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HomeMy WebLinkAbout615 S Palmetto Ave (2)AVk.-\ 54-0 � C, DEC 0 5 2016 1 A Document CU s Job Address: /o/S 1�A��F 7Te. ��-ti- Parcel ID: Type of Work: New Description of Work: Addition ❑ Alterati R XL Plan Review Contact Person: Phone: (mb-iQ��/ Name Street: ca City, State Zip: Name Street: City, State Zip: r. C)5- CITY S CITY OF SANFORD BUIL NG & FIRE PREVENTION PERMIT APPLICATION tion No: _ —32L(. I o� Value: $ �_ 300 y � Historic District: Yes U No ❑ Residential ❑ Commercial ❑ ow Repair ❑ Demo ❑ Change of Use❑' Move ❑ Title: a L41AIF � I: �1 /yea G A J `L , G A A Owner Information Phone: 6 tl—t2Q/ - U6Y Resident of property? : YES rmation Phone: Fax: State License No.: Architect/Engineer Information Name: Phone: Street: City, St, Zip: Bonding Company: Address: Fax: E-mail: Mortgage Lender: AJ! h - 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. 1 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, ohederal. 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 coyltract is required in order to calculate a plan review charge and will be coAsidered the estimated construction value of the job at the time of submittal. The actual construction value will be figured based on the curTen ICC Valuation Table in effect at the time the permit isaissued, 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. ./4 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 regulatiinng-iconstructioneand zoning. Signature of Owner/Agent Date U 8 iF_uc_-i4A u S Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID . -I: f -s` Si nature of Contractor/Agent Date z Print Contractor/Agent's Name Signature of Notary-State.of'Flonda Date Contractor/Agent is , Persdnally Known to Me or Produced ID Type of 1D t. • 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: ENGINEERING: COMMENTS: UTILITIES: FIRE: 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 homeoWfiers 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 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 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. / ' J 1 understand that building permits -are not required to be signed by a property owner unless he or she is �\ J 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 1 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. 1 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 wo 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. 1 understand that, as the owner -builder, l must provide direct, onsite supervision of the construction. 1 understand that 1 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 J 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 14.% 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 1 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 l ( 5• P A -C 6,7-0 A-VIC 1, l f 28:y 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 A be Photo ID) t/sZ� 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 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 Wb � 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. understand that 1 may obtain more information regarding my obligations as an employer from M Internal Revenue Service, the United States Small Business Administration, the Florida Department of Finan Fial Services, and the Florida Department of Revenue. I also understand that I may contact the Florida Construction Industry Licensing Board at 1-850487-1395 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. L* 'TJ 1 agree to notify the building department immediately of any additions, deletions, or changes to any of the 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 7 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 l ( 5• P A -C 6,7-0 A-VIC 1, l f 28:y 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 A be Photo ID) t/sZ� 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 CITY OF SANFORD BUILDING SERVICES Residential Re -Roof Hurricane Mitigation Inspection Affidavit Permit #: 1/0 — —WLJ5— 1, `�r►�� �,t�� S hereby acknowledge that I personally inspected 6'Koof deck nailing and/or 0 Secondary water barrier work at SO/ ) J j_'n%P_P_4 ,,Y,, 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 837.06 F.S. �--� ! 2 11,01(o Signature of Contractor Date 15., wd ! i.I.,eS ccc 137_59'1? Printed Name of Contractor License # License Type: 0 General 0 Building 0 Residential 0 Roofing Contractor 0 or any individual certified in accordance with F.S. 468 to make such an inspection. STATE OF FLORIDA COUNTY OF SW n to (or affil d) and subscribed before mess day of , 20 �, by 9x, 1 25 , who is Mersonally Known to me or has 0 Produced (type of i ' kation) as identification. (SEAL) Signature of Potary Public State of Florida of F,0dde gag 990959 Print/Type/Stamp ame of Notary Public CITY OF SANFORD HISTORIC PRESERVATION BOARD APPLICATION FOR A CER TIFICA TE OF APPROPRIA TENESS P.O. Box 1788, Sanford, FL 32772-1788 Phone: 407 330-5672 Fax: 407 330-5679 In addition to a Certificate of Appropriateness, a building permit may be required. Check with the Building Department: 407 330.5660. A Certificate of Appropriateness may be required for projects that do not require a building permit. This Certificate must be Drominently disDlaved on the buildin4 when work is in Dro4ress. 1. General Information Property Owner: 55A,)12f (� IEL14#6 (J roperty Address: Mailing Address: 6LS. /"k�^f—%%O Phone Number. Agent: Address: Fax Number. Phone Number: Fax Number: /.�- S., P4 - 11a 7 67 FJ 7- ❑ Downtown Commercial Historic District: ❑ Residential Historic District: ❑ This application is filed in response to a notice from the Code Enforcement Department certify that all information contained 0 this application is true and accurate to the best of my knowledge. Applicant: /� Owner: Date: Z g Zarj ! n � Date: Please use the attached criteria checklist as a guide to completing the application. Incomplete applications cannot be reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at 407 330-5672 to make sure your application is complete. A Certificate of• Appropriateness is valid for six months unless otherwise noted OFFICIAL USE ONLY Historic Preservation BoardM ting Date: Staff Review Date: Application is Approved, Approved with Conditions Conditions: 44)�Signed: Date: �a'�7 v l o FASHA ENGUiistoric Preservation BoardWCenificate of Appropriateness.doc 1 . Denied 2. Description of Proposed Work Application Category: (Check all that apply) ❑ Site Improvements/driveway/walkway ❑ Storage shed ❑ Moving structures ❑ Replacement windows or doors ❑ Underskirting ❑ Awnings ❑ New construction/additions ❑ Signs ❑ Demolition ❑ Roofs/gutters/downspouts ❑ AC/Mechanical ❑ Fences/Gates/Pergolas ❑ Replacement siding/flooring/porch ❑ Paint ❑ Other Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building, where on the property the work will occur and how the work will be accomplished. For large projects, an list is recommended. A'ttaa�chA additional if //itemized necessary. �U opages 3. Documentation: ' In order to be reviewed by either the staff or the Historic Preservation Board, applications must be complete. The documentation listed below must be submitted with the application form 11 copies of all drawings larger than 11" X 17" and 11 copies of all photos must be submitted. Paint: Color samples of all colors must be submitted. Fences/Gates/Pergolas/ Sheds: • A site plan of the property showing the location of the fence, gates and/or pergola. The plan must show the property's dimensions. • A picture of the proposed structure. This can be an elevation drawing, sketch, brochure or photo of an existing shed, fence, gate or pergola provided that the dimensions are included. • A description of the materials that will be used in the project. • Photos of the yard(s) in which the structure will be placed. (11 copies of each photo must be submitted). New construction/additions Elevation drawings to scale of each fagade indicating proposed alterations or additions. Drawing must clearly depict the existing building and the proposed changes. Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed addition, location of all exterior ground and roof mounted equipment.. Description and/or samples of materials to be used. Where applicable, drawings and site plan of other improvements such as fences, walkways, lighting, decks, etc. Photos (11) of existing structure. Awnings/ Signs • Sketch or elevation drawing of the building fagade with proposed sign/awning. Dimensioned drawing of awning/sign. Sample of colors. Site Improvements/driveway/walkway/AC/Mechanical >ite plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed mprovements. )escription and/or samples of materials to be used. dote: AC/Mechanical equipment must be screened by shrubs. \SHA ENG\Historic Preservation Board\#Cenificate of Aoorooriateness.doc 2. CITY OF SANFORD HISTORIC PRESERVATION BOARD APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS P.O. Box 1788, Sanford, FL 32772-1788 Phone: 407 330-5672 Fax: 407 330-5679 In addition to a Certircate of Appropriateness, a building permit may be required. Check with the Building Department: 407 330.5660. A Certificate of Appropriateness may be required for projects that do not require a building permit. This Certificate must be prominently displayed on the building when work is in progress. 1. General Information Property Owner. P& (� 1 A C/;roperty Address: r IS- Mailing Address: K L S. PA(^F—M Phone Number: �zQ 7 Agent: Fax Number. Phone Number. Address: Fax Number: ll�7 - 3 2 7--- 23 V ❑ Downtown Commercial Historic District: ❑ Residential Historic District: ❑ This application is filed in response to a notice from the Code Enforcement Department 1 certify that all information contained 0 this application is true and accurate to the best of my knowledge. Applicant: /� Owner: Date: �� ! n Date: Please use the attached criteria checklist as a guide to completing the application. Incomplete applications cannot be reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at 407 330-5672 to make sure your application is complete. A Certificate of. Appropriateness is valid for six months unless otherwise noted OFFICIAL USE ONLY Historic Preservation BoardM ting Date: Staff Review Date: Application is Approved, Approved with Conditions Conditions: r O Denied • O Signed: Bate: Q l �Y i � FASHA ENG1Historic Preservation Board\#Certificate of Appropriateness.doc 1. I 2. D�scgption of Proposed Work Application Category: (Check all that apply) ❑ Site Improvements/driveway/walkway ❑ Storage shed ❑ Moving structures ❑ Replacement windows or doors ❑ Underskirting ❑ Awnings ❑ New construction/additions ❑ Signs ❑ Demolition ❑ Roofs/gutters/downspouts ❑ AC/Mechanical ❑ Fences/Gates/Pergolas ❑ Replacement siding/flooring/porch ❑ Paint ❑ Other Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building, where on the property the work will occur and how the work will be accomplished. For large projects, an itemized list is recommended. Attach additional pages if necessary. /�- 5 ktx� — woo o 4- 14m/ �o 3. Documentation: ' In order to be reviewed by either the staff or the Historic Preservation Board, applications must be complete. The documentation listed below must be submitted with the application form. 11 copies of all drawings larger than 11" X 17" and 11 copies of all photos must be submitted. Paint: Color samples of all colors must be submitted. Fences/Gates/Pergolas/ Sheds: • A site plan of the property showing the location of the fence, gates and/or pergola. The plan must show the property's dimensions. • A picture of the proposed structure. This can be an elevation drawing, sketch, brochure or photo of an existing shed, 'fence, gate or pergola provided that the dimensions are included. • A description of the materials that will be used in the project. • Photos of the yard(s) in which the structure will be placed. (11 copies of each photo must be submitted). New construction/additions • Elevation drawings to scale of each fagade indicating proposed alterations or additions. Drawing must clearly depict the existing building and the proposed changes. • Site plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed addition, location of all exterior grourid and roof mounted equipment.. Description and/or samples of materials to be used. Where applicable, drawings and site plan of other improvements such as fences, walkways, lighting, decks, etc. Photos (11) of existing structure. %wnings/ Signs Sketch or elevation drawing of the building fagade with proposed sign/awning. Dimensioned drawing of awning/sign. Sample of colors. iite Improvements/driveway/walkway/AC/Mechanical :ite plan showing lot dimensions, location and dimensions of existing building, location and dimensions of proposed nprovements. lescription and/or samples of materials to be used. 'ote: AC/Mechanical equipment must be screened by shrubs. OSHA ENG\Historic Preservation BoardWCenificate of Aoorooriateness.doc 2. PIAT OF SURVEY ADDENDUM ._p,. Legal 'Ddsc ri pt ion LAT 9, BLOCr, 8. TIER i. FIARIDA LAND & COLDNIZATION COMPAP. iTD., E.R. TRAFFORD'S KAP OF THE TOWN OF SANFOBD. according to the.Plat thereof as recorded in Plat Book 1, Pages 56 through 64, of the Public Records of Seminole County. Florida. + �„+ N 8937'30" E 117.00' +r �`w .+ % away C P. x L ` EJ -iri 4 X' zM low Z .1w. MTA as ISSN • s N 89-57-30- E 117.00 jaw I —617 --me il!� g 10 5 I 117.bo' i I• I SCALE: 1"=30' SURVEY NOTES: 1) The street address of the above described property is 615 PAIMEM AP8lM 2). The above described . pro perty' lies in a Flood Zone z SURVEYOR'S CERTIFICATE This is to certify that I have saft a S+aevey of the above dn=Ibsd psopesty and that the Plat haraon delirmted Is an accurate repreasnbtion of the wawa. I furt.wQ certify that this Survey wets '00 Pdnias, Tadvdal Standards set Torth by 'Um Florida Board of Land Surveyors pursuant to Swtn AV.027 of tea ootids StatUtss. RL f NLR WMVLT1NG. IML. rvw COWDIM BAIK R. BLAIR KITNER - P.L.S. NO. 3382 ABSILM TI MOMC11► Sdkn Iaid r Peet Office Bax 923, Sanford, Fl. 3Trrj-= E ;& (40l) T1Z UIIOW9( BLDG . DC. ' oar No: "Ot. M SUOY >r DATE: 25 FED. 001 77 Heli L, pa, pkq FMISM MtfAI, ROOD FRONT UUMION // / - / MEOW O ©Um © � /"/ KOTPA ©HUM / / M ©© HAMI.0OAI 5112ING L. ff UVAMON 5ca.e: 1/ �� � -1'0" IrnAwN VY: 1. RAnIFF G II3I35 5N� n PAZ: MaMMR 2001 Dalton, Christine From: Dalton, Christine Sent: Wednesday, December 14, 2016 3:34 PM To: Hank Dieckhaus (hankd114@gmail.com) Subject: RE: CofA Needed Hank, Just a reminder, I am waiting for the updated CofA application so I can sign off on that and the building permit. Thanks, Christine Dalton, AICP Historic Preservation Officer Community Planner City of Sanford 300 N. Park Avenue Sanford, FL 32771 Phone: 407.688.5145 Fax: 407.688.5141 christine. dalton(&sanfordfl. oov www.sanfordfl.gov From: Dalton, Christine Sent: Thursday, December 08, 201611:22 AM To: Hank Dieckhaus (hankd114@gmail.com) <hankd114@gmaii.com> Subject: CofA Needed Hank, The CofA you had for the shed has long expired. Please complete the attached application so I can continue processing your permit application. Thanks! Christine Dalton, AICP Historic Preservation Officer Community Planner City of Sanford 300 N. Park Avenue Sanford, FL 32771 Phone: 407.688.5145 Fax: 407.688.5141 christine.dalton(cDsanfordfl.00v www.sanfordfl.gov 1