HomeMy WebLinkAbout2803 Grove Dr�CEIVED
JUK 2 3 2016 CITY OF SANFORD
m• _ BUILDING & FIRE PREVENTION
L
: PERMIT APPLICATION
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Application No: (�
Documented Construction Value: S
Job Address: G� g n 3 C7 Y o V e '6r St+ ✓1 &rA N 1 3a 1��iistoric District: Yes ❑ No
Parcel ID: Residential commercia]E]
Type of Work: New ❑ Addition ❑ Alteration ❑ Repair ❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work: Fey, C P 621 W o (��-�
Plan Review Contact Person: Title:
Phone: 3a l Na o 3 o � -; Fax:
Email:
Property Owner Information
Name /R%r ce �p ��m.'>1 �U V- Phone: -2,.),t qA o Lo �l
Street: Resident of property?
City, State Zip:
Name
Street:
City, State Zip:
Contractor Information
Phone:
Fax:
State License No.:
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail:
Bonding Company:
Address:
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 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: 51" 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 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.
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Signature of Owner/Agent Date
Signature of Contractor/Agent Date
Print Owner/Agent's Name Print Contractor/Agent's Name
&,aA� _J(" (, - Z3.1�
Signatu o 0 of o ' a Date Signature of Notary -State of Florida Date
ANNETTE SCOTT
Notary Public - State of Florida
• ii My Comm. Expires Jan 16, 2018
Commission # FF 071760
R=0 National Notary Assn.
Owne a or Contractor/Agent is Personally Known to Me or
Produced ID Type of ID L Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building ❑ Electrical ❑ Mechanical ❑ Plumbing❑ Gas❑ Roof ❑
Construction Type: Occupancy Use: Flood, Zone:
Total Sq Ft of Bldg: Min. Occupancy Load: # of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures
Fire Sprinkler Permit: Yes ❑ No ❑ # of Heads Fire Alarm Permit: Yes ❑ NO ❑
APPROVALS: ZONING: IGS/1"'�TILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS: Off- In i`,64c.l l t o F W;:� o- S 5 .,.,., n..
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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)
Rev. 9.14.2009
1 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 1, 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
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responsible for the construction and is not hiring a licensed contractor to assume responsibility.
1 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
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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 1 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
1residence
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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 I 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.
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I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
I understand that 1 may not hire an unlicensed individual person to act as my contractor or to supervise
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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
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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
Property Address: R00 3 C7Y O LJ 2 T)r S o h orI/ 3a � ;z?
I, „/2rwce6o 'T7dy"k","AD , 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.
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Signature of Owner -Builder
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Form of Identification
(Must be Photo ID)
Date
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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
I agree that, as the party legally and financially responsible for this proposed construction activity, 1 will
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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.
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1 am of aware of construction practices and I have access to the Florida Building Codes.
1 understand that 1 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
1Services,
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and the Florida Department of Revenue. 1 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 infonnation about licensed contractors.
1 am aware of, and consent to, an owner -builder building permit applied for in my name and understand
that 1 am the party legally and financially responsible for the proposed construction activity at the address
listed below.
agree to notify the building department immediately of any additions, deletions, or changes to any of the
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information that 1 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
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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: R00 3 C7Y O LJ 2 T)r S o h orI/ 3a � ;z?
I, „/2rwce6o 'T7dy"k","AD , 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.
VVc A %11 ce LC2 13 a
Signature of Owner -Builder
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Form of Identification
(Must be Photo ID)
Date
l /as�G
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
BOUNDARY SURVEY
of
Lot 2, Block G of WOODMERE PARK 2ND REPLAT, according 'to the plot thereof recorded in Plot Book
13, Page 73 of the public records or Seminole County, Florida.
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Land Solutions Group Ina
1ro0erWALer: Westcor LOM TIUe 1naMmNce Co
LICENSED BUSINESS (7725
"DIT 5401 Pullman Drive Ph: (407) 485-2020
ALL DIMENSIONS ARE IN U.S. SWIVEY TEST. OAondo,
n. 32912 Foe (407) 273-3270
ALL OaECTIONAL MEASUR MTS ARE DOM USNO THE TORWAT OF KOM (7• MINUTES (? SECONDS M
CON N I, SURVEY ACCRACY R VIN M.SBS'. r1.ONDA STAtmM1 K PRACIroE fY-17AS1(SKW)la." FIVIUM A CLOSURE Or 1`01 TAW.
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WHEN LOCATION Or EASEMENTS R mORT K WAYS or RECOPA OTIER.TLOI W= OR RECORD PUTS. IS KO RM THIS INFORMATION RUST K MIND"
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USE O ME LAW
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NO UNOOIUIOUND oVROVDADITS, aaIIONO BU DM rOU DATIONS, MAK BEEN LOCATED EIl®T AS SNOW".
Thomas M. Pearl
SURVEY WAP ANO REPORT ON THE COPRS THEREOF ARE NOT VALID \IT1alT THE SIOUTLRE AND INE DIOGOAL RAISED SEAL K A rLOROA UCD=
SURWLAST Cs bliSELYADORi:
P.S.M. 6737
DAATiE �E0 a/10/m111
Prepared by:
Maria A. Connell
Classic Title & Solutions, Inc.
1341 East trio Bronson Memorial Highway
Saint Cloud, Florida 34771
File Number: 16-100
General Warranty Deed
Made this June 20, 2016 A.D. By Mahendra S Samaroo, a single person whose address is: 11312 Shandon Park Way, Windermere,
Florida 34786, hereinafter called the grantor, to Marcelo Domingo Vasquez and Myra Ramirez, husband and wife, whose post office
address is: 2803 Grove Dr., Sanford, FL 32773, hereinafter called the grantee:
(Whenever used herein the term "grantor' and'grantea' include all the parties to this instrument and the heirs, legal representatives and assigns of
individuals, and the successors and assigns of corporations)
Witnesseth, that the grantor, for and in consideration of the sum of Ten Dollars, ($10.00) and othec valuable considerations,
receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the grantee,
all that certain land situate in Seminole County, Florida, viz:
Lot 2, Block G, Woodmere Park 2nd Replat, according to the Plat thereof, recorded in Plat Book 13,
Page(s) 73, of the Public Records of Seminole County, Florida.
Parcel ID Number: 06-20-31-505-OG00-0020
Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining.
To Have and to Hold, the same in fee simple forever.
And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor
has good right and lawful authority to sell and convey said land; that the grantor hereby fully warrants the title to said land and will defend
the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances except taxes accruing
subsequent to December 31, 2016.
In Witness Whereof, the said grantor has signed and sealed these presents the day and year first above written.
Signed, sealed and delivered in our presence:
Witness Printed Name
Witness Printed Name
State of Florida
County of Osceola
(Seal)
Mahendra S Samaroo
Address: 11312 Shandon Park Way, Windermere, Florida 34786
The foreeoine instrument was acknowledeed hefore me thic 70th day nf bine 7111A by Mahvnrira C Camomn whn ie/aro nsrcnnolty