HomeMy WebLinkAbout413 S Myrtle AveCITY OF SANFORD PF?2MIT APPLICATION
Permit No.:Q — /`
Job Address: S
Permit Type: Buii ing Electrical Mechanical Plumbing Fire Alarm/Sprinkler
Description of Work: VMV
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: Residential Commercial _Industrial Total Sq Ftg: Value of Work: $
60
Type of Construction: Flood Zone: Number of Stories: Number of Dwelling Units:
Parcel No.: _ (Attach Proof of Ownership & Legal Description)
Owner/Address/Phone:
Contractor/Address/Phone:
State License Number:
Contact Person: Phone & 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.
of permit is verification that I will n
of Owner/Agent Date
ier/Agent's Na .
of Notary -State Yf Florida Date
NRY
JOANNM.JOHNSON
MY COMMISSION # CC 921808
E _ S: March 23, 200419710rFOQndedThruBudgetNotaryservices
OwnerlAgent is"-Peor Produced
ID fy
the owner of thepropertyof the requirements of Florida Lien Law, FS 713. Signature of
Contractor/Agent Date APPLICATION APPROVED
BY: r Print Contractor/
Agent's Name Signature of
Notary -State of Florida Date Contractor/Agent
is Personally Known to Me or Produced ID
Date: Z
2-0 2 Special Conditions:
CITY OF SAN,F_IkBUILDING DIVISION
OWNER/BUILDER-AFF DAVIT
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 commereial 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 presrn11ption 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 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 qualifi: for exemption under this
subsection, an owner must personally appear and sign the building permit application.
State law requires constriction to be done by licensed contractors. You have applied for a permit under
an exemption to that lave. 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 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 your
costs do not exceed $25,000. The building or residence must be for your oven 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. do hereby state that I am qualified and capable of performing the
requested construction involved with the permit application filed.
I will assume f i.11 responsibility as an Ovvner/Builder Contractor, and will personally supervise all work
allowed by law on the perunktted structure.
3 Z4\V Builder ignature Date
Print Owner/Builder Name
IC} -d^,. V!. JGHNSON
iS na[ure of Notary State Florida Date # x MY +i icy iCC921808
Mtrh 23, 2004 HJc
of F,Y" bondc Tnr c Buc otan/ Services O\\
ner is p-ersonalk Kno\vn to Me or has ----- --- Produced
ID
WATERFRORT CITr' OF SANFO.IRD
HISTORIC PRESER VA TION BOARD
APPLICATION FOR A
CER TIFICA TE OF APPR OPRIA TENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407 330-5672 Fax: 407 330-5679
FLOR[DA
I .tPropertyOwner: . iq i I Property Address:——UI
Mailing Address: Phone Number: -4L 7 `,: 22 "3 Z.11 Fax
Number: 7.
Agent:
Phone Number: Address:
Fax Number: Downtown
Commercial Historic District: Residential Historic District: Describe
all changes in material, color or location to the exterior of the buildi Agnd property: hi
re,t) in j I)h or r)
Applicant'
s Signatur Date: Owners'
Signature Date: OFFICIAL
USE ONLY Historic
Preservation Board Mee "ng Date: Staff Review Date: c3- Z2 -o Zi Application
is Approved k Approved with Conditions Denied Conditions:
Signed: (
VVA , Date- V - 2 Z-0Z _