HomeMy WebLinkAbout109 W 17 StQQ1 1 201 CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: to — Q 9 O rl
00
Documented Construction Value: $ 00
tk
Job Address: 10 9 () 1-1 -r Historic District: Yes No
Parcel ID: 2(o - t cl " 30 - 50 (p - 0000 - 041 `0 Residential 19 Commercial
Type of Work: New ® Addition Alteration Repair Demo Change of Use Move/
Description of Work: Re l t, ZJ i ! STp 2.W1 M I CrE Gl{/}(IV L [ N K 1` E -NCEIL / R ft,.,
E WJ STo c L A ENC, ALEA _ C Plan
Review Contact Person: Phonel
407 - 40I.O1 Ob Fax: Name
L I N.DA Q t cr 0 0 G- Street: .O
q W t `l"' ST City, State
Zip: f) ior k- O P> YL- -5;'771 Title: nn
Email: /
Property
Owner
Information Phone• 40 `] •
40 4 - 0 a:O C7 Resident of
property?: 7 ES Contractor Information
Name k4n
rA F_-OW NX,(L. Phone: Street: Fax:
City, State
Zip: State License No.: Architect/Engineer
Information Name: Phone:
Street: City,
St,
Zip: Bonding Company:
Address: 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 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: 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 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.
10/3 o/0
S' of Own / ent Date Signature of Contractor/Agent Date
L4A)Olq ! Fo o&
Print er/Agent's Name Print Contractor/Agent's Name
co
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me 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 Gas Roof
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric - # of Amps
Fire Sprinkler Permit: Yes No # of Heads
Jc' _
APPROVALS: ZONING:br-*_UTILITIES:
ENGINEERING:
COMMENTS:
FIRE:
Flood Zone:
of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Ok to remove chainlink fence and install 6 foot wood stockade fence as shown on plan. Fence shall be
constructed with finished side facing outward.
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
n 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
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 ee that as the arty le all and financially res onsible for this proposed construction activity I willaIn7pgYp
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
oning regulations.
AM r 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
o struction Industry Licensing Board at 1-850-487-1395 or at www.myflorida.com/dbpr/pro/Cilb/ for
re information about licensed contractors.
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
in rmation that I have provided on this disclosure or in the permit application package.
IJ icensed 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.
O9 7 a77PropertyAddress ,
I, L\1 N li A- I (_;::70 /06 , do hereby state that I am qualified
and capable of performing the requested construction involved with the permit application filed and agree to the
ate
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
J !7-, >r—
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Tay 67 4677EVANS
STREET) 50' PLATTED R/W 2'
CURB 8 GUTTER ASPHALT
FND
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NO ID - — — --- 0.
3' N. 5' CONC. WALK s0' (
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LOT 41 FENCE
LOT
42 FND
1• NO
ID 150.
W 0.1' N.. 0.2r W. 60' (
P) i
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r 1 ENTRY \
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LOT
44 N
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PLAN, I} ( CONC. o
IV
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m LOT
45 IR #
3382 ^ S 90°0010(° E 'Qf ^^' 1k2
Ok
to remove chainlink fence and install 6 foot , ID wood
stockade fence as shown on plan. Fence LOT
50 LOT shall be constructed with finished side facing LOT 46 outward.
1 f--
u Bce>k -4-40-4) Pao. 2q5) The &
5e 'i of Loe yi aiad a// of Lots 42, 43, 6,4111,104!2) VI ZI >1 ' 6 1MZ-10,, caC, o ; j I!o the
0"30 -,Plat thereof, as recorded ;a Plat &14 2, Aar(s) &2 and ba, of eoi& Pu6;c ecau
dS of S iiao% C.ou, nor der. CERTIFIED
TO: (AS FURNISHED) Walter
E. WftV and Lynda L. Wilforg Lawyers
Advantage TMe Group, Inc. Old
RaPublio Natlaial Title Insurance Cornpany Wept
FaW Bank, NA, ISAOA FLOOD
ZONE SUBJECT
PROPERTY SHOWN HEREON APPEARS TO BE LOCATED IN FLOOD ZONE
9P, AREAS DETERMNED TO BE OUTSIDE THE WD-YEAR FLOOOPLAIN, PER
F.I.R.M. PANEL NUMBER 1211700070F, LAST REVISION DATE 09-28-07. THIS
SURVEYOR MAKES NO GUARANTEES AS TO THE ACCURACY OF THE ABOVE
INFORMATION. THE LOCAL F.E.MA. AGENT SHOULD BE CONTACTED FOR
VERIFICATION. LIST
OF POSSIBLE ENCROACHMENTS: CONC.
CROSSES PROPERTY LINE OWNERSHIP
OF FENCES NOT DETERMINED BASIS
OF BEARING BEARINGS
ARE BASED ON THE SOUTH RIGHT-OF-WAY OF W 17th STREET WHICH
HAS AN ASSUMED BEARING OF N 90'OOW E. NOTES
1.
Undwwwnd ufWey Inwood a, undaMmund knpovwnarft toumW" andfar other
underground sb%x* rsa were not located by INs survey. 2.
The purpose of tlda survey Is for use in obudnkrp Opt hmuarwe and Wrmxkg and should
not be used for conabuclion punpmp. 3.
Addison or deleeont to this wrvey by 00wr than In alpning Party or pareea is PmhbW %"
Xka eo wrebn oonwd of the signing pony or partlat. 4.
The property shown trreon Is suWO to ere easerrmft, MWICtlorw and Mowveftm
wNch may be dawn or noted on the rem Plat andvANln ew P>ublk
records of the county the subject PMPWV 4 looatsd. This survey only dapkft awvey
related Iannaeon such ea eassnonta and sefbardra Nat are shown an
t ramrd PW er have been furnished to the Surveyor. S. Buedkg
On and dkronabna for lmprovartony should not be used to recorwho bmidary Mae.
THIS SURVEY
IS PREPARED FOR THE EXCLUSIVE 113E AND
BENEFIT OF THE PARTIES LISTED HEREON. LIABILITY
TO THIRD PARTIES MAY NOT BE TRANSFERRED
OR ASSIGNED. t3wn [PAD
Se wee, 9413.PenrtarKle
Avenue Winter Palk,
FC 32789 Phone (888)
399.8474 LB -4-
n8 SURVEYOR'S
CERTIFICATE I HIM
aRTIFY THAT THIS SURVEY IS A TRUE AND ACWRATE REPRE WA71ON
OF A SURVEY PREPARED UNDER MY DIRECTION. Man Williamson,' ' %,
DATED:
041412 PR FESSILANDSU ;,n%% FLORIDA REGISTRATION #5573
NOT VALID WITHOUT
THE ELECTRONIC SIGNATURE AND/OR ORIGINAL RAISED SEAL OF
THE LISTED FLORIDA LICENSED SURVEYOR AND MAPPER DATE REVISION
I
DATE REVISION
SCPA Parcel View: 36-19-30-506-0000-0410
s
Page I of 2
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Parcel Information
PropertV Record Card
Parcel: 36-19-30-506-0000-0410
Owner: WILFONG WALTER E HEIRS
Property Address: 109 W 17TH ST SANFORD, FL 32771
Parcel 36-19-30-506-0000-0410
Owner WILFONG WALTER E HEIRS
Property Address 109 W 17TH ST SANFORD, FL 32771
Mailing C/O LYNDA L WILFONG 101 CRESCENT BLVD SANFORD, FL32771
Subdivision Name SANFORD HEIGHTS
Tax District S1-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions 00-HOMESTEAD(2013)
30 130 60 60
L--J
j
40 41 42 4
e
I
LNEW
Value Summary
2017 Working 2016 Certified
Values Values
Valuation Method Cost/Market Cost/Market
Number of Buildings 1 1
Depreciated Bldg Value 131,757 127,444
Depreciated EXFT Value 1,500 1,534
Land Value (Market) 32,430 32,430
T
Land Value Ag
Just/Market Value" 165,687 161,408
Portability Adj
Save Our Homes Adj 31,942 28,593
Amendment 1 Adj
P&G Adj 0 —' 0
Assessed Value 1 $133,745 132,815
Tax Amount without SOH: $2,412.15
2016 Tax Bill Amount $1,838.98
Tax Estimator
Save Our Homes Savings: $573.17
Does NOT INCLUDE Non Ad Valorem Assessments
http://parceldetail.scpafl.org/ParcelDetailInfo.aspx?PID=36193050600000410 10/31/2016