HomeMy WebLinkAbout209 S Elliott AveCITY OF SANFORD PERMIT APPLICATION
!rmit # : 14 (21
Date:
,b Address: 2)�C\ S E �' 10Y\
-scription of Work: NINO. slar ���s
Ct rs,uJfr�
Total Square Footage
istoric District: Zoning:
Value of Work:
S \000'
:rmit Type: Building Electrical
Mechanical Plumbing
Fire Sprinkler/Alarm Puol
ectrical: New Service — # of AMPS
Addition/Alteration
Change of Service Temporary Pole
echanical: Residential Non -Residential
Replacement New
(Duct Layout & Energy Calc. Required)
umbing/ New Commercial: # of Fixtures
k of Water & Sewer Lines
# of Gas Lines
umbing/New Residential: # of Water Closets
3 Plumbing Repair — Residential or Commercial
✓at
xupancy Type: Residential Commercial
Industrial
instruction Type: # of Stories:
# of Dwelling Units: _
Flood Zone: (FEbIA form required )
veers Naine�& Address:
Phone: _
,ntractor Name & Address:
A�jQ ?�. C`z�t 1 _ State License Number:_ --
one & 1
nding
(dress:
wtgagc
.dress:
chitectf -
dress: Fa z:
plication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no souk or installation has commenced prior to die
lance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. f understand that a separate
mit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
t CONDITIONERS, etc.
JNER'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
istnrction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENTMAY RESULT IN YOUR PAYING
flCE FOR IMPROVEMENTS TO YOUR PROPERLY. IF YOU INTEND TO OBTAIN FINANCING. CONSULT WITH YOUR LENDER OR AN
TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NICE: In addition to the requirements of this permit, there may be additional restrictions a�plic
county, and there may be additional permits required from other governmental entities s ch as
xptance of permit is verification that I will notify the owner of the property of the
Signature of Owner/Agent
Print Owner/Agent's Name
Signature of Notary -State of Florida
OwncdAgent is _ Personally Known to Me or
Produced ID
?ROVALS: ZONING:
cial Conditions:
03/2006
Date
of Florida
Sign ureofContracto Ag rl(
v v
Print Co tor/ is Name
be found in the public records of
lets, tate agencies, or federal agencies.
i 713.
i I b 0'7
Date
Date SivnaturNZf NotOt -State of Florida
UTIL: FD:
Date
Contractor/Agent is Personally Known to Me or
Produced ID
ENG:
BLDG:
CITY OF SANFORD PERMIT APPLICATION
Tfuit8: (�� — -?v 0 Date: 160 o %
,b Address: 4 Q 1 a_SAA141) 4C 3i%) 1
-scription of Work:
Total Square Footage
_33-0-0,
S t
istoric District
Zoning:
Value of Work: S
:rmit Type: Building _)e_ Electrical _ _ _ Mechanical Plumbing Fire Sprinkler/Alarm _ Pool
eetricaL New Service - # of AMPS __.?OC) Addition/Alteration _0 Change of Service _ Temporary Pole
eehanical: Residential _)_0 Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
umbing/ New Commercial- # of Fixtures # of Water & Sewer Lines_ # of Gas Lines
umbing/New Residential: # of Water Closets Plumbing Repair - Residential or Commercial
zcupancy Type: Residential_ Commercial Industrial
instruction Type: tt of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
vuers Name & Address:-'iy l d � �C
,utractor Name & Address:
State License Number:
one & Fax: M_3;w-034 t— vo Contact Person:
uding Company:
[dress: _
irtgage tinder:
dress.
chitect/E:ugineer:
dress:
Phone:
Fax:
plication 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
lance 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
mit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
2 CONDITIONERS, etc.
, NER'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
istruction and zoning WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT M YOUR PAYING
(ICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
TORNFY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NICE: 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
county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
xptance of permit verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
e of Owner/Agent Date Signature of Contractor/Agent
Print Owner/Agent's
I) -V
Date
v .,. JO ANN M. JOHNSON
My COMMISSION # DD 285622
rd o� EXPIRES: March 23, 2008
ne pp`' F10nf/!?A "rhrq g�l� t nN
Si�li�t
Owner/ ent is _ Personally �Rk or
roduced ID I- (--
'ROVALS: ZONING: UTIL- FD:
cial Conditions:
03/2006
Print Contractor/Agent's Name
Signature of Notary -State of Florida
Contractor/Agent is
_ Produced ID
ENG:
Date
Date
Personally Known to Me or
BLDG:
CITY OF SANFORD BUILDING DIVISION
OWNER/BUILDER AFFIDAVIT
ELECTRICAL & FIRE ALARM SYSTEMS
An owner of property making application for permit, supervising, and doing the work in connection with
the construction, maintenance, repair, and alteration of and addition to a single-family or duplex residence
for his or her own use and occupancy and not intended for sale or an owner of property when acting as his
or her own electrical contractor and providing all material supervision himself or herself, when building
or improving a farm outbuilding or a single-family or duplex residence on such property for the
occupancy or use of such owner and not offered for sale or lease, or building or improving a commercial
building with aggregate construction costs of under $75,000 on such property for the occupancy or use of
such owner and not offered for sale or lease. In an action brought under this subsection, proof of the sale
or lease, or offering for sale or lease, of more than one such structure by the owner -builder within 1 year
after completion of same is prima facie evidence that the construction was undertaken for purposes of sale
or lease. This subsection does not exempt any person who is employed by such owner and who acts in
the capacity of a contractor. For the purpose of this subsection, the term "owner of property" includes the
owner of a mobile home situated on a leased lot. To qualify for exemption under this subsection, an
owner shall personally appear and sign the building permit application.
State law requires electrical contracting to be done by licensed electrical 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 electrical contractor even though you do not have a license. You may install electrical
wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in
a commercial building the aggregate construction costs of which are under $75,000. The home or
building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or
lease more than one building you have wired yourself within 1 year after the construction is complete, the
law will presume that you built it for sale or lease, which is a violation of this exemption. You may not
hire an unlicensed person as your electrical contractor. Your construction shall be done according to
building codes and zoning regulations. 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.
I; 2/�/) ��/ •!L , do hereby state that I am qualified and capable of performing the
req tseu ed 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.
�z - 7 o-2
wner/Builder Signature Date
Print OwnerBuilder Name
C�4A A/% VVN 4tk,,6, '0-7
ature of Notary—State 6f Florida Date
Owner is Perso ally Known to Me orhasi:a'°�;�� JO ANN M. JOHNSON
Produced lD G MY COMMISSION # DD 285622
EXPIRES; March 23, 2008
•\9rFpc p�,1e Bonded Thru Budget Notary Services r
CITY OF SANFORD PERMIT APPLICATION
-rmit # : 01 — 7 Y 0 •liDate: 0
/ l7—
,b Address: c2cN'5 S G- t 1�•b
-scription of Work: IJA b,'Total Square Footage 330(7.
istoric District: Zoning: — Value of Work: S
:rmit Type: Building Electrical _ Mechanical _ Plumbing Fire Sprinkler/Alarm Pool
ectricai: New Service - # of AMPS Addition/Alteration >-'— Change of Service _ Temporary Pole
echanicaL Residential _y__ Non -Residential _ Replacement New (Duct Layout & Energy Calc_ Required)
umbing/ New Commercial # of Fixtures __�k # of Water & Sewer Lines K _ # of Gas Lines
umbing/New Residential: # of Water Closets rY Plumbing Repair - Residential or Commercial _
cupancy Type: Residential Commercial Industrial
)nstruction Type: It of Stories: # of Dwelling Units: Flood Zone: (FEMA foram required )
caers Name & Address: Zl*mo 1ArP/t- a_U) S C/1,b
Phone:
,ntractor Name & Address
one & Fat:
nding Compauy:
(dress:
)rtgagc [ender:
'dress:
chitect/Eagineer:
dress:
Contact Person:
State License Number:
Phone:
Fax
plication 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
lance 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
mit must be secured for ELECTRICAL. WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
Z CONDITIONERS, etc.
✓NER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with At applicable laws regulating
tstruction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
!ICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NICE: 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
;county, and there maybe additional permits required Gom other governmental entities such as water management districts, state agencies, or federal agencies.
X13tance. of is veri 17tio at I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
-/7 -7
,itoiature of Owner/Agent Date Signature of Contractor/Agent
Print Owner/Agent's Name ) ii
ature of Not Sta[e E! Date
M. JOHNSON
My GOMMISSIDN # DD 285622
EXPIRES: March 23, 2008
n�>°t Rendell Thnr Rudget Notary Services
Owner/Agent is _ Petsonally Known to Me or
�Pfoduced ID
'ROVALS: ZONING:
tial Conditions:
03/2006
UTIL: FD:
Print Contractor/Agent's Name
Date
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID
ENG:
BLDG:
CITY OF SANFORD BUILDING DIVISION
OWN' ,E,P&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 sale or lease, or building or improving commercial buildings, at a cost not to
exceed $75,000, 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 1 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 $75,000. 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 1 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
re sted 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.
er/Builder Signature Date
,71
Print Owner/Builder Name
rA A �— 11 J0"7
ature of Notary] tate of Florida Date
201pHY Pg9ec JO ANN M. JOHNSON
My 00WAISSION # DD 285622
Owner is Personally Known to Me or has ;, 'Aarch 23, 2008
Produced ID�� "' ilp}3NS9Nhf.'