDO FL 32839 Exemptions: Depreciated EXFT Value: $0 Property Address: 1216 13TH ST WSANFORD32771 Land Value (Market): $5.832 Subdivision Name: SOUTH SANFORD Land Value Ag: $0 JusUrwlarket Vacua $14,917 SALES Assessed Value (SOH): $14,917 Deed Date Book Page Amount Vactlmp Exempt Value: $0 WARRANTY DEED 03/2000 03841 1227 $15.000 Improved Taxable Value: $14,917 ADMINISTRATIVE DEED 10/1989 02146 1259 $100 Improved 282 WARRANTY DEED 02/1979 01212 1249 $100 Vacant LAND Land Assess Method Frontage Depth Land Unit Land LEGAL DESCRIPTION Units Price Value LEG LOT 5 BLK A SOUTH SANFORD PB 1 PG 94 FRONT FOOT & 60 140 000 9000 S5 832 DEPTH 11 BUILDING INFORMATION Bid Num Bid Type Year Bit Fixtures Gross SF Heated SF Ext Wall Bid Value Est. Cost New 1 SINGLE FAMILY 1935 3 1,791 1.224 SIDING AVG $9,085 $18,635 Appendage 1 Sgft SCREEN PORCH FINISHED / 208 Appendage t Sgft ENCLOSED PORCH FINISHED / 224 Appendage t Sgft OPEN PORCH UNFINISHED / 135 NOTE: Assessed values shoavn are NOT certified values and therefore are subject to change before being finalized for ad valorem tax purposes littp://www.scpafl.org/pis/web/re web.seminole county title9PARCEL=i519)05AJOA00005C... 5/7/02 CERTIFIED COPY Permit No. State of Florida County of Seminole MARYANNE MORSE NOTICE OF COMMENCEMENT CLERK OF CIRCUIT COURT Tax Folio No. SEMIN0L F MMNTti d1l" OW 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. MAY n noon 1. Description of property: (legal description of the property and street address if available) C il) - 2. General description of improvemey:' A n - -A 3. Ownd niformation / ' b y : / a. Name and address /evss- ctF n/-c oei 3 , o S , „r d b. Interest in property / o .D w Al eR c. Name and address of fee simple titleholder (if other than Owner) nr mn w••r m n ur m r r nw au r rr r on a ar wa 4. Contractor a. Name and address S' — C o WA -re le- l b. Phone number Fax nu% r04415 ^r, 'Soo 5. Surety / CLERK'S #! 2002BB3290 a. Name and address ( /`r7JAr-rREMBED OUV312M O2,41,155 RN RECORDING FEES 6.00 b. Phone number Fax nuffA RDED BY M Noldm c. Amount of bond 6. Lender ` a. Name and address /on. 1 b. Phone number Fax number 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes: a. Name and address 0 " /it /Z. b. Phone number Fax number 8. In addition to himself or herself, Owner designates CCU "r ^'C2 ) of to receive a copy of the Lienor's Notice as provided in Section 713.13( l)(b), Florida Statutes. / a. Phone number Fax number 4T o 7 Z23 -7 G SL 9. Expiration date of notice of commencement (the expiration date is 1 year from date of recording unless a different date is specified) Signature of O er i2ksse.,/ 3 1;-Ootrv e Swo: 'to ( or affirmed)add-tubcrib before me this 23 day of 20 U by Personally Known Produced Identification Type of Identification Produced Y`19Z(o-7 Z7 49l2Li6 Signature of Notary Public, State of Florida Commission Expires: lZ Z la YP''., Melissa Cameron eMComjnission # DDo7Z,8 EXPisDBondedThruAdandcBonding Co., Inc. U'J 1*a m rpop! , I-Q u y PERMlT # oi.., m m Fe 60 CITY OF SANFORll PERMIT APPLICATION Permit No.: ,, rd ( Date: Job Address: / l W - / 3 's s A-./dV-" 1%/ Permit Tvne: Buildine Electrical Mechanical Plumbing Fire Alarm/Sprinkler Additional Information for Electrical & Plumbing Permits Electrical: —Addition/Alteration _Change of Service _Temporary Pole _New AMP Service (# of AMPS ) Plumbing/Residential: Addit ion/A Iteration New Construction (One Closet Plus Additional) Plumbing/Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines Occupancy Type: _Residential _Commercial _ Industrial Total Sq Ftg: Value of Work: Type of Construction: A 5 Flood Zone: Number of Stories: Number of Dwelling Units: Parcel No.: L. f. /o A S • S,,,P % /, ? 95" (Attach Proof of Ownership & Legal Description) Owner/Address/Phone: 3 9 10 -S • To /1 I a it nr .n, C9 &P , 3 z4- 3 5 Contractor/Address/Phone: c$-C State License Number: Contact Person: is R.J C'er Phone & Fax Number: D 9 ) `el;7-3 -X,,Dv i Z10 7 Z- Title Holder (If other than Owner): Address: Bonding Company: _ f M-c__ Address: Mortgage Lender: IV-0-ITC Address: Architect/Engineer O LJ:w-fAl, Phone No.: Address: Fax No.: 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. 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. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCINY, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1 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. I.-S-< 1%1 2- Signature of Owner/Agent Date Signature of Contractor/Agent Date 9f 91 / 13A-1; ItF M 0 AJrRfe Emily Anne Dilliplane k * My commission CC899919 Expires January 05.2004 Owner/Agent is Personally Known to Me or Produced ID Print Contractor/Agent's Name Signature of Notary -State of Florida Date Contractor/Agent is Personally Known to Me or Produced ID APPLICATION APPROVED BY: Date: S Z Special Conditions: Nck.c 4-0 F 2 L b .4 ' gv CITY OF SANFORD BUILDING DIVISION OWNER/BUILDER AFFIDAVIT CONSTRUCTION CONTRACTING Owners of property when acting as their own contractor and providing direct. onsite supervision themselves of all work not performed by licensed contractors. when building or improving farm outbuildings or Onc-family or two-family residences on such property for the occupanc\' or use of such owners and not offered for sale or [case_ or building or improving commercial buildings, at a cost not to exceed $25,000, on such property for the occupancy or use of such owners and not offered for sale or lease. In an action brought under this part. proof of sale or [case, or offering for sale or lease, of any such structure by the owner -builder \within I year after completion of same creates a presumption that the construction \\'as undertaken for purposcs of -sale or lease. This subsection does not exempt an\' person who is employed by or has a contract With such owner and who acts in the capacity of a contractor. The owner may not delegate the owner's responsibility to directly supervise all work to any other person unless that person is registered or certified under this part and the work being performed is within the scope of that persons license. 1-or the purposcs of this subsection. the term 4-o\wners of property includes the owner of a mobile home situated on a leased lot. To qualify for exemption under this subsection. an owner must personally appear and sign the building permit application. State law requires construction to be done by licensed contractors. YOU have applied for a permit under an exemption to that law. The exemption allows V011- as the owner of your property. to act as \'our o\VIl contractor with certain restrictions Cye11 though \'OU do not have a license. YOU must provide direct. onsite supervision of the construction \'ourself'. You.maw build or improve a onc-f"11111Iw or two-fanllly residence or a farm outbuilding. You illaw also build or improve a commercial bUlldln pI'OylCled \'011r costs do not exceed $25.000. The building or residence must be for your own use or Occupanc\-. It slaw not be built or substantially unproved for sale or lease. If VOu sell or lease a bUddltl" you have built or substantially improved yourself within I wear after the construction is complete, the law \will presume that yOu built or substantially improved it for sale or lease. which Is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working Oil y011r blllldlllg. It IS your responsibilih to make sure that people employed by \•oil have licenses required by state la\w and by count' or municipal licensing ordinances. You may not delegate the responsibility for supervising ork to a licensed contractor who is not licensed to perform the \work being done. Anv person working Oil your building who is not licensed must work under your direct supervision and must be employed by woU. which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws. ordinances, building codes, and zoning regulations. I- Ru S 4-ir C" /_Oc oti't-,do hereby state that I am gUahfled and capable ofperforming the requested construction involved with the permit application filed. I \will assume full responsibility as an Owner/Builder Contractor. and \\'ill personally supervise all work allowed by law on the permitted structure. cj :1 — 7 z Z Owner/13tidder Signature Zile USSt// i3 2vc / LL In Owncr/f3uilder Name Emily Anne Dilliplane my Commission CC899919 Expires January O5. 2004 Si naturc btarv—Slate of I-lo Ida 1 ;11c / OZ O\\ ner is Personall\' Known to iMe or II;Is Producccl I L