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13 MAY 14 2011 CITY OF SANFORD
BUILDING & FIRE PREVENTION
BY: PERMIT APPLICATION
Application No: mot' (p Documented Construction Value: $C 3 SD
00,
F-_t'.ToIAAddress: r Cf'y Id Ay. A&A049 22M , Historic District: Yes No
Parcel ID: Zoning:
esc = tion of Work: (A)p g h
Plan Review Contact Person: Title:
Phone: Fax: E-mail:
i
Property Owner Information
NamePhone:Q Str-
fet: Resident ofproperty?: fl1zb ` c_
Citnstate Zip: Contractor
Informtation Name
Street:
City,
State Zip: Name:
Street:
City,
St, Zip: Bonding
Company: Address:
Building
Permit Square
Footage. No.
of Dwelling Units: Electrical
New
Service — No. of AMPS: Phone:
Fax:
State
License No.: Architect/
Engineer Information Fax:
Exmll
orteaee
Lender: ' Address:
l711371
t0 9iGIG - :11it7U`i (t&lO I .`',/ v dM,
83 d91 angxj mmoD @h1 _• :4 0 •= PERMIT
INFORMATION S8105 73 noizaimmo =~yo raaA
VislaA lnralW OpoulT habio8 P
Construction
Type: No. of Stories: Flood
Zone: Plumbing
New
Construction - No. of Fixtures: Mechanical
0 (Duct layout required for new systems) Fire Sprinkler/Alarm 0 No. of heads:
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: P 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. Y
from other governmental entities such as water management districts, state agencies, or federal agencies.
7. d
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.
Sig -nature,"' . gent te
Print Owner/Agent's Name
1 Q.
to or riMWE BLANTON I
Notary Public - State of Florida
My Comm. Expires Fetr 25, 2015
Commission # EE 60162
Bonded Through National Notary Assn.
Owner/Agent is Personally Known to Me r),,)
Produced ID Type of ID 1 L
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
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:
Rev 11.08
I will
1 1. 1
r
f
do hereby state that I am qualifieda
and cable of performing the requested construction involved with the permit application filed and agree to the \ conditions
specified above. ature
o Owner -Builder Date Property
Address: G
1 biff
apl
Form
of
Identification Must be
Photo ID) A violation
of this exemption is a misdemeanor of the first degree punishable by a term of imprisonments t not exceeding
1 year and a $1,000.00 fine in addition to any civil penalties. In addition, the local dy permitting
jurisdictionshallwithholdfinalapproval, revoke the permit, or pursue any action or reme for unlicensed
activity against the owner and any person performing work that requires licensure under the permit
issued. Rev. 9.
14.2009 abide by
all applicable laws and requirements that govern I agree
that, as the party legally and financially responsible this proposed f hiedactivity,
IN
WI
9
r,
I
i
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
VC1) 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 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 city ordinance.
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- i/
VV 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
PLAT OF BOUNDARY SURVEY
0
3
for
LINDA & FREDIE COATES O
Legal Description
LOTS 7 and 8, BLOCK 11, HIGHLAND PARK, according to the plat thereof as recorded in Plat Book ( I4, Page 28, of the Public Records of Seminole County, Florida.
SURVEY NOTES:
1) The street address of the above -described property is 2208 Community Way. •
2) The above -described property lies in Flood Zone X W
3) This survey was completed on the ground on 08 March 2004.
SURVEYOR'S CERTIFICATE
This is to certify to LINDA & FREDIE COATES, BANK OF AMERICAN, N.A., ISAOA, ATTORNEYS' TITLE INSURANCE FUND, INC. and U
HARRY G. REID, III, ATTORNEY -AT -LAW, that this "Boundary Survey' of the above -described property and the plat hereon delineated is I)
an accurate representation of the same. I further certify that this survey meets the Minimum Technical standards set forth by the Florida
Board of Surveyors and Mappers pursuant to Chapter 61 G17-06 of the Florida Administrative Code pursuant to Section 472.027 of the
Florida Statutes.
z
I
KITNER SURVEYING
R. BLAIR KITNER— P.S.M. No. 3382
P. 0. Box 823 — Sanford, Florida 32772- (407) 322-2000
Not valid without raised seal of Surveyor
C1Ty 0'F SAi'dFDR 1IEREVIEW01LOING
PLANLOPME
T SERVtCES PLANItN6ANAPPRGVECI _,
R=
666.78' D=
09.11'18"(ACT) D=
09"9'02"(PLAT) L=
106.93'(ACT) L=
106.00'(PLAT) L.
COURT
R=
191.25'(ACT) R=
170.00'(PLAT) D=
28'36'22" D=
32'02'06" L=
95.49'(ACT) L=
95.05'(PLAT) 25.
00' 88'
07'43" 38.
45' 0
N
PROJECT#
04-246