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Home My WebLink About820 W E 20 StTTJ~ CITY OF SANFORD j 7FEB 0 4 2016 BUILDING & FIRE PREVENTION F PERMIT APPLICATION D -_ Application No: Documented Construction Value: $ Job Address: a U Historic District: Yes No Parcel ID: Residential Commercial Type of Work: New Addition Alteration [R Repair Demo Change of Use Move Description of Work: Plan Review Contact Person: Title: Phone: Fax: Email: Property Owner Information Name d-S e 2) 1'9_ z Af C 15 C'd Phone: Street: 2 b \,A/ e U Resident of property? j 4 d1 t Yu ittl pb, .- City, State Zip: D 9-'2 - , to 9+s13 • aito 4 ttsle l = ';'Jt\ '. 1'0 .$[ "bl L311QX .(rt1110 !d ` "' ° - Contractor Information '10fIN0`3"r It noWis, MG I f :t+.aA ty iL 1r't' :RrJe."YI rrrrrr Hr`• Name O i Co ( Z Phone: Street: Fax: City, State Zip: State License No.: Architect/ Engineer Information Name: Phone: Street: Fax: City, St, Zip: E-mail: Bonding Company: Mortgage Lender: Address: 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: 51h Edition (2014) Florida Building Code Revised: June 30, 2015 Permit Application r 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 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. Signature of Owner/Agent Date Owner/Agent's Name Date Signature of Contractor/Agent Date Print Contractor/Agent's Name Signature of Notary -State of Florida Date 11YP'% ANNETTE SCJ16.2018 Notary Pub Stat_ . N• My Comm. Expires JCommlStionOFF Tbr Owne e or Contractor/Agent is Personally Known to Me or Produced ID Type of ID Produced ID Type of ID BELOW IS FOR OFFICE USE ONLY Permits Required: Building Electrical Mechanical Plumbing Construction Type: Total Sq Ft of Bldg: Occupancy Use: Min. Occupancy Load: New Construction: Electric - # of Amps Fire Sprinkler Permit: Yes No APPROVALS: ZONING: ENGINEERING: COMMENTS: of Heads UTILITIES: FIRE: Gas Roof Flood Zone: of Stories: Plumbing - # of Fixtures. Fire Alarm Permit: Yes No WASTE WATER: BUILDING: 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 response 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 lic n n Florida and to list his or her license numbers on all permit and contracts. FEN 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 1, which violates this exemption. N I underqtaPA 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 eapWy.44ve 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- bui u d am aware of the limits of my insurance coverage for injuries to workers on my property. A 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 ther yee. 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 d zoning regulations. I am of aware of construction practices and I have access to the Florida Building Codes. V` b 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 jakrmation 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 low. i I agree to notify the building department immediately of any additions, deletions, or changes to any of the I- infbEWo,ltion 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 cove T, r Property Address: oc S U I, , do hereby state that I am qualified and capable of performing the requested construction involved with the permit application fled and agree to the conditions specified above. Signature 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 SCPA Parcel View: 36-19-30-520-0000-1470 Page 1 of 2 ip Property Record Card Parcel: 36-19-30-520-0000-1470 Owner: DIAZ JOSE & DIAZ FRANCISCO INOLECC+LINTY FLORIDA Property Address: 820 W 20TH ST SANFORD, FL 32771 I Parcel:36-19-30-520-0000-1470 I Property Address: 820 W 20TH ST Owner: DIAZ JOSE & DIAZ FRANCISCO Mailing: 820 WEST 20TH ST SANFORD, FL 32771 Subdivision Name: PINEHURST Tax District: Sl-SANFORD Exemptions: DOR Use Code: 01-SINGLE FAMILY 147 148 111 p i Legal Description LOT 147+W4FTOF LOT 148 PINEHURST PB3PG71 Taxes 149 Value Summary 2016 Working Values 2015 Certified Values Valuation Method Cost/Market Cost/Market Number of Buildings 1 1 Depreciated Bldg Value 24,188 23,799 Depreciated DCFT Value Land Value (Market) 9,602 9,602 Land Value Ag Just/Market Value 33,790 33,401 Portability Adj Save Our Homes Adj 0 0 Amendment 1 Adj 0 0 Assessed Value 33,790 33,401 Tax Amount without SOH: $679.75 2015 Tax Bill Amount $679.75 Tax Estimator Save Our Homes Savings: $0.00 Does NOT INCLUDE Non Ad Valorem Assessments Taxing Authority Assessment Value Exempt Values Taxable Value County General Fund 33,790 0 33,790 Schools 33,790 0 33,790 City Sanford 33,790 0 33,790 SJWM(Saint Johns Water Management) 33,790 0 33,790 County Bonds 33,790 0 33,790 Sales Description Date Book Page Amount Qualified Vac/Imp SPECIAL WARRANTY DEED 8/1/2011 07623 1768 23,800 No Improved SPECIAL WARRANTY DEED 3/1/2011 07549 1519 100 No Improved CERTIFICATE OF TITLE 11/1/2010 07486 1882 100 No Improved WARRANTY DEED 5/1/2006 06258 1528 141,900 Yes Improved SPECIAL WARRANTY DEED 2/1/2005 05687 1254 56,500 No Improved WARRANTY DEED 2/1/2005 05625 1891 45,000 No Improved WARRANTY DEED 2/1/1987 01831 1093 31,000 Yes Improved ADMINISTRATIVE DEED 12/1/1986 01795 0058 100 No Improved I Find Comparable Sales within this Subdivision I Land Method Frontage Depth Units Units Price Land Value http://www.scpafl.org/ParcelDetailInfo.aspx?PID=36193052000001470 2/4/2016 City of Sanford Roof Permit Application Checklist All permit application packages must be complete prior to acceptance. You must check each box to the left or indicate n/a on this submittal. A complete application package shall include the following: uilding Permit Application completed, signed and notarized. Application must include correct address and complete parcel I.D. number. PA Copy of applicable contractor's license issued by the State of Florida (if the contractor is the applicant). A A site specific notarized power of attorney shall be required from the licensed contractor if he/she appoints an employee of his/her company to sign the permit application as the contractor. NA Certificate of insurance indicating worker's compensation insurance coverage and naming the City of Sanford as certificate holder, or a copy of a worker's compensation exemption issued by the State of Florida (must be submitted with each application if contractor is the applicant). Lp Completed and signed Owner Builder Statement / Affidavit (if the owner is the applicant). These guidelines were compiled to assist the applicant in preparing a roofpermit application and may not be complete. The applicant is required to meet all City of Sanford, state, and federal code requirements. d CITY OF SANFORD BUILDING SERVICES r Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: A60 " 4 hereby acknowledge that I personally inspected Goof deck nailing and/or (94econdary water barrier work P at 0 KA 0 0? 0 and have determined that the work Job Site Address) was done according to the Hurricane Mitigation Retrofit Manual. (based on 553.844 F.S.) I certify that my statements herein are true and accurate to the best of my belief and that I fully understand that making any false statements in writing with the intent to mislead a public servant in the performance of his or her official duty shall constitute a misdemeanor of the second degree pursuant to Section 837 F.S. Signature of Contractor Date Printed Name of Contractor License # License Type: General Building Residential Roofing Contractor or any individual certified in accordance with F.S. 468 to make such an inspection. w STATE OF FLORIDA COUNTY OF / S7!rn t2;Q r affirmed) and subscribed before me this day of , 20 l O , by who is Personally Known to me o has Produced (type of identification) as identification. ham' Z (SEAL) Signature of Notary Public Stat o lor' a Pr' t ype/Stamp Name of Notary Public DEBBIEBLANTON MY COMMISSION # FF 178648 EXPIRES: February 25, 2019 Bonded Thru Notary Pubrw Underwriters 3