HomeMy WebLinkAbout404 Orange Ave 04-347 Roofr— -
CITY OF SANFORD PERMIT APPLICATION "
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Permit # : t — J Date:
DescriptionofWork:"" U®F
Historic District: Zoning: Va(ue
Permit Type: Building f?VF Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
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Plumbing/ New Commercial: # of Fixtures of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories: of Dwelling Units: Flood Zone: (FEMA form requ i (cd for other than X)
Parcel #:
Owners -Nam & _Adddress: Contractor
Name & Address: Phone &
Fax: Bonding
Company: Attach
Proof of Ownership & Legal Descripfi.oa.) P7 %
1 "i'- Phone:'- n CJ % ` 25U `613 f State License
Number: Contact Person:
Phone: Address: -- Mortgage
Lender-:- °
RIY7i` ' l e 19,-J 66NEA6 L. Address: Architect/
Engineer:
Address: Phone:
Fax:
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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT. 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
ermit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. Signature of
Owner/Age Date Signature of Contractor/Agent Pri weer/
Agent's Xame Print Contractor/Agent's Name Signature of
Notary -State of Florida Date Signature of Notary -State of Florida DEBBIE ANTO
MylQAmWsXnoybb 81
1.800-
3-NOTARY FL No,,, -_. punt Assoc.
Co. APPLICATION APPROVED
BY: Special Conditions:
Date Date
Contractor/
Agent
is _ Personally Known to Me or Produced ID
Initial & Date)
Utilities: FD:
Initial & Date) (
Initial & Date)
i
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 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 $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 lease, or offering for sale or lease, of any such
structure by the owner -builder within 1 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 pexsun
unless that person is registered or certified under this part and the work being performed is within the
scope of that person's 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 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 r.trrdtr
an exemption to that law. The exemption allows you, as the owner of your property, to act are Siotu 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 "Alo-farnily
residence or a farm outbuilding. You may also build or improve a commercial building, provi J(ed yotxz
costs do not exceed $25,000. 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 you sell or lease a building you have. (:ru iill. or
substantially improved yourself within 1 year 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 on your building. It
is your responsibility to make sure that people employed by you have licenses required by sta.tc; 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 ern-ployed by
you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' co ripe-,usa.ti.on
for that employee, all as prescribed by law. Your construction must comply with all applicable laws,
ordinances, building codes, and zoning regulations.
I,c Si9 N' Dei , do hereby 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 Owner/Builder Contractor, and will personally supervise all work
allowed by law on the permitted structure.
k,4-A 1° -D
Owner/Builder SV nature Date
Print Owner/Builder Name
Signature of Notary —State of Florida Date
DEBBIE BLANTON
lAill OOwnerisPerso11C . ,
aNs #
DD 18M1
Produced ID '
a d
nt Assoc. Co.