HomeMy WebLinkAbout1800 W 16 Sti
RECEIVED
OCT 2 10 CITY.OF SANFORD25BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application'? o: I ( Documented Construction Value: $TjgK
Job Address: 4 Historic District: Yes No
Parcel ID• Zoning:
Description of Work " _ O
Plan Review Contact Person: Title:
Phone: Fax: E-mail:
T
Property Owner Information
Name elo .2, Phone:
l/ y—
Street:PDQ W " 14h / Resident of prepeyty.
City, State Zip7 Contractor
Information le _
Fri[: Street:
City,
State Zip: _ Name:
Street:
City,
St, Zip: Bonding
Company: Address:
Building
Permit Square
Footage: _ No.
of Dwelling Units: Electrical
Phone:
Fax:
State
License No.: Architect/
Engineer Information Phone:
Fax:
E-
mail: Mortgage
Lender: Address:
w-
PERMIT
INFORMATION.",y Construction
Type: No.. of Stories: Flood
Zone:` New
Service — No. of AMPS: Mechanical (
Duct layout required for new systems) Plumbing
New
Construction - No. of Fixtures: Fire
Sprinkler/Alarm 11 No. of heads:
1
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 certifythat 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. Ib
Signa
re of Owner/Agent Date Signature of Contractor/Agent Date Prin
er/Agent's Name Print Contractor/Agent's Name Signature
of Notary -State of Florida .... Vte;!Xlam Z7ECG .• •. O i LLJ
D,
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Owner/
Agent is Person, InoKrn. Produced
ID Type of NOT APPROVALS:
ZONIN ,*0 ENGINEERING:
COMMENTS:
UTILITIES:
1'
Signature
of Notary -State of Florida Date Contractor/
Agent is Personally Known to Me or Produced
ID Type of ID WASTE
WATER: BUILDING: .
7ho k10
C
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D
I agree that, asi thCparty legally and financially responsible for this proposed construction activity, .I will
r abide Sy 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 ma obtain more information regarding obligations.as an em loyer from the Internal, Y. g g m Y.p
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 Indust 'Licensing Board at 1-850-48,7-1395 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 sustaiwas 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 maybe held liable for,damages: If you ..
obtain an owner-builder'permit and wish to bite -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.
Pro erty Address:
do hereby. state that I am qualified.,
and capable of performing the requested construction involved with the permit application filed. and agree Ito the
conditions specified above.
Signa ure of Owner -Builder' Date
Form of Identification
Must be Photo ID)
A violation of this exemption is a .misdemeanor: of the first degree punishable by a term of imprisonment
not exceeding .l year and a $1,000.00 fine in addition to any civil- penalties: In addition, the. local
permitting jurisdiction shall withhold' finch 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:
a
5
Rev. 9.14.2009
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OWNER BUILDER STATE M ENT/AFF1 DAVIT
Altamonte Springs,Casselberry, Lake Mary, Longwood, Oviedo,
Seminole County, Winter Springs
Florida Statutes are quoted here in part for your information to indicate the authority for exemptions for
homeowners from qualifyir ig 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 /e.ft 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 1, as the owner of611bthepropertylisted, 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 4 property owner unless he or she is
for is hiring licensed to assume responsibility. responsible the construction and not a contractor
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 h
I
iring 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
herlicensedinFloridaandtolisthisor 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 I 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
employ have the licenses required by law and by,.6ty ordinance.
I understand that it is.. afrequent 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. 1, 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
Permit No. l J l u
Tax Folio No.',35 q 36 508 0000< < 09b
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
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.
I. De crt Lion Of prop rty, legal desciipti n of roperty and
MOE NNEg CLERK OF CIRCUIT CST
SERIMXE CMWY
8K 07467 Pg 1083; Opg)
CL.ERKI S 0 2010123622
RECOM 10/25/2010 103107 11
REMIND FEES 10.00
RECO D BY T Beith
if available)
3. Owner information: Name: ex, C,
Address:
b. Interest in property:
c. Name and aqdwss of fee simple titlehol r (if ther than Owner): Name:
Address: ` CAJ e
4. Contractor a Phone number: . ANN_
c. Address: P F G EOwl
5. Surety Name C
Address:
b. Amount of bond: $ANEPA
6. Lender: Name:
Address:*
b. Lender's phone number:
Ta. 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: Name: _
Address:
8.a. In addition to himself or herself, Owner designates of to receive a copy of the
Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes.
b. Phone number of person or entity designated by owner: _
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different
date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE,CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1,
SECTION 713.13, FLORIDA STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF
Si atCe f Owner ed Officer/Director/Partner/Manager Signatory's Title/Office
The foregoing f#.,' tovJedged before me this _ day of , (year) , by (name of person) as (type of
autho 'ty, .. trus{ee, atoflSraey in fact) for (name of party on behalf of whom instrument was executed) .
0
SEAL)
Signature of No yr Jjoioy°rF 1,,.'t O e``
Personally Known %i PU 5`hroduced Identification Type of Identification Produced
Dig A ktj 1N
Verification pursuant to Section 92.525, Florida Statutes: Under penalties of perjury, I declare that I have read the foregoing and that
the fact stated in it are true to the best of my knowledge and belief.
9L---
Signa ure of Natural P ,onqSining Above
Rev. date 3/2008
Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 1
4 3 2 i.l?
A 2 A.4 A.0:
DAVID JOHHSON: CFA. A5A
47_A 3'E 43 2'1 1p t8 i7ii1rS15
a i':,+.'
A A I47.9 48 C 3 0 1 0 1.0 a48148. pPROPERTY ®
P'Ilr f'-i WR d3 d7 dd 7 8 71121 42 i:j 122Ilii;.0'E
is1
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3E7r11NOLE COUNTY FI-. 47:B 48.D7.0 9— 'A t
t tl)1 E FIR5T:5T t ig .. t iF, 1 i6TT s.
BANFORO FL 32771-74iG6' ts.
VALUE -SUMMARY
r_
2011 2010
VALUES
Working Certified
GENERAL Value Method Cost/Market Cost/Market
Parcel ld: ,35-19-30-508-0000-0090 Number of Buildings 1 1
Owner: KELLY LOUISA R Depreciated Bldg' -Value 15,112 15;532
Mailing Address: 1800 W 16TH ST Depreciated EXF.T:Value 0 0
City,State,ZipCode: SANFORD FI-32771 Land Value (Market) 10,424 10'424
Property Address: 1800 16TH ST W SANFORD 32771 Land, Value Ag 0 0
Subdivision Name: ASSESSORS MAP OF LOTS 44 AND Just/Market Value 25,536 25,956
Tax District: S1-SANFORD
P,ortablityAdj 0 0
Exemptions 00-HOMESTEAD (2007)
Save Our Homes Adj 0 0
Dor: 01-SINGLE FAMILY
Amendment 1 Adj 0 0
Assessed Value (SOH) 25,536 25,956
Tax Estimator .
2011TAXABLE VALUE'WORKING ESTIMATE'
Taxing Auihority' Assessment Value Exempt Values, Taxable Value.
County General Fund 25,536 25,536 0
Amendment 1`adjusiment i3not applicable toschool assessment) - Schools 25,536 25,000 536 City
Sanford 25,536 25;000 536 SJWM(
Saint Johns.Water Management) 25,536 25,000 536 County
Bonds 05,5361 25,000' 536 The
taxable values and taxes are calculated using the. current years working values and the prior years' approved millage rates.': SALES
heed '
Date' Book Page Amount Vacllmp Qualified QUITCLAIM
DEED 11/2006 06484 0577 $100 Improved No 2010 VALUE SUMMARY` PROBATE;
RECORDS 07/2006 06337 1056 $100 Improved No 2010 Tax Bill Amount: $15 PROBATE'
RECORDS 06/2006 06307 1272 $100 Improved No 2010 Certified' Taxable Value and Taxes DOES
NOT INCLUDE NON -AD VALOREM ASSESSMENTS WARRANTYDEED09/1985 01669 0980 $10,0 Improved No ADMINISTRATIVE
DEED 08/1985 01665 0823 $100 Improved No Find
Comparable Sales within this Subdivision LAND
LEGAL DESCRIPTION. Land
Assess Method Frontage Depth Land Units Unit Price Land Value LEG LOT 9 ASSESSORS MAP-0F LOTS 44 + 45 BLK A M M, FRONT
FOOT & DEPTH 44 154 .000 - 230:00 $10,424 SMITHS 2ND SUBD DB 107 PG.487- BUILDING
INFORMATION Bid
Num Bid Type Year Bit Fixtures Base SF Gross SF Living SF Ext Wall Bid Value Est.
Cost ' New
Building
1
SINGLE FAMILY 1941 3 936 Sketch "
1,
140 936 SIDING AVG $15,1.12 =: 38,583 Appendage /
Sgft OPEN PORCH FINISHED / 132 Appendage /
Sgft, SCREEN PORCH UNFINISHED / 72 NOTE:
Appendage Codes included in Living Area: Base, Upper Story Base, Upper Story Finished, Apartment, Enclosed Porch Finished, Base Semi
Finshed Permits
NOTE:
Assessed values shown are NOT certified` values and therefore, are subject to change before being finalized for: adwalorem.tax purposes. If
you recently purchased, a homesteadedproperty, .our next ear's,property.tax;will be based.on`JusUMarket value. s
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http://
www.scpafl.prg/web/re_web.seminole_county_title?parcel=35193050800000090&.'.. 10/25/2010
PLAT OF "BOUNDARY" SURVEY
for
f LOU ISA R. KELLY OFFICE
Legal Description
Lot 9, ASSESSOR'S MAP OF LOTS 44 AND 45, BLOCK A, M M SMITH'S SECOND SUBDIVISIONB, according
to map thereof as recorded in Deed Book 107, Page 487, of the Public Records of Seminole County, Florida.
5 4 3
mo
S 89"56'44" E
FOUND IRON
AXLE (NO /) 44.00'
1.1' NORTH 4' CIF, FOUND IRON &
P #5154
0.61'
00
0.68•
00
V
a
11.34'
12'
9
Z Z T
8 g N 9 10
0 0
WODO RAMP
24.6'
0 0 J
24.6• Q
N U
W
Uf Q o
I
I
Ir
2.6t' 24.6' 1
5. 7' CM -UNDEOPORCH R
CO. I IItO.T I 1
SET IRON & FOUND IRON &
CAP /3382 CAP #5154
6 44.00.
CONCRETE
OCV
VIE-S T- 6 Try STE-E-T---------
SURVEY NOTES:
1) The street address of the above -described property is 1800 West 16T" Street. -
2) The above -described property lies in a Flood Zone X.
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SURVEYOR'S CERTIFICATE
This is to certify that I have made a Survey of the above described property and that the, plat hereon delineated
is an accurate representation of the same. I further certify that this Survey meets the Minimum Technical
Standards set forth by the Florida Board of Land Surveyors pursuant to Section 427.027 of the Florida Statutes.
CERTIFIED CORRECT TO:
ITNER :SURVEYING, INC.
R. BLAIR KITF?EIt P.L.S. NO. 3382
Post Office Box E23, Sanford, Fl. 32772-0823
o (407) 322 _vi
PROJECT NO: 10-'i00 SURVEY DATE I NOV. 2LNO
II
Gv
SEE PLAN
SGALE: 1/4' = V-O'