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Home My WebLink About107 Hays Drm. m 77s CITY OF SANFORD PERMIT APPLICATION Per # _ 3v , / Date: i lob Address: Description of Work:Total Square I oota�e "L U i f .. i Kistoric District_ >� ,Zoning:' _Value of Work: $ �C/UV Permit Type: Building ✓ Electrical _ Mechanical Plumbing Fire Spunkier/Alarm Pool Electrical: New Service - It of AMPS Addition/Alteration ' Change of Service Temporary Pole ' Ntechanical:"Residential Non -Residential Replacement New (Duct Layout'fk Energy Calc. Required) Plumbing/. New Commercial; # of Fixtures #, of Water & Sewer Lines H of Gas;Lines Pluinbing/New Residential; # of. Water Closets Plumbing Repair — Residential or`Commercial . Occupancy Type: Residential Commercial Industrial i Construction Type: # of.Stories: 1# of Dwelling Units: Flood Zone. (FEMA form required ) 3wners Name & Address �% Phone: ::oatractorName &;Address: l State License Number ?hone & Fax: Contact Person: Phone: i Bonding Company: I \ddress 14ortgage Lender. tddress \rchitect/Engineer Phone. \ddress' Fa c: \pplication is hereby made to obtain a permtfto do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the ssuance of a permitand that all work will'be,performed to meet standards of all laws regulating construction in this jurisdiction I understand that a separate iermit`must besecured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and UR. CONDITIONERS, etc. ')WNER'S AFEIDAV[T::I ceitfythat all of he foregoing information is accurate and that all work wi(l;be done,.in compliance ,with all applicable laws regulating i ;A nstruction and inning. WARNING TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULTIN YOUR PAYING i WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN \TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 4OTICE in;addition to the requirements of this permit, there may be additional restrictions applicable to this property'that may be found in the pubiic`records of his county; and there may, be additional permits required from other govemmental'entities such as water management distracts, state agencies, or federal agencies - Will , P� � ty � property � J 9 cements of Florida Lien Law, FS 713 �ece tante of permit is verification [[ wd� owner,of [hof theJ^e u� Si atureofOwnu/ t Date Signature of Contractor/Agent Date r v enAge name i DEBBIE 13LANTON PAY CDl+IWSSION #"DD.1 BM1 EXPIRFC: February 25, 2007 Owner/Agent is LOPeA iW Kn,)"t R"nt,Assoc. CO Produced �.. �..� ....�= d'PROVALS: ZONING: UTIL: pecial Conditions: .ev 03/2006 -- FD: Print Contractor/Agent's Signature of Notary -State of Florida Date a -g. 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 sate 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 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 ning regulations. 1, -Q , do hereby state that I am qualified and capable of performing the requ ted 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 law on the permitted structure_ �- 'I v O erBuilder Signature Dat t Owner/Builder Name Signature of Notarygw; loriMEB819MANTON MY CDF� NSSION # DD 188491 EXPIRES: February 25, 2007 OTARy FL d ".esy Co. Owner is Pe Lw e -4 Assoc.1.M_ Produced ID Company: AFFIDAVIT REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS License #: Project Information Owner: Permit #: name Subdivision: address 3�0 Lot #: affiant, hereby affirm, that I am the duly licensed. contractor of record for the above referenced permit, that all the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced address or lot has been installed in accordance with the applicable codes and standards. C6i6C: signature printed name STATE OF FLORIDA COUNTY.OF This instrument was acknowledged before me this . day of 320 , by the above referenced individual, , who acknowledged. that he/she is a duly licensed contractor with , and who acknowledged that he/she was authorized•to execute thisdocument. He/she is either personally known to me or produced as valid identification: WITNESS my hand and seal this day of 320, N ary Public DEBBIE BLANTON MY Cf OMISSION # DD 188491 ' a EXPIRES: February 25,2007 1 8003 NOT.;R'r` =i_ Notary Discount Assoc. Co. ;rA Company: AFFIDAVIT REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS License #: Project Information Owner: Permit #: name Subdivision: address 3�0 Lot #: affiant, hereby affirm, that I am the duly licensed. contractor of record for the above referenced permit, that all the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced address or lot has been installed in accordance with the applicable codes and standards. C6i6C: signature printed name STATE OF FLORIDA COUNTY.OF This instrument was acknowledged before me this . day of 320 , by the above referenced individual, , who acknowledged. that he/she is a duly licensed contractor with , and who acknowledged that he/she was authorized•to execute thisdocument. He/she is either personally known to me or produced as valid identification: WITNESS my hand and seal this day of 320, N ary Public DEBBIE BLANTON MY Cf OMISSION # DD 188491 ' a EXPIRES: February 25,2007 1 8003 NOT.;R'r` =i_ Notary Discount Assoc. Co.