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Home My WebLink About129 Pine Isle Dr (2)MAR 0 7 i CITY OF SANFORD BUILDING & FIRE PREVENTION PERMIT APPLICATION Application No: 16— 19L9 Documented Construction Value: $ ZOO Job Address: 12 C% IAM- E U Historic District: Yes No Parcel •ID: ( 2 D - 3' s 1%(t} tog/ ResidentialEl Commercial Type of Work: New Addition Alteration Repair Demo Change of Use Move Description of Work: Plan Review Contact Person: Title: Phone: Fax: Email: 1 A o. Property Owner Information 1 NamelI ,ILso,Jj Phone: 7- --_]s Street: / GJ ,JF_ L> Resident of property? : City, State Zip:73 1 J Contractor Information Name Street: City, State Zip: Name: Street: City, St, Zip: Bonding Company: Address: lift, " N." Phone: .,_ u, 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 PAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDEDANDPOSTEDONTHEJOBSITEBEFORETHEFIRSTINSPECTION. 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 dothework 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 thisjurisdiction. 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 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may befoundinthepublicrecordsofthiscounty, and there may be additional permits required from other governmental entities such as water management dp'i age ' fpief, or federal agencies. 1. Acceptance omt?is verificah 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 inordertocalculateaplanreviewchargeandwillbeconsideredtheestimatedconstructionvalueofthejobatthetimeofsubmittal. TheactualconstructionvaluewillbefiguredbasedonthecurrentICCValuationTableineffectatthetimethepermitisissued, 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 d e in complia a with all applicable laws regulating construction and zoning. Signature of Owner/Agent Date Signature of Contractor/Agent Date Print Contractor/Agent's Name Print awner/Agents Name r\ of 3- 7- (,(o Date Signature of Notary -State of Florida Date o s,•; ANNETTE SCOTT Notary P bi .State of Florida y Comm. Expires Jan 16, M2018 Fo• ;,. Commission N FF 071 Owner/ A dirt ssion ; 01VI or Contractor/Agent is Personally Known to Me or Produced ID ype o 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 JO( &_ APPROVALS: ZONING: —7' I CvUTILITIES: ENGINEERING: COMMENTS: FIRE: Flood Zone: of Stories: Plumbing - # of Fixtures Fire Alarm Permit: Yes No WASTE WATER: iBUILDING: Permit Application Revised: June 30, 2015 11 l 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. 1 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. 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 agree that, as the party legally and financially responsible for this proposed construction activity, 1 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: 1, , do hereby state that I am qualified and capable of performing the requested construction involved with the permit application filed and agree to the conditions specified above. Signature of Owner -Builder Form of Identification Must be Photo ID) Date 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 SURVEY SKETCH OF BOUNDARY SURVEY COPYRIGHT 2005 FINSTAD LAND NOT FOR FENCE CONSTRUCTION AND SPATIAL SURVEYING CORP. NOT FOR CONSTRUCTION APPROVED PLANS NOS Of' T11RNOTFORDESIGN OSURVEYFOHETITLENT FLORIDA STATUTE 61617-6.004, TWO SITE BENCHMARKS REQUIRED FOR CONSTRUCTION) sue.}` rJ THIS SURVEY DOES NOT REFLECT OR DETERMINE OWNERSHIP. w E . r D 2 SCALE 1' = 30, a ENG. DEPT. FPK&D Lio fe ;c c' i3669 STREET ADeS- ?5 ems, S Z 129 PINE ISLE DR. SANFORD, FLORIDA ^. 7- Wra '° tA F N264 LOT 86 OiP / N. 89'15'59'I. 100.00' (P) N. 89.15'59'W. 100.51, CM) 0BASIS OF BEARING I 58. 0' SINGLE -STORY I RESIDENCE o ENTRY 4I 4.9" N 5264 S891. 4. 99. 96_ ) ' 100.Od CP) LOT 8 4J cis q UFOP 1' S A 5 rj 0 5264 DRIVE ; o- 4 ` fA T Syr FOP1- qy NO ID 01 a2 2 FOP I' CURVE DATA 5264 IL L EGIBL E LEGAL DESCRIPTION pOp LOT 87, STERLING WOODS SUBDIVISION, ACCORDING TO THE MAP OR PL A T THEREOF, ASRECORDEDINPLATBOOK54, PAGES 93 THRU 95, OF THE PUBLIC RECORDSOFSEMINOLECOUNTY, FLORIDA CERTIFIED TO : NA THAN JOHNSON PRIME LENDING, A PLAINS CAPITAL CO. FLORIDA TITLE & ABSTRACT CHICAGO TITLE INSURANCE CO. APPROXIMATE WATER DARIES NOTE, ALL APPROXIMATE WATER BOUNDARIES ARE GRAPHICALLY DISTINCT FROM OTHER PORTIONS OF THE BOUNDARY. THE WATER BOUNDARY THAT IS REFLECTED IS APPROXIMATE LOCATION ONLY AND DOES NOT REFLECT THE LEGAL LOCATION OF THE WATER BOUNDARY FOR THIS PARTICULAR PARCEL OF LAND. NOTE, FEM. 4 FLOOD HAZARD MAPPING. THIS DATE PRODUCT VAS NOT DESIGNED TO MAKEPRECISEIN/ OUT FLOOD RISK DETERMINATIONS. THIS PRODUCT IS NOT SUITABLE FORENGINEERINGAPPLICATIONSANDCANNOTBEUSEDTODETERMINEABSOLUTEDELINFATrnWnFFinnnan„e,nearcc ,-n, , ,-077_C-C-- ,,,, ,-...., Curve number 1 Radius= 75. 00 Delta= 17' 55'03' Arc= 23. 45 Tangent= 11. 82 Chord= 23. 36 Chord Brg. N.49'06'46'W. N.48' 40'10'I. 22.32' (M) 0 7 IS 30 60 GRAPHIC SCALE NOTE: IF APPLICABLE, FENCES SHOWN MEANDER ON OR OFF LINES (APPROX. LOCATION ONLY) FOUNDATION/UTILITIES DISCLAIMER NOT£+ FOUNDATION BENEATH THE SURFACE OF THE GROUND HAS NOT BEEN LOCATED. UNDERGROUND UTILITIES HAVE NOT BEEN LOCATED. PROVIDED BY COUNTY FLOOD ZONE : X COMMUNITY PANEL 120294 0045E DATED : 4- 17-95 FLOOD ZONE : " B","C","D", do "X" ARE NOT IN DESIGNATED FLOOD HAZARD ZONE AREA.) SURVEY SKETCH OF BOUNDARY SURVEY COPYRIGHT 2005 FINSTAD LAND NOT FOR - FENCE CONSTRUCTION f, AND SPATIAL SURVEYING CORP. NOT FOR CONSTRUCTION APPROVED PLANS NOTE, THE INTENT OF THIS SURVEY NOT FOR DESIGN t IS FOR TITLE TRANSFER ONLY THIS SURVEY DOES NOT REFLECT ORFLORIDASTATUTE61617-6.004r a ' s DETERMINE OWNERSHIP. CTWO SITE BENCHMARKS REQUIRED FOR CONSTRUCTION) - ENG. DEPT. FPK&D 4O I CC `' fP•Q . # 3669 PC STREET ADDRZSM z 129 PINE ISLE DR. C>n •O - SANFDRD, FL DRIDA l c N A E r- c^ w o 1T o Q) I f. 3 •/f ZabSCALE1' = 30, a 4 264 \ LOT 86 O I / FOP 1' 5264 N.89.15159'1,,. 100.00, (P) Ag 23 , .0 052645 Z AO' JJ N.B9.15'S9'W. 100.5!' CM) 1 0' BASIS OF BEARING Sp9 5.1 25 DRIVE 58.0' 10- SINGLE -STORY tk01 FOP 1' yl' I RESIDENCE 17.1' b `3' NG.ID ON a V•cr' ENTRY 4.0' D 2oo LOT 8 t 2 4- 2 ,o a rZb 36.9' t 45.4' 9 4.9 FOP I ' S # .. 3'57 E 96 5264 •1S9900.Op9 FOP j - CURVE DATA IL L EGIBL E LOT 88 5264 01 LEGAL DESCRIPTION LOT 87, STERLING WOODS SUBDIVISION, ACCORDING TO THE MAP OR PL A T THEREOF, AS RECORDED IN PLAT BOOK 54, PAGES 93 THRU 95, OF THE PUBLICRECORDSOFSEMINOLECOUNTY, FLORIDA CERTIFIED TO : NA THAN JOHNS17N PRIME LENDING, A PLAINS CAPITAL CO" FLORIDA TITLE & ABSTRACT CHICAGO TITLE INSURANCE CO, APPROXlMAT WAT R BO!/NDARIFS NOTE, ALL APPROXIMATE WATER BOUNDARIES ARE GRAPHICALLY DISTINCT FROM OTHER PORTIONS OF THE BOUNDARY. THE WATER BOUNDARY THAT IS REFLECTED IS APPROXIMATE LOCATION ONLY AND DOES NOT REFLECT THE LEGAL LOCATION OF THE WATER BOUNDARY FOR THIS PARTICULAR PARCEL OF LAND. NOTE, FEM.4 FLOOD HAZARD MAPPINGTHIS DATE PRODUCT 114S NOT DESIGNED TO MAKEPRECISEIN/ OUT FLOOD RISK DETERMINATIONS THIS PRODUCT IS NOT SUITABLE FORENGINEERINGAPPLICATIONSANDCANNOTBEUSEDTODETERh1INEABSOLUTED£I. INFAMAt z nF Fi nnn nniminn,orcc r er , ,-o-7-7-C- — -An Curve number 1 Radius= 7500 Delta= 17. 55'03' Arc= 23. 45 Tangent= 11. 82 Chord= 23, 36 Chord Brg. N"49'06'46'W. N.48' 40'10'IV. 22,32' (M) 0 7 15 30 60 GRAPHIC SCALE NOTE, IF APPLICABLE, FENCES S/IOWN MEANDER ON OR OFF LINES CAPPR17X. LOCATION ONLY) FOUNDATION/UTILITIES DISCLAIMER NOTE: FOUNDATION BENEATH THE SURFACE OF THE GROUND HAS NOT BEEN LOCATED. UNDERGROUND UTILITIES HAVE NOT BEEN LOCATED. PROVIDED BY COUNTY FLOOD ZONE : X COMMUNITY PANEL 120294 0045E DATED : 4- 17-95 FLOOD ZONE " B "C","D", do "X" ARE NOT IN DESIGNATED FLOOD HAZARD ZONE AREA.)