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9
CITY OF SANFORDoBUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: Documented Construction Value: $ 560
Job Address: / D'5- M'e: / f"b Historic District: Yes P---No
Parcel ID: a 5,7-1 q S p 5 R, 6- - (),3 o f 0 (.gip Zoning:
Description of Work: 7"A-N 4^ D41V411 6! C' G-6
Plan Review Contact Person: Title:
Phone: Fax: E-mail:
Property Owner Information
Name t, o 14yi d o vY1 r Ke Phone: 321 '-3.5. 41 - 4 (1,10 Street: 1/
3 Resident of property? : o City, State
Zip: 40 /Na tLxt oc F1 Jc,2 77 Contractor Information
Name - - - Phone:
Street: i '
Fax: r, City,
State
Zip: State License No.: Architect/Engineer
Information Name: Phone:
Street: > Fax:
City, St,
Zip: E-mail: Bondin Addres
Mortgage
Address:
PERMIT
INFORMATION
Building Permit
Square Footage:
Construction Type: No. of Stories; No. of
Dwelling Units: Flood Zone: Electrical Plumbing.
New Service.;-
No. of AMPS: New Construction - No. of Fixtures: newsystems) , Fire
Sprinkler/Alarm No. of heads: Mechanical V (D_
uct layout required , for r ` Y
i 4
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.
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.
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.
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. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract. is submitted, credit will be applied to your permit fees when the
permit is released.
Signature of Owner/Agent Date Signature of Contractor/Agent Date
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
t
APPROVALS: ZONING: M5.s.<< UTILITIES:
ENGINEERING:
t - -
COMMENTS:
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
t tpi,
l ' /
l RAi •
I Rev 11.08
D CITY OF SANFORD
BUILDING.& FIRE PREVENTION
PERMIT APPLICATION
Application No: y ` Documented Construction Value: $ 4119,0 @e'
Job, Address: (D5 S ?PUk M Historic District: Yes "No
Parcel ID: Zoning:
Description of Work: C ELC T Uh.S fJ L EP t jzS
Plan Review Contact Person: Title:
Phone: Fax: E-mail:
Property Owner Information^
Name , rr, r1{ Phone:
Street: r-s •=6La V0i ,1.-P p 5L-- La",41 Resident of property?
City, State Zip: -; 27?!` r
Contractor Information
Name L ELT Ai c,AL 5 o L r),L (Av , C, bt Phone: L, 00 - 7 9 7-
Street: 6 L t`f'J i4 Fax:
C 1
itg, State Zip:State T "lceuse-No __ I fZ $ 0_1 y
Architect/Engineer" Information'
Name: Phone:
Street: `. Fax:
1
City, St, Zip: E-mail:
z
Bonding Company: Mortgage Lender:
Address: Address:
Building Permit
Square Footage:
No. of Dwelling Units:
Electrical 0-'
PERMIT INFORMATION
Construction Type:
Flood Zone:
Plumbing
New Service — No. of AMPS:
Mechanical (Duct layout required for new systems)
No. of Stories:
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm No. of heads:
s
I
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.`,
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.
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.
NOTICE: In addition to the requirements of this permit, there may be additional,,testrictions.agplicable .to, this
property that may be found in the public records of this county, and there may be additionalpermits required from
other governmental entities such as water management districts, state 'agencies;tor 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. A copy of the executed contract is required in order to
calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the Plan
review fee based on past permit activity levels. Should calculated charges exceed the documented construction
value when the executed contract is submitted, credit will be applied to your permit fees when the permit
is released. Signature
of Owner/Agent Date eignature of Contractor/Agent Date 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 APPROVALS:
ZONING: ENGINEERING:
COMMENTS:
Print
Cop tractor/Agent's Name Si
V ature of Notary -State of Florida Date XN
Contractor/
Agent i'`o` ersottajtwn to Me or Produced
ID a;ocf ID v
a-
n•R O • •Z- UTILITIES: ;
ASfLo W" y
9 :, tloi FIRE:
f1/
l lAl ltl4t;4e1,` Rev
11.08
r
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 fled
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 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, 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
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 ate tprd F1. 2; a 1f
I, & lJ`/ri l d ea n4 y P l_, , 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 sDQfled above.
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
Semihole County Property Appraiser Get Information by Parcel Number
Personal Property', Please Select Account 13
Page 1 of I
IAA 4;L, P_ '.. it
DAYIO.IOHH SON CFA,ASA
PRIWER
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APPRAISES
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SEEMINOLE CSfIINTY1FL. m iS ,,i
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030111DtEFIRT,ST
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to a rye,
5.0 0 11 11.0 2 A s 0
9.0 5.A JJ VALUE
SUMMARY VALUES,
2011
2010 Working
Certified GENERAL
Value Method Cost/Market Cost/Market Parcel
Id: 25-19-30-5AG-0301-0150 Number of Buildings 1 - 1 Owner:
BISHOP BLOCK BUILDING LLC Depreciated
Bldg Value 326,746 337,517 Mailing
Address: 113 HAVILLAND PT Depreciated EXFT Value 0 1 $0 City,
State,ZipCode: LONGWOOD FL 32779 Land Value (Market) 42,780 42,780 Property
Address: 301 1 ST ST E SANFORD 32771 Land
Value Ag 0 0 Facility
Name `. Just/
Market Value 369,526 380,297 Tax
District: S3-SANFORD-WATERFRONT REDVDST Portablity,
Adj 0 0 Exemptions: Save
Our Homes Adj 0 0 Dor: 11-STORES GENERAL -ONE S Amendment
1 Adj 0 0 Assessed
Value (SOH) 1 $369,526 380,297 Tax
Estimator 2011
TAXABLE VALUE WORKING ESTIMATE Taxing
Authority Assessment Value Exempt Values Taxable Value County
General Fund 369,526 0 369,526 Amendment
1 adjustment is not applicable to school assessment) Schools 369,526 0 369,526 City
Sanford 369,526 0 369,526 SJWM(
SaintJohns Water Management) 369,526 0 369,526 County
Bondsl 369,526 0 369,526 The
taxable values and taxes are calculated using the current years working values and the prior years approved millage rates. SALES
Deed
Date Book Page Amount Vacllmp Qualified QUIT
CLAIM DEED 01/2011 07511 0377 $100 Improved No QUIT
CLAIM DEED 02/2008 07205 0207 $100 Improved No 2010 VALUE SUMMARY WARRANTY
DEED 08/1997 03281 0684 $375,000 Improved Yes 2010 Tax Bill Amount: 7,639 QUIT
CLAIM DEED 09/1987 01894 0222 $100 Improved No 2010 Certified Taxable Value and Taxes DOES
NOT INCLUDE NON -AD VALOREM ASSESSMENTS ADMINISTRATIVEDEED10/1985 01684 1191 $100 Improved No GUARDIAN
DEED 02/1985 01615 1475 $100 Improved No ADMINISTRATIVE
DEED 09/1982 01413 1404 $100 Improved No Find
Sales within this DOR Code DESCRIPTION
LAND
LEGAL
Land
Assess Method Frontage Depth Land Units Unit Price Land Value PLATS Pick... SQUARE
FEET 0 0 7,130 6.00 $42,780 LOTS 15 + 16 8 E 2 FT OF ST ADJ ON W BLK 3 TR 1 TOWN OF
SANFORD PB 1 PG 58 BUILDING
INFORMATION Bid
Num Bid Class Year Bit Fixtures Gross SF Stories Ext Wall Bld'Value Est. Cost New Buildinq
1 MASONRY PILAS 1888 63 12,615 2 CONCRETE SketchBLOCK - MASONRY $326,746 $718,122 Subsection /
Sgft OPEN PORCH FINISHED / 45 Subsection /
Sgft CANOPY / 1890 Subsection /
Sgft OPEN PORCH FINISHED / 35 Subsection /
Sgft OPEN PORCH FINISHED / 40 Subsection /
Sgft OPEN PORCH FINISHED / 24 Subsection /
Sgft OPEN PORCH FINISHED / 28 Permits
NOTE:
Assessed values shown are NOT certified values and therefore are subject to change before being finalized for ad valorem tax purposes. If
you recently purchased a homesteaded property your next ear's property tax will be based on Just/Market value. I
PERSIT #
2 Zoe
r CITY OF SANFORD HISTORIC PRESERVATION BOARD
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
rt87
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407.688.5145 • Fax: 407.688.5141
Answer all the questions on this form and submit all required attachments. Incomplete applications will not be
reviewed. If you have questions about application requirements contact the Historic Preservation Officer at
407.688.5145 to ensure your application is complete. A building permit may be required for the activity detailed
below. Please contact the Building Department at 407.688.5150 for more information. Failure to obtain a building
permit may result in fines and/or double permit fees.
1. GENERAL INFORMATION
Downtown Commercial Historic District D- Residential Historic District Is this a retroactive request? Yes No
Is this application filed in response to a Notice of Violation from the Code Enforcement Department? Yes No
Property Address: #L
Property Owner Information
Print Name: !)- ,aIc1 1i rIlit•Vk;f.,
Mailing Address: r t
Phone: 3 2 l 3-6 tr / _ Fax: Email: &i r 1 rc' ^ C C aj A
Signature:
Applicant/Agent Information
Print Name:
Mailing Address:
Phone: Fax: Email:
Signature: l ;+ s .,._2.,.
I certify that all information
Applicant/Owner Signature:
in Jliis application is true and accurate to the best of my knowledge.
ould you like to receive emails regarding Historic Preservation and Community Planning within your community?
2. APPLICATION CATEGORY (Check all that apply)
Proposed improvements will affect the following elevations: North South East West
ite Improvements/Driveway/Walkway Storage Shed Replacement Siding/Floor/Porch
Replacement Windows or Doors Underskirting Signs/Awnings
New Construction/Additions Paint Fences/Gates/Pergolas
Roofs/Gutters/Downspouts AC/Mechanical Other
3. DESCRIPTION OF PROPOSED WORK
Completely describe the entire scope of work, including changes in material and color, and methods that will be used to
accomplish the proposed work. /For large projects an itemized list is required. Use the reverse side if necessary.
i9 ;^l%G= <"?id'r e ! A f/''l't 't'(JL-.: %.! ) v <" C
OFFICIA)_`)SE ONLY Application Received On:
Hist is Preservation Board Meeting Date: ,J((
Approved El Denied (Conditions Noted Below)
Signature: 'bate: sy26r
APPROVAL IS VALID FOR SIX MONTHS UNLESS OTHERWISE NOTED.) PAGE 1 OF
THIS CERTIFICATE MUST BE PROMINENTLY DISPLAYED ON THE SITE WHEN WORK IS IN PROGRESS. ****
Ij
M Ay 5 2011
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