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HomeMy WebLinkAbout615 Osceola Dr (4)Permit # CITY OF SANFORD PERMIT APPLICATION Date: Job Address: �►1� EDC �� 1 V 5 A iN i r p 3 7 7 3 ---Description of Work: � e aD tQt� (�� a0.; Q �� CC-Jct.Gf t-�.-C)< 4 Historic District: Zoning: Value of Work: $ o 0 L) Permit-Type:_Building ✓ Electrical Electrical: New Service — # of AMPS Mechanical: Residential Non -Residential Plumbing/ New Commercial: # of Fixtures Plumbing/New Residential: # of Water Closets Occupancy Type: Residential Commercial Construction Type: # of Stories: Mechanical Plumbing Fire Sprinkler/Alarm Pool _ Addition/Alteration Change of Service Temporary Pole _ Replacement New (Duct Layout & Energy Calc. Required) # of Water & Sewer Lines # of Gas Lines Plumbing Repair — Residential or Commercial _ Industrial Total Square Footage: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: ` ` e (Attach Proof of Ownership & Legal Description) Owners Name-& Address: P0. p k� \3 l 0: E: e3 LPhone: 9 ©% '3a`D 0 10— 3 Contractor Name & Address: Phone & Fax: Bonding Company: Address: Mortgage Lender: Address: Architect/Engineer: Address: Contact Person: State License Number: 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 comity, and there may be additional pennits required from other governmental entities such as water management districts, state agencies, or federal agencies. Acceptance of Aature�o verification that I will otif the owner of the property of the requirements of Florida Lien Law, FS 713. SigrOwner/Agent Date Signature of Contractor/Agent a �l� V,9 mt O er/ ent-s Name Print Contractor/Agent's Name ignature of Notary - State of Florida Date Signature of Notary -State of Florida t3BIE BLANTON =iSS! N DD 188491 jnpr' sly ' PeisonaT�y ingr>�]�le o D C.),t"ebtuary 1-800-3-NOT;\RY FL Discount APPLICATION APPROVED BY: Bld Zoning: (initial & Date) Special Conditions: Contractor/Agent is Produced ID _ Utilities: (Initial & Date) Date 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 I 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 I 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 t)% Vo /pl' 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. -26- 05 Owner/Builder Signature Date PA 6 (_ U Ti4c.(21' P n Owner/Builder Name Signature of Notary—State of Florida Date DEBBIE BLANTON �C0,0i11rtfSSION # DD 188491 Owner is Personall K oto Nle;,or,:h,as2bruary2s,2007 Produced ID 1-900-3-N Et Notery Discount Assoc. Co. AFFIDAVIT REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS Company: Owner: V Qom. name address phone License #: Project Information Permit #: Subdivision: Lot #: affiant, hereby affirm that I am the duly licensed contractor of record for t e above referenced permit, that all the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced address or lot has been installed in accordance with the applicable codes and standards. Contractor: 7 signature printed name STATE OF FLORIDA COUNTY OF This instrument was acknowledged before me this day of , 20 , by the above referenced individual, , who acknowledged that he/she is a duly licensed contractor with , and who acknowledged that he/she was authorized to execute this document. He/she is either personally known to me or produced as valid identification. WITNESS my hand and seal this day o 5.20 NotPu �• °= t7BBlE :ND hY(;`ifBIO88491 8Fe007iE00-3-NOTT,Ry PL N^Laryoc. Co.