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Home My WebLink About1300 S Magnolia Ave 11-471 (install line for tankless water htr)RECEIVED DEC 13 2010 CITY OF SANFORD 5 BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: % Documented Construction Value: $ 3 D Job Address:. Historic District: Yes UY No 0 Parcel ID• Zoning:: Description of Work: IOw( 6r c,z tl"1" f' nW tn tAkjVATk' Plan Review Contact Person: ma V At eh Title: Phone: LIU- Fax: E-mail: bel/-s a W Property Owner Information Name Fi V pt6 k Phone: -f ' 32` - J/3 Street: 0 (Atinz I i u Aw• Resident of property? City, State Zip:i Contractor Information Name 0 ow,'' Phone: Street: Fax: City, State Zip: State License No.: Architect/ Engineer Information Name: 0 W vVIf Street: City, St, Zip: Bonding Company: jl1 & Address: Building Permit Square Footage: — Phone: Fax: E- mail: Mortgage Lender: Address: PERMIT INFORMATION Construction Type: No. of Dwelling Units: Flood Zone: Electrical on<- -P_xk'r' or Nf ltl New Service — No. of AMPS: Mechanical ( Duct layout required for new systems) No. of Stories: Plumbing New Construction - No. of Fixtures: Fire Sprinkler/Alarm 0 No. of heads: r: 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 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 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. Signature of Owner/Ag t Date M6(q E. ve4 fe J, 7,0- Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Nte or Produced ID Type of ID f L D L APPROVALS: ZONING: UTILITIES: COMMENTS: Rev 11.08 ENGINEERING: 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 WASTE WATER: BUILDING: 66 464ig-fd i 6 ilok ff--- AT sim, idMAfX,. XRT C T Ar RMR, 4 R v 1`14 ult 54 W-6.01" s FAnswer alltlie uestions on .thisf form and submit call ;r:.e uiced attachments * Incompleteapphcations W ill not be, reviewed you ha e questions about the Historic Preservahont cer-, it : If application requirements contact On") epar W permit may result m fines and/or double- 011 y1 powntowtn Commercial Historic District Residential Historic Distnctfi h Is this4 a"retroactive request Yes No s Is d, epMDepartments gProperty AddressMa no ` g M RS IF -v uwb aAddressl 407 324 z90Ph*@ o Signature k 4AIM 4IU5PIAgpp p2Ii. AiNO,N"A PrintNameMa'M ""Ad00OT- W g, sM L; cerh ;that &diFffitobhkoP ee ywigg r M J N" nand CominiwityPjann -`c M X, U% I.-APPLICAT10W. CATE MY ' SI, V1' emenf§me616taygns: w hk w Ng6'4, ® is K 7 0 Replacement Windowsor Doors qeqPk1009.0 Tg§t io /Additipps! 51ih fi IZ.i C i MROCA WT' IMOdftD- Kj ZA ,0q1s i I19' 51gDESCRIPTIONSEW_WORK% Completelyc6sdibethO)dfffie&'kbp jh5VIM6, used to WE, 6S64 4lristall natural qas tankless water heater on"extenor wall South elevation below Mudroom:windows k.,,- _ ' h7 0 n'd'methods j 7.a* A-6,t gi- RNZ OFFICIAL ceivOdDh X 1, Re I M " IMW"" MA. . PAI fes Date', T M aN2IN'(APPR IR 'n W CERTIFICATEtMUS SITE S N, PROGR- ESS Ti TROM NENTLYMISPLAYED- OWTHE WORK'IS WHEN g Zk Z JEW 44"k `w 'F'4 P A. Ma" ;'IM , te Pa, Mkztil-R , ;W. Aft, Oz if. V it ex5y+3.2a 5 DEC 13 ,; i 0 OWNER BUILDER STATEMENT/AFFIDAVIT i 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 PERSONALLYAPPEAR 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 do havethepropertylisted, may act as my own contractor with certain restrictions even though I not 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 beI V 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 V 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 by law by ordinance. employ have the licenses required and city v 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 D'J and materials. I, as an owner -builder, may be held liable and subjected to serious financial risk for any injuries sustained by an tin licensed.;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 I agree that, as the party legally and financially responsible for this proposed construction activity, :I will A 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 JServices, 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.mAorida.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 J 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 lossI V 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 3 277 VCR 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 Owner ilder.. Sy06 2op 9Fs..* a'rc.C36 a Q Form of Identification ; . Must be Photo ID) Op9cIV Bon0\'. s•. Tads\ p'`` A violation of this exemption is a misdemeanor of the fir ptiable by a term of imprisonmentfF/ 1 VOL F t not exceeding 1 year and a $1,000.00 fine in addition >d«aurY141 il'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