HomeMy WebLinkAbout106 Rose Hill TrlCITY OF SANFORD PERMIT APPLICATION
YJob
rmit No.: t / c7 ' —7 Date: 5 ^! 3 4
Address: / 06 R65 k // 7RG _15aC144e_d r r / gaz 7 73 Permit
Type: Building Electrical Mechanical n
Plumbing
Fire Alarm/Sprinkler Description
of Work: Ln f- ae_55 Zr rPa/` P1_1r&6CCy 62ZAICP Additional
Information for Electrical & Plumbing Permits Electrical:
Addition/Alteration _Change of Service Temporary Pole New AMP Service (# of AMPS ) Plumbing/
Residential: Addition/Alteration New Construction (One Closet Plus Additional) Plumbing/
Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines n
Occupancy
Type: _Residential Commercial _ Industrial Total Sq Ftg: Value of Work: S 6 00, Type
of Construction: Flood Zone: Number of Stories: Number of Dwelling Units: Parcel
No.: Attach Proof of Ownership & Legal Description) kOwner/
Address/Phone:Ag6eR.T M ARG 10'
Ase ZKY/ T,eL _4 CVA/11-L 3 273 Contractor/
Contact
Person: Title
Holder (If other than Owner): Address:
Bonding
Company: Address:
Mortgage
Lender: Address:
ArchitecttEngineer
Phone &
Fax Number: State
License Number: Phone
No.: Address:
Fax No.: 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. Acceptance
of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. gnature
of Owner/Ag6it Date t
Owner/Agent's Name ."_4A/
W , wx 57 f 3/2 ignature
of Notary -State of Florida Date JO
MN M. JOHNSON 4 *
MY
COMMISSION # CC 921808 EXPIRES:
March 23, 2004 BondadTkuBudge!
Noion Services Owner/
Agent is Personally Known to Me or Produced
ID O(-1 r- 3 Zy -7-)37// 7GX>-, APPLICATION
APPROVED BY: Signature
of Contractor/Agent Date Print
Contractor/Agent's Name Signature
of Notary -State of Florida Date Contractor/
Agent is Personally Known to Me or Produced
ID Date:
Special
Conditions:
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 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.
Q- 127f/RG 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 lawn on the permitted structure.
offOwner/
Builder Signature Date ne,
4c 4 C/IG// Print
Owner/Builder Name gyp
P•`t. JO ANN M. JOHNSON MY
COMMISSION N CC 921808 gnature
of Notary-S ate of Florida Date , EXPIRES: March 23, 2004 Fc:
r.o Bonded Thru Budget Notary Services Owner
is Perso% llv Known to Me or has Produced
ID l-,DLI F3Z® 3 11Zt
F I N f--\ lZ--> v F- V I- A
d
0
ry
LOT #
68 1'
15'
drainage -- — easement
ROSE_
TRACT "
A" RETENTION
POND DRAINAGE
EASEMENT) LOT #
67 a
N89'
58'30"E 50.00'* EGAL
DESCRIPTION: r01_
L, ACCORDING TO THf. III -Al THEREOF AS RGED !
N PLAT BOOK 54 , PAGES 41 AND 42, OF THE UBLIC
RECORDS OF SEMINOLE COUNTY, fLORIDA. GENERAL
NOTES: 1. BEARINGS ARE BASED ON RECORD PLAT. 2.
THIS SURVEY IS NOT INTENDED TO LOCATE ANY UNDERGROUND
UTILITIES. 3. BASED ON THE NATIONAL FLOOD INSURANCE PROGRAM FIRM MAPCOMMUNITYNO12MC, PANEL N0.0045F. DATED APRII_ tTf :
rug. .nn„-..- LOT #
5 3'
x3' CONC. PAS L---------------
I10'
UTIUTY EASEMENT TRAIL
NOTE:
FINISH
IPLAN SECTION
6 7DII FLOOR ELEVATION
CITY OFSANFORDSUBDIVISION
CODED LEGEND: FINISH rLOOR
F.F CENTER LINE ROAD E
ooNo FND. LOT LINE — ADJACENT LOT
LINE —_ EASEMENT
ESMT. DRG. EASEMENT LINE DRANAGE
U11fL11Y
UTIL. o—
SET
5/8"
IRONROD #5192 RiGHT-OF_WAY RW END 5/8' IRON
ROD # 2498 4"W CONC. MONUMENT #
2498 ? CABLE I TV9 1< K END
POINT OFCURVAIURE -
MMBOX
fR c };a_
4:
TRACT "A"
RETENTION POND
DRAINAGE EASEMENT)
LOT #67
LOT #68
N89'58'30"E 50.00 *`ffl
1
15' drainage r
easement 6.
13.33 o covered o12.0'
CONC. 6
LOT #512.6]
LO1 'r 3:21
106
ONE STORY
CONC. BLOCK
RESIOENCE 3'x3' Ca":C. PAD
O
Z
L t
l
Y
E
O
at_-------
QI— — — — — — — — S89'58'30"W 50.00'
z 110- UTTLITY EASEMENT
ROSE_ HILL TRAIL
0,
NOTE:
FINIPLANLIMEMEETS SECTION6 CITYOF SANFORD I
ENGINEERED COD
SUBDIVISION
E3AL
DESCRIPTION: n_
I- ACCORDING TO Tlif. III -Al 1HEREOF AS K !
N PLAT BOOK 54 , PAGES 41 AND 42, OF THE UBUC
RECORDS Of SEMINOLE COUNTY, Lt.ORIDA. GENERAL
NOTES: 1. BEARINGS ARE BASED ON RECORD PLAT. 2. THIS SURVEY IS NOT INTENDED TO LOCATE ANY UNDERGROUND
UTILITIES. 3BASEDONTHENATIONALFLOOD INSURANCE PROGRAM FIRM MAPCOMMUNIIYN0.1211X, PANEL N0.0045F. DATED APRIL LEGEND:
FINISH FLOOR F.F. CLNTER
LINF ROAD FOUND FND. LOT
LINE .. — _ EASEMENT ESMT. ADJACENT
LOT LINE _ DRAINAGE DRG. EASEMENT
LINE UTITLITY UTIL o—
SET5/8 IRON ROD j5192 RIGHT-OF-WAY R/w FND
5/9'IRON ROD A 2498 • 2498
T CPB+SF:
G48RX V.
FND
4"x4" CONC. MONUMENT POItJT
OF CURVATURE ac;