HomeMy WebLinkAbout1014 S Oak Ave 12-2493 (fence)RECEWED
SEP242012
,BY:
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: �' �79� Documented Construction Value: $ �9
Job Address: n"ALe Historic District: Yess No ❑
Parcel ID:
Description of Work: T S<<,3�4 Iz, A10 x ,o
Zoning:
Plan Review Contact Person: h e- H:u Jl Title: e Q
Phone: '�o %- 3s!(/ Fax: E-mail: re-4 N, A� M a-1 Leh-c
Property Owner Information
Name rl� l� Phone:
Street: 16.144 s ��`?` W,,e Resident of property?: V ao
City, State Zip: S411
Contractor Information
Name Phone:
Street:
Fax:
City, State Zip: State License No.:
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Building Permit ❑
Square Footage:
No. of Dwelling Units:
Electrical ❑
New Service — No. of AMPS:
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type:
Flood Zone:
No. of Stories:
Plumbing ❑
New Construction - No. of Fixtures:
Mechanical 13 (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads:
P
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. 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 POUR
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 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. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
2 L
Signature of blrmjrrAjent Dafe
Print Owner/Agent's Name
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Signature of No Sta(@,a�Florida DEBBIE BLANMW
Notary Public -State of Florida
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My Comm. Expires Feb 25, 2015
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Commission # EE 60182
OF F�
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Bonded Through National Notary Assn.
Owner/Agent is Personally Known to Me orrr
Produced ID �� Type of ID��"(>'
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
A
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
Rev 11.08
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 &'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.
a
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 10 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:
.,
1, _ ( �12�lp i �f / , 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.
Signature of Ow e -�'uii der
Form of Identification
(Must be Photo. ID)
_ � L
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
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BOUNDARY MIRVEY
FOR
CFLARLES W. & KATHLEEN H. HULL
LOT 4 BLOCK 12
TIER 5 TOWN OF SANFORD
PLAT BOOK 1, PAGES 56-64,
SEMINOLE, FLORIDA
14' DIRT ALLEYWAY
3.00'
SHED t 1.3' OFF N00'02'30"E 50.00'
PROPOSED DRIVE
20.2' 24.00' 14.00'
WOOD co PROPOSED
SHED U o GARAGE b
METAL
N LIGHTPOLE N
SHED t 1.3' OFF 12.00' 24.00
N
/D
W PROPOSED
O 10' x15' POOL
O
0
O
0 PORCH
rn
N
10.00' 1--- 30.00'
O PROPOSED
(66 RESIDENCE
� h
30.00'
PORCH
10.00'
11111, 11 c\\I
N
�P G�
22.77'