HomeMy WebLinkAbout2542 El Portal AvePermit No.: 0a —(.000
CITY OF SANFORD PERAUT APPLICATION
a
Date:
Job Address:
Permit Type: All, Building Electric 1 Me hanical Plumbing Fire Alarm/Sprinkler
Description of Work: ? _ A % c SC l - - 10-+ D ZO A,
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
Occupancy Type: v Residential
Type of Construction:
Commercial —Industrial Total Sq Ftg: Z% CS19
Flood Zone: Number of Stories: I
n Q
Value of Work: S l 9
Number of Dwelling Units:
Parcel No.: (Attach Proof of Ownership & Leaal Description)
Contact Person: H r
Title Holder (If other than Owner):
Address:
Bonding Company:
Address:
Mortgage Lender:
Address:
State License Number:
Phone & Fax Number: _f-kU / -
Architect/Engineer 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.
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S' ature of Own gent ate
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Owner/Agent's Namr,
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Si211 of Notary- to of Florida Date
JO ANN M. JOHNSON
MY COMMISSION # CC 921808
E 'RES: March 23, 2004
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ded TMu Budget Notary Services
Owner/A — ersona y own -to a or
Produced ID
APPLICATION APPROVED BY:
Special Conditions:
Signature of Contrac or/Ag t Date
Print Contracto Agen 's 7111_)
Signature of Notary-State/of Florida Date
Contractor/Agent is
Produced ID
Personally Known to Me or
Date: f- Z S 0 Z
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 Nvork not performed by licensed contractors. when building or improving farm
outbuildings or one -family or mo-family residences on such property for the occupancy or use of such
owners and not otfered 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 officred for sale or
lease. In an action brought under this part. proof of sale or lease, or offering for sale or lease, of am- such
structure by the owner -builder within I ycar 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 owners responsibility to directly supervise all work to any other person
unless that person is registered or certified under this part and the work being nerfonned 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 la\v requires construction to be done by licensed contractors. You have applied for a pen -nit 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 onc-family or two-family
residence or a farm outbuilding. You may also build or improve a commercial building, provided your
costs do not exceed $ -;.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 \-car 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 \corking on your building. It
is our responsibilih to make sure that people employed by you have licenses required by 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 work under your direct supervision and must be employed by
you. which means that \-oil must deduct F.I.C.A. and \ithholding tax and provide workers' compensation
for that employee; all as prescribed by law. Dour construction must comply \\ ith all applicable laws.
ordinances; building codes, and zoning regulations.
I. t -19 do hereby state that I am qualified and capable of performing the
requested construction involy d Nit the permit application filed.
will assume full responsibility as an O\\ner/Builder Contractor. and will personally supervise all work
alloyed by lacy on the permitted stricture.
O\\-ner/Builder Signs Ire Da
e
ajn I
Print 0i ner/Builder Name
rn -
of Notary -
Owner is Pcrsonalh
Produced ID
4 1 W W —1 "ray vp
ofFlorida lorid;i Date ? JO ANN M. JONNSON Me
COMMISSION B CC 9218M EXPIRES:
March 23, 20pq BMW
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