HomeMy WebLinkAbout2508 Mellonville AveCITY OF SANFORD PERMIT APPLICATION
Date: ✓ ! '�
.b Address: ATO
ascription of Work: �` )lm Total Square Footage
istoric District: Zoning: Value of Work: S
I
rmit Type: Building Electrical ✓ _ Mechanical Plumbing Fire Spnnkler/Alarm Pool
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 # 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: # of Stories: # of Dwelling Units: _ Flood Zone: (FEMA form required)
veers Name & Address:
Phone0
atractor Name & Address:
State License Number"
one & Far:
ading Company
(dress:
! utgagc (",ender:
dress:
i
I chitcct/Engineer
+ dress:
Contact Person:
Phone:
fax
I 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
ranee 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
+ t 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.zonin& WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
!ICE FOR IMPROVEMENTS TO YOUR PROPERLY" IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT-
1-TICE
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
I ;county, and there may be additSonal permits required Goin other governmental entities such as water management districts, state agencies, or federal agencies.
xptanceof itis eri6gdon that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713"
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name Print Contractor/Agent's Name
144 114� r '25-0
gnatufc o Notary -State of rida Date Signature of Notary -State of Florida Date
Y 0��� JO ANN M. JOHNSON
# * MY COMMISSION # DD 285622
EXPIRES: March 23, 2008
Owner/Agent is '> tiA°all I5/edFhnutlael(p1N�tyServires Contractor/Agent is Personally Known to Me or
.�oduced Produced ID
'ROVALS: ZONING: UTIL- FD: ENG: BLDG:
cial Conditions:
03/2006
CITY OF SANFORD BUILDING DIVISION
OWNERIBUILDER AFFIDAVIT
GO?NSIRUCTION 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 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 $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.
Q, , do hereby state that I am qualified and capable of performing the
requested construction involved with the permit application filed.
I will assume�fill responsibility as an Owner/Builder Contractor, and will personally supervise all work
41loweed by law on the permitted structure.
Signature Date
�l
< rint OwnerBuilder Name
i nature of Nota tate of -Fro orida Dat �P�. P+� at M. JOHNSON
g ry 20 : i
* PAY COMMG�SiON # DD 285622
* EXPIRES. March 23, 2008
Owner is Personally Known to Me or has �T9TFoF F opo Borded rnru Budget Notary services
Produced ID F -Ci l/