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Home My WebLink About1803 W 16 StCITY OF SANFORD, FLORIDA APPLICATION FOR THE DEMOLITION.AND REMOVAL OF BUILDINGS AND'STRUCTURES q s p o$ 4. 3 G1 C E ro c Z D. G O N O ro W N 0 4) ZaH PERMIT ADDRESS W i l([j, PERMIT NUMBER TOTAL CONTRACT PRICE OF DEMOLITION 6 b TOTAL SQUARE FT. / TAX PARCEL NUMBER -5,519 —30 —,yoo c / to D .+ OWNER %/ 7/ , /-/'dS PS J6 /tjj y C( /r PHONE NUMBER(U Z) sa "`' CITY CONTRACTOR ADDRESS CITY STATE ZIP PHONE NUMBER ST. LICENSE NUMBER STATE ZIP TYPE OF STRUCTURE TO BE DEMOLISHED: FRAME V CONCRETE BLOCK STEEL` OTHER PREVIOUS USE OF BUILDING OR STRUCTURES !. _Ce- PROPOSED USE OF THE SITE A149A GAS COMPANY DISCONNECT NUMBER (IF APPLICABLE) GAS COMPANY PERSONNEL ISSUING NUMBER NOTE: GAS COMPANY SECTION MUST BE COMPLETED BEFORE DEMOLITION PERMIT WILL BE ISSUED. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER THE WORK IS COMMENCED. 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. THE NAMED CONTRACTOR/OWNER BUILDER TO WHOM THE PERMIT IS ISSUED SHALL HAVE THE RESPONSIBILITY FOR SUPERVISION, DIRECTION, MANAGEMENT, AND CONTROL OF THE CONSTRUCTION ACTIVITIES ON THE PROJECT FOR WHICH THE BUILDING PERMIT WAS ISSUED. OWNER'S AFFIDAVIT: I CERTIFY THAT ALL THE FOREGOING INFORMATION IS ACCURATE AND THAT ALL WORK WILL BE DONE IN COMPLIANCE WITH ALL APPLICABLE LAWS REGULATING CONSTRUCTION AND ZONING. A COPY OF THE RECORDED COPY OF THE NOTICE OF COMMENCEMENT. WILL BE POSTED ON THE JOB SITE WITH PERMITS NO LATER THAN SEVEN (7) DAYS AFTER THE PERMIT HAS BEEN ISSUED. FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR THE IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ASBESTOS NOTIFICATION STATEMENT (SEC. 553.79(11), FL STATUTES) FOR FACILITIES OTHER THAN SINGLE FAMILY OR DUPLEX HOUSING. I HEREBY AFFIRM THAT I HAVE COMPLIED WITH THE PROVISIONS OF SECTION 455-302, FL STATUTES, AND HAVE NOTIFIED THE DEPARTMENT OF ENVIRONMENTAL REGULATION OF MY INTENTION TO REMOVE ASB STOS, IF APPLICABLE. UnVV44- SIGNATURE OF OWNER/AGENT b DATE SIGNATURE OF CONTRACTOR b DATE TYPE OR PRINT OWNER/AGENT NAME TYPE OR PRINT CONTRACTOR'S NAME I Q, rrt irdti-- l z SIGNATURE OF NOTARY b DATE SIGNATURE OF NOTARY b DATE OFFICIAL SEAL) ( OFFICIAL SEAL) W-14" Melissa_co u; on# araeron yEup Dm79918 Q. Bonaw ec 20' zoos aatic Bofn Co., Inc. APPLICATIONAPPROVED BY FEES: BUILDING APPLICATION PERMIT VALIDATION: DATE OTHER CHECK CASH DATE BY H ro z 4 0 O bM O O M 0 a 14 1C z 0 M I r 0 z b O a C f1 fD d H C ORIGINAL ( BUILDING) YELLOW ( CUSTOMER) PINK (COUNTY TAX OFFICE) 0 05/e'.2- DEMOLITION Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing YXublic Works Acknowledgement A. Sidewalk Closing B. Street Use/Closing 1. Walkways — Protection — Width 2. Barricades — Protection — Width 3. Fencing — Protection — Width - Height 4. Curb Protection/Sidewalk Protection/Street 5. Storm Sewer Protection C. Dust Control Police Department Acknowledgement A. Traffic Control B. Crowd Control/Security Utility Department Acknowledgement A. Water, Sewer — Capped off, Sealed B. Water for Dust Control (Meter) Engineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: lw- Lx) I (Ot") 'S' Additional Comments: 111 110 a.11 W eI . 01/15/2011 14:36 4073022540 SANFORD PD PAGE 02 P. 1 5-18-1995 6 : 01 PF'1 FROM DEMOLITION Budding Divisioa Acknowledgement A. Permit Application B. Stag Foram C. State StatutwCorttmow Licensing INbllc Works Ae mvMedgerawt A. Sidcwalk Civsing B. Suva Use/C105* 1. Walkways — Pratcctim — Width 2. Banicades — Protection — Width I Fencing — Protectioa — Width - Height 4. Curie ProteatiDWSldewalk ptotecti0WStreet 5. sum Sewer protection C. Dust Control police Department Acknowkdgement A. Traffic Control B. Crowd ContsoUSecuority Utility Department Acknow kilgemeot A. Water, Sewer — Capped off, Sealed B. Watm for Dust Control (Near) Engineering & Pbnning Acknowledgement A. Historic District B. Zoning Issues Address of Job: I DEMOLITION Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing Public Works Acknowledgement A. Sidewalk Closing B. Street Use/Closing 1. Walkways — Protection — Width 2. Barricades — Protection — Width 3. Fencing — Protection — Width - Height 4. Curb Protection/Sidewalk Protection/Street 5. Storm Sewer Protection C. Dust Control Police Department Acknowledgement A. Traffic Control B. Crowd Control/Security Utility Department Acknowledgement A. Water, Sewer — Capped off, Sealed B. Water for Dust Control (Meter) L /l'v "//,s-/o z GV,?-761P, S,': R 1/ tE / 5 a ff . 7c Cop sesw64 XdRV;c/ G!. Engineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: LID Additional Comments: ' C_ ondkun reed b u CC on PH 10 ;L 0. w W DEMOLITION Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing Public Works Acknowledgement A. Sidewalk Closing B. Street Use/Closing 1. Walkways — Protection — Width 2. Barricades — Protection — Width 3. Fencing — Protection — Width - Height 4. Curb Protection/Sidewalk Protection/Street 5. Storm Sewer Protection C. Dust Control Police Department Acknowledgement A. Traffic Control B. Crowd Control/Security Utility Department Acknowledgement A. Water, Sewer = Capped off, Sealed B. Water for Dust Control (Meter) Engineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: Lj (Dt Additional Comments: L OnaP-Yn 0;- GkA lbwej 1 1151a-7- DEMOLITION Building Division Acknowledgement A. Permit Application B. State Forms C. State Statutes/Contractor Licensing Public Works Acknowledgement A. Sidewalk Closing B. Street Use/Closing 1. Walkways — Protection — Width 2. Barricades — Protection — Width 3. Fencing — Protection — Width - Height 4. Curb Protection/Sidewalk Protection/Street 5. Storm Sewer Protection C. Dust Control Police Department Acknowledgement A. Traffic Control B. Crowd Control/Security Utility Department Acknowledgement A. Water, Sewer — Capped off, Sealed B. Water for Dust Control (Meter) Engineering & Planning Acknowledgement A. Historic District B. Zoning Issues Address of Job: x— Lj l (D- t,,,, S+ Additional Comments: (_nnAe y-nneel In, i CL on PH 10;L CITY OF SANFORD BUILDING DIVISION OWNERIBUILDIE-R AFFIDAVIT CONSTRMCTIOT7l CONTRACTING Owners of propem when acting as their o\\-n 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 t\yo-famIiN- 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 personal]\• 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 vou, 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 constriction 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 \-our 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 l 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 \our contractor or to supervise people working on \our building. It is \-our responsibI Iy to make sure that people employed by you have licenses required bN state lacy 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 \\ork under your direct supervision and must be employed by you. Which means that vou must deduct FTC.A. and withholding tax and provide workers compensation for that employee. all as prescribed by la\\ . four constriction must comply with all applicable lays, ordinances; building codes, and zoning reuti lat ions. I. Um i h r. A 4 LL- . do hereby state that I am qualified and capable of performing the requested construction involved \\ith the permit application filed. I will assume full responsibility as an Owncr/Builder Contractor. and will personally supcn:isc all \\ork alloyed by lacy on the permitted stricture. SL 4"Q fi OxN-ner/Builder Signature Date 161(Y' - FiefS Print O\\'ncr/Builder Manic Signature of Nowr.—State of Florida Datc O\\-ner is Personally hno\\ n to Me or has Produced ID / qoo-26r,33 9:Zi6 aA N° a3 ca: w ad bk n 0rD