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Home My WebLink About400 Orange Ave (3)Permit No.: 0 CITY OF SANFORD PERNUT APPLICATION Date:3/ Job Address: Permit Type: v Building Description of Work: LMS Electrical Mechanical Plumbing Fire Alarm/Sprinkler fr I -. i 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: _e Residential Commercial _ Industrial Type of Construction: A (0% i rW.m, Flood Zone: Parcel No.: Owner/Address/Phone: W J _J[/ Contractor/Address/Phone: Total Sq Ftg: Value of Work: $__ 1750 Number of Stories: Number of Dwelling Units: Attach Proof of Ownership & Legal Description) State License Number: Contact Person: SAPhone & Fax Number: Title Holder (If other than Owner): Address: Bonding Company: Address: Mortgage Lender: Address: 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 FINANCINY, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1 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. Agent Print Owner/Agent's Name la SignatureofNotary -State of Florida to ti rv•.,, Melissa Cameron r° ommissiOn * DDDM8 W Bonded ILru yOF `W` Atlantic 80 nding Co., tac Owner/ Agent is Personally Known to Me or pf— Produced ID S lu b :79 344 S7s l Signature of Contractor/Agent Print Contractor/Agent's Name Date Signature of Notary -State of Florida Date Contractor/ Agent is Personally Known to Me or Produced ID APPLICATION APPROVED BY: Date: :312,116 Special Conditions: CITY OF SANFORD BUILDING DIVISION OWNEWBUILDER AFFIDAVIT CONSTRUCTION CONTRACTING I It Owners of property when acting as their own contractor and providing direct. onsite supervision themselves of all work not performed by licensed contractors, -%yhen 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 stricture by the owner -builder within I year after completion of same creates a presumption that the constriction 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 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 qualifi- for exemption under this subsection, an oAvner 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 wider an exemption to that law. The exemption alloys \-oil, 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 .-our costs do not exceed $25,000. The building or residence must be for \-our 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 la\y'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 la\\° 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 ou. 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, do hereb-,- state that I am qualified and capable of performing the requested constniction involved with the permit application filed. I will assume full responsibility as an O%xner/Builder Contractor, and will personally supervise all work alloyed by lacy on the permitted stricture. O Z N\ er/Builder Signature Date Print O\yner/Builder Name 3 2-1 Z dap w ignature of Notan—State of Florida Date • ' w o 13 Omyner is Personally Knox\n to Me or has Produced ID 7S 1 s aFooRD SURVEY " RFa PRQP'"Q'^' nFSCRIPTION" LOT 18, FELLOWSHIP ADDfTION TO SANFORD, ACCORDING TOPUBLICRECORDSOF SEMI QLE COUNTYFFLOR DTHEPLATTHEREOASEA.ORDED IN PLAT BOOK 8, PAGE 3, THE ZL FOURTH STREET PAVED ROAD) —4 LOT 17 BLOCK ' A' FELL P TPBADDI00K IO P TOESANFORD V 1 A T 1 0 N