HomeMy WebLinkAbout116 W 17 StIi I lid'! i 1Wolymm] pfi"K UAKNU IIMI
r, l cojr• CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: I & " 4 (— t
Documented Construction Value: $ 1 , (off • "---
Job Address: 11(4p- U3. Historic District: Yes No N
Parcel ID: Residential Commercial
Type of Work: New IS] Addition Alteration Repair Demo Change of Use Move
Description of Work:-y'f'Gc. h e. Lo Woo c
Plan Review Contact Person: Title.'.
Phone: Fax: Email:
Property Owner Information
Name Phone:
Street: f , i,J . 1 7 Resident orproperty? r
City, State Zip:
Contractor Information
Name AIA
Street:
City, State Zip:
Name: IM
Street:
City, St, Zip:
Bonding Company:
Address:
Phone:
Fax:
State License No.:
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICEr 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: 5t' Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applic ble 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. ,' s
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.
Z
Signatur Date Signature of Contractor/Agent Date
Print Owner/Agent's Name
a .0 y./,(.
Si =
PAY CgiNON
Date iy
S' OMMISON # FF 17864E1 t ' S: February 25. 2019 OondedlREPub5lUnderwdters5.., .
h ihru
Notary L•,
P.•, Owner/
Agent is Personally K own to Me or Produced
ID Type of ID e9V
p ' ' 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: Z- o " UTILITIES: ENGINEERING:
COMMENTS:
FIRE:
Flood
Zone: of
Stories: Plumbing - #
of Fixtures Fire
Alarm Permit: Yes No WASTE
WATER: BUILDING:
Ok
to install 6 wood fence with 2 gates as shown on plan. Fence shall be constructed with the finished side
facing outward. The fence extending past the edge of the house shall be landscaped with shrubs and/
or groundcovers from the plant list in Schedule J. Revised:
June 30, 2015 Permit Application
r
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 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
r 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 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 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.
Property Address: I t,_(,, L3 . I i'}V,- 't
and capable of performing the
Form of Identification
Must be Photo ID)
do hereby state that I am qualified
involved with the permit application filed and agree to the
ate
zlc4fr,L
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
SCPA Parcel View: 36-19-30-506-0000-0200 Page 1 of 2
David Johnson. CP;q Property Record Card
P'ROPE rrV Parcel:36-19-30-506-0000-0200
A#aPRAISER Owner: STERNBERG JOHN H & DARROW DEBORAH M
8FMIN=COM1N 7Y,FLORIGA Property Address: 116 W 17TH ST SANFORD, FL 32771
Parcel:36-19-30-506-0000-0200 I
Property Address: 116 W 17TH ST
Owner: STERNBERG JOHN H & DARROW DEBORAH M
Mailing: 116 W 17TH ST
SANFORD, FL 32771-
Subdivision Name: SANFORD HEIGHTS
Tax District: Sl-SANFORD
Exemptions: 00-HOMESTEAD (2016)
DOR Use Code: 01-SINGLE FAMILY
Value Summary
2016 Working
Values
2015 Certil
Values
Valuation Method Cost/Market Cost/Marke
Number of Buildings 1 1
Depreciated Bldg Value 82,465 72,038
Depreciated EXFr Value 975 988
Land Value (Market) 22,701 22,701
Land Value Ag
Just/Market Value
106,141 95,727
Portability Adj
Save Our Homes Adj 0 - 0
Amendment 1 Adj 0
Assessed Value 106,141 95,727
Tax Amount without SOH: $1,
2015 Tax Bill Amount $1,
Tax Estimator
Save Our Homes Savings:
Does,NOT INCLUDE Non Ad Valorem Assessments
Legal Description
LOT 20 + E 45 FT OF LOT 21
SANFORD HEIGHTS
PB2PG63
Taxes
Taxing Authority Assessment Value Exempt Values Taxable Value
County General Fund 106,141 50,000
Schools 106,141 25,000 i
City Sanford 106,141 50,000
SJWM(Saint Johns Water Management) 106,141 50,000
County Bonds 106,141 50,000
Sales
Description Date Book Page Amount Qualified Vac/Imp
SPECIAL WARRANTY DEED 7/1/2015 08526 0932 147,000 No Improved
WARRANTY DEED 9/1/2014
4/1/2006
08334
06204
0465
0330
242,200 No Improved
WARRANTY DEED 310,000 Yes Improved
QUIT CLAIM DEED 5/1/2005 05717 1302 100 No Improved
h4://www.scpafl.org/ParcelDetailInfo.aspx?PID=36193050600000200 2/4/2016
PREPARED BY:
E)''C A C T A
Land Surveyors, Inc.
www.exactaland.com i
Toll Free 866-735-1916 • F 866-744-288z
it P .
PROPERTY ADDRESS: 116 WEST 17TH STREET SANFORD, FLORIDA 32771 ;SURVEY NUMBER: 1506.4670
FIELD WORK DATE: 7/14r2m REVISION DATE(S): m o 7/152otsl
1606.4670
BOUAVARYSURVEY
SEMINOLECOUNIY
TABLE:
L I 75.00' (P)
5 89Y45'50' E 74.98' (M)
L2 15.00' (P)
D PLANES
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N 89e5G'37' E 105.03' (M)
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27- 99, W.F. O.
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Nothing hereon shall be Construed to Give ANY Rights oraenefits to Anyone Other than those Certified FLOOD INFORMATION: POINTS OF INTEREST
BY PERFORMING A SEARCH WITH
THE LOCAL GOVERNING NONEVISIBLE MUNICIPALITY OR W W W.
FEMA.GOV, THE PROPERTY APPEARS TO BE LOCATED IN ZONE X THIS
PROPERTY WAS FOUND IN THE CITY OF SANFORD, COMMUNITY NUMBER 120294, DATED
09/28/07. AFFILIATE CLIENT NUMBER: CE1410-FL-
2186023DATE:7/15/2015 y ; L ' a ' BUYER:JOHN H STERNBERG
and
DEBORAH M DARROW rx MEMBERS SELLER: OCWEN LOAN SERVICING, LLC
CERTIFIED TO:JOHN H STITLE
SE G AND D INC.;WES
M DALAND PREMIUM
TITLE SERVICES,
C.; WESTCORLANDTITLEINSURANCECOMPANYkCTALand Surveyors
Inc. 19M-26.
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REMAINDER OF I
LOT 21WE
ILI I tL 5.0 2 5 Y.
APPROVED PLANS
ENG. DEPT.
04 LIN
Ok to install 6 wood fence with 2 gates as
shown on plan. Fence shall be constructed with N
the finished side facing outward. The fence z-3 --E. 455 Off- I
extending past the edge of the house shall be ,
C
LOT
I
landscaped with shrubs and/or groundcovers Ctii I
from the plant list in Schedule J. kq
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