HomeMy WebLinkAbout1006 S Palmetto AveG -, ,r- CITY OF SANFORD
V 'I
BUILDING & FIRE PREVENTION
o . JAN PERMIT APPLICATION
Application No: 16 3 g
Documented Construction Value: 0
Job Address: looms, GG.e Historic District: Yes No
Parcel ID:
e —
Residential Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work:
Plan Review Contact Person:
Phone:
Title:
Fax: Email: BoNV
Property Owner Information oUN 7G-7'i .COP'j
Name - Phone: E7A .31 /—GO /8
Street: /O 6 C GIQ, Residenilof property N
t...cr,.,!
City State Zip:
Contractor Information
City, State Zip:
Name: VIA
Street:
City, St, Zip:
Bonding Company:
Address:
Phone:
Fax:
State License No.:
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender: & 2
Address:
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.
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.
FBC 105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5th Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
1/1
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're uired from other governmental entities such as water
management districts, state agencies, or federal agencies.
r
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 at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current ICC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
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.
44, 1z"
rgnatu a of Owner/Agent Date
Print Owner/Agent's Name
JO ANNl41. JOHNSON
MY COMMISSION # EE 159467
EXPIRES: March a 2016
Bonded Thru Notary ftk Underwriters
Owner/Agent is Personally Kn" oyvvnto Me r
Produced ID Type of I k)pl—
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
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas[] Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
New Construction: Electric - # of Amps,
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING: 0 2' l'2olly UTILITIES:
ENGINEERING:
COMMENTS:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING: f I •1
Revised: June 30, 2015 Permit Application
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
n n 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 -
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 tag 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 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
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.
I,, do hereby state that I am qualified
and?ab le of performing the requested construction involved with the permit application filed and agree to the
conns specified above.
k,// A / Z V41
Sfftifdre 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 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
1/25/2016
wld John or,, CFP
noPPRAISEF
5EMIN a COUNTY FLOFtIDA
Parcel: 25-19-30-5AG-1202-0040
SCPA Parcel View: 25-19-30-5AG-1202-0040
Property Record Card
Parcel: 25-19-30-5AG-1202-0040
Owner: MARSHALL)OHN A LIVING TRUST FBO
Property Address: 1006 PALMETTO AVE SANFORD, FL32771
Value Summary - - ---
Property Address: 1006 PALMETTO AVE
Owner: MARSHALL JOHN A LIVING TRUST FBO
Mailing: 1006 PALMETTO AVE
2016 Working
Values
2015 Certified
Values
Valuation Method Cost/Market Cost/Market
SANFORD, FL 32771
Subdivision Name: SANFORD TOWN OF i
Number of Buildings 1 1
Tax District: S1-SANFORD Depreciated Bldg Value $102,290 $90,806 i
Exemptions: Depreciated EXFT Value $938 $950
DOR Use Code: 0102-SINGLE FAMILY - SANFORD HISTORICAL
DISTRICT
J
Land Value (Market) $13,500 $13,500
I
i „:.. alp: •...* Y '} • '.{y
i - }
Y t
Land Value Ag
Just/Market Value $
116,728 $105,256
Portability Adj
Save Our Homes Adj $0 $0
Amendment 1 Adj $0 $0
Assessed Value $116,728 $105,2S6
Tax Amount without SOH: $2,142.10
2015 Tax Bill Amount $2,142.10
Tax Estimator
Save Our Homes Savings: $0.00 j
Does NOT INCLUDE Non Ad Valorem Assessments I
Legal Description
LOT 4 BLK 12 TR 2
TOWN OF SANFORD j
PB1PG59
Taxes
Taxing Authority 1 Assessment Value I Exempt Values Taxable Value
County General Fund 116,728 --- 0 $116,728 1
Schools 116,728 0 $116,728
City Sanford
SJWM(SaintJohns Water Management)
CountyBonds--------- 116,
728 116,
728 116,
728 0 $
116,728 i 0 $
116,728 i
0 - - - - $
116,728 Sales
Description
Date Book Page Amount Qualified Vac/Imp WARRANTY
DEED 12/1/2015 08606 1751 156,700 Yes Improved QUIT
CLAIM DEED 8/1/2003 04973 1094 100 No Improved WARRANTY
DEED 6/1/2002 04440 0435 130,500 Yes Improved i
WARRANTY
DEED 5/1/1997 03243 0436 55,000 Yes Improved I
QUITCLAIM
DEED 1/1/1997 03184 0066 300 No Improved WARRANTY
DEED 11/1/1996 03163 1670 45,000 Yes Improved I
WARRANTY
DEED 5/1/1987 01848 1466 29,500 No Improved i WARRANTY
DEED 11/1/1986 01811 1637 100 No Improved WARRANTY
DEED 11/1/1986 01787 0246 27,000 Yes Improved Find
Comparable Sales within this Subdivision Land
http://
www.scpafl.org/ParcelDetaillnfo.aspx?PID=2519305AG12020040 1/2
Answer all the
be reviewed. If
at 407,688.6145
PI 10
APPLICATION # 1 .336
FOR A CERTIFICATE OF APPOPRIATENESS
istions on this form and submit all required attachments. Incomplete applications will not
i have questions about application requirements contact the Historic Preservation Officer
ensure your application is complete.
General Informa ion
Downtown Comrr ercial Historic District Residential Historic District Is this a retroactive request? Yes NoFV1
Is
this application filed, in response to a Notice of Violation from the Code Enforcement Department? Yeso Nfo//Proposedimprovmentswillaffectthefollowingelevations: North South East West Property
Address] —me)(, S p/4 C !7 77" ti (/ ,I.St462R
oil i) F 4. j' 2 7% Property Owner
Print Name:
Mailing Address:.
Phone(71
ApplicantlAgent Print
Name:
Mailing Address:.
Phone: BY
SIGNING
BI SCOPE OF %
DETERMINE IF
RESULT IN ,
A BELOW, YOU
1 TRUE AND
AC( Signature: Email:
BG19/
uG49VW
6,P,, e_4>4 Email: Signature:
Signature:
W
YOU
ACKNOWLEDGE THAT A BUILDING PERMIT MAY BE REQUIRED FOR THE 1K LISTED
BELOW. YOU MUST CONTACT THE BUILDING DEPARTMENT TO BUILDING PERMIT
IS REQUIRED. FAILURE TO OBTAIN A BUILDING PERMIT WILL P WORK
ORDER, DOUBLE PERMIT FEES, AND POTENTIAL FINES. BY SIGNING O ACKNOWLEDGE
THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS LATE TO
THE BEST OF YOUR KNOWLEDGE. Date: i
Y. yyWould you
like to receive emails regarding Historic Preservation and Community Planning within your community? Description of
pro osed work Completely describe
the entire scope of work, including changes in material and color, and methods that will be used to accomplish the
proposed work. For large projects an itemized list is required. Use the reverse site if necessary. HISTORIC PRESERVE
TION BOARD • 300 S. Park Avenue o Sanford, Florida 32771 •407.688.5145 • www.sanfordfl.gov/HP
REQUIRED INSPECTION SEQUENCE
BP# I& - 74(2 Address: 1,4-11
BUILDING PERMIT
Minn Max Inspection Description
Footer / Setback
Stemwall
Foundation / Form Board Survey
Slab / Mono Slab Pre our
Lintel / Tie Beam / Fill / Down Cell
Sheathing — Walls
Sheathing — Roof
Roof Dry In
Frame
Insulation Rough In
Firewall Screw Pattern
Drywall / Sheetrock
Lath Inspection
Final Solar
Final Roof
Final Stucco / Siding
Insulation Final
Final Utility Building
Final Door
Final Window
Final Screen Room
Final Pool Screen Enclosure
Mobile Home Building Final
Pre -Demo
Final Demo
Final Single Family Residence
Final Building (Other)
E+ L-ECTRICAL !u"tERMIT
Min Max Inspection Description
Electric Underground
Footer / Slab Steel Bond
Electric Rough
T.U.G.
Pre -Power Final
Electric Final
ftwmmo
Min Max Inspection Description
Plumbing Underground
Plumbing Sewer
Plumbing Tub Set
Plumbing Final
QME CHANICWL fl?ZFNiiil
Min Max Inspection Description
Mechanical Rough
Mechanical Final
Min Max Inspection Description
Gas Underground
Gas Rough
Gas Final
REVISED: June 2014
THIS
Name:
NSTRPiPRE P#1RED ..BY: J, Address:
1Y V '' 1-al NOTICE
OF COMMENCEMENT State
of Florida County
of Seminole Permit
Number: Parcel ID Number: MAiiYANNE
NORSEr SEN114OLE COUNTY CLERK
OF C:IRC:UIT COURT & C:OVIPTROLLER BK
8629 Pq 1571 (IPgs) CLERK'
S T 2016013751 RECORDED
02/08/2016 02:52:42 P11 RECORDING
FEES $10.00 RECORDED
BY hdevore 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. Df§
qRIPq10N OF P OPERTY• (Legal de cription of the ropey d str address if available OWNER
w
Q
tiw Alik\\\
libe 9Y
Address:
I LI o 1 Co,-),-+ S"- J MLJ Av QP El -5n ) i Fee
Simple Title Holder (if other than owner) Name: Address:
CONTRACTOR'
Name:
t J 11 Address:
Persons
within the State of Florida Designated by Owner upon whom notice or other documents may be served as
provided by Section 713.13(1)(b), Florida Statutes. Name:
Address:
In
addition to himself, Owner Designates Section
713.13(1)(b), Florida Statutes. of
To
receive a copy of the Lienor's Notice as Provided in Expiration
Date of Notice of Commencement (The expiration date is 1 year from 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 I, 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 COMMENCEMENT. Under
pe ;PIties of/rjury, I declare that I have read the foregoing and that the facts stated in it are true to
the ?SI f m nowledge and belief. I
Owners Signature Owners Printed Neme Florida
Statute 713.13(1)(g): "The owner must sign the notice of commencement and no one else may be permitted to sign in his or her stead: State
ofCounty ofgo emu"----cj1The
foregoing
instrument was acknowledged before me this day of by . Who
is personally known to me Name orpersonmaking
statement ORw o has
produced identification r eoidentification produced: L DEBBIEBLANTON 'Si MY
COMMISSION # F'
r 172 EXPIRES: February 25, 2019 ` r-'— 9onded•Thw Notary
Public Undenvritzrs d t,t i, U Notary Signature