HomeMy WebLinkAbout124 Pinefield Dr (3)Permit # :
Job Address:
Description of Work:
Historic District:
CITY OF SANFORii PERMIT APPLICATION
5 <—, Date:
Zoning:
4/v
Value of Work:
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Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Nab &Address:
/,� y/.CJEF/�
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
(Attach Proof of Ownership & Legal Description)
Phone:
State License Number:
Contact Person: Phone:
Phone:
Fax:
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. 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.
Accepta4ofpit is ver'fication that tll notithe ow er of theproperty/e of Owner/Agent �� Date Signature of Contractor/Agent Date
Owner/Agent's
Print Contractor/Agent's Name
Aiggat.re or -SM
N # DD 285622 Date Signature of Notary -State of Florida
EXPIRES: March 23, 2008
0, F`�Q Bonded Thru Budget Notary Services
Owner/Agent is Pe sonally KnoW to Me or. G Contractor/Agent is.
oduced ID_c C (0 - S / '� Produced ID _
APPLICATION APPROVED BY: Bldg: orl Zoning: Utilities:
(Initial & Date) (Initial & Date)
Special Conditions:
Date
Personally Known to Me or
FD:
(Initial & Date) (Initial & Date)
CITY OF SANFORD BUILDING DIVISION
OWNER/BUILDER AFFIDAVIT
CONSTRUCTION CONTRACTING
Owners of property when acting as their own contractor and providing direct, onsite supervision
themselves of all work not performed by licensed contractors, when building or improving farm
outbuildings or one -family or two-family residences on such property for the occupancy or use of such
owners and not offered for sale or lease, or building or improving commercial buildings, at a cost not to
exceed $25,000, on such property for the occupancy or use of such owners and not offered for sale or
lease. In an action brought under, this part, proof of sale or lease, or offering for sale or lease, of any such
structure by the owner -builder within 1 year after completion of same creates a presumption that the
construction was undertaken for purposes of sale or lease. This subsection does not exempt any person
who is employed by or has a contract with such owner and who acts in the capacity of a contractor. The
owner may not delegate the owner's responsibility to directly supervise all work to any other person
unless that person is registered or certified under this part and the work being performed is within the
scope of that person's license. For the purposes of this subsection, the term "owners of property"
includes the owner of a mobile home situated on a leased lot. To qualify for exemption under this
subsection, an owner must personally appear and sign the building permit application.
State law requires construction to be done by licensed contractors. You have applied for a permit under
an exemption to that law. The exemption allows you, as the owner of your property, to act as your own
contractor with certain restrictions even though you do not have a license. You must provide direct,
onsite supervision of the construction yourself. You may build or improve a one -family or two-family
residence or a farm outbuilding. You may also build or improve a commercial building, provided your
costs do not exceed $25,000. The building or residence must be for your own use or occupancy. It may
not be built or substantially improved for sale or lease. If you sell or lease a building you have built or
substantially improved yourself within 1 year after the construction is complete, the law will presume that
you built or substantially improved it for sale or lease, which is a violation of this exemption. You may
not hire an unlicensed person to act as your contractor or to supervise people working on your building. It
is your responsibility to make sure that people employed by you have licenses required by state law and
by county or municipal licensing ordinances. You 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 your building who is not licensed must work under your direct supervision and must be employed by
you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation
for that employee, all as prescribed by law. Your construction must comply with all applicable laws,
ordinances, building codes, and zoning regulations.
I;;Z�;, L)14ck_�o IBJ , do hereby state that I am qualified and capable of performing the
requested construction involved with the permit application filed.
I will assume full responsibility as an Owner/Builder Contractor, and will personally supervise all work
allowed by law on the permitted structure.
Date
rj/-9N
Print Owner/Builder Name
jigknatuLe of Notary–S e of Florid. ;.9,°t*e o
My COMMISSION
04
pp 285822
* * EXPIRES, March 23, 2008
rr Bonded TMU Budcet Notary Services
Owner is Pers, a ly Known to''M& r has
Produced ID �L�L
CELERY L'ArKFS HOMEOWNERS' . A..q..grY'lT2kTTe*im , Tw rN
PLAT OF BOUNDARY SURVEY
for
MARONDA HOMES
Legal Description
LOT 12, CELERY LAKES PHASE 1, according to the Plat thereof as recorded in Plat Book 62,
Pages 75 and 76, of the Public Records of Seminole County, Florida.
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SURVEY NOTES:
1) The street address of the above-described property is 124• PIN EFIELD DRIVE.
2) The above-described property lies in a Flood Zone X per FIRM 12117C 0065E dated APRIL 1995.
5
5.
SURVEYOR'S CERTIFICATE
This is to certify that I have made a Survey of thelabovedescribed property and that the plat hereon delineated
is an accurate representation of the same. I further certify that this Survey meets the Minimum Technical
5tandards set forth by the Florida Board of Land Surveyors pursuant to Section 427.027 of the Florida Statutes.
REVISIONS:/ CERTIFIED CORRECT T0:
REVISED FOR WIJpATiON- 2! AUG. '03 -K C DEBRA ANN JACKSON
REVISED FOR FINAL%RYEY� 10 DEC. 2003 KI NER SURVEYING, INC. TAYLOR, BEAN dWHITAKER
R. BLAIR K1rNER - P.L.S. NO. 3382 CHICAGO TITLE INSURANCE COMPANY
Post Office Box 823, Sanford, Fl. 32772-0823 KAMPFTITLE 3GUARANTY CORPORATION
( 407) 322-2000 ADNORAM TITLE COMPANY, INC.
PROJECT NO: 034010 SURVEY DATE: 15 A060$7- ZOO -3
1-kim
SURVEY NOTES:
1) The street address of the above-described property is 124• PIN EFIELD DRIVE.
2) The above-described property lies in a Flood Zone X per FIRM 12117C 0065E dated APRIL 1995.
5
5.
SURVEYOR'S CERTIFICATE
This is to certify that I have made a Survey of thelabovedescribed property and that the plat hereon delineated
is an accurate representation of the same. I further certify that this Survey meets the Minimum Technical
5tandards set forth by the Florida Board of Land Surveyors pursuant to Section 427.027 of the Florida Statutes.
REVISIONS:/ CERTIFIED CORRECT T0:
REVISED FOR WIJpATiON- 2! AUG. '03 -K C DEBRA ANN JACKSON
REVISED FOR FINAL%RYEY� 10 DEC. 2003 KI NER SURVEYING, INC. TAYLOR, BEAN dWHITAKER
R. BLAIR K1rNER - P.L.S. NO. 3382 CHICAGO TITLE INSURANCE COMPANY
Post Office Box 823, Sanford, Fl. 32772-0823 KAMPFTITLE 3GUARANTY CORPORATION
( 407) 322-2000 ADNORAM TITLE COMPANY, INC.
PROJECT NO: 034010 SURVEY DATE: 15 A060$7- ZOO -3