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Home My WebLink About306 E 4 StCITY OF SANFORD PERMIT APPLICATION Application # : b - "' Submittal Date: ^J66 &d ss: -J 3� �Q �. -r C4 Va'l`ue of'Work; $ L4Q Q' Parcel ID: Zoning: ,HistoricDistrict:---i 5 Description of Work: Square Footage: ........................................................................................... 0............................ Permit Type: Building ❑ Electrical 0 Mechanical 0 Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑ Electrical: New Service – # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑ Mechanical: Residential ❑ Non -Residential 0 Replacement ❑ New ❑ (Duct Layout & Energy Calc. Required) Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines Plumbing/New Residential: # of Water Closets Plumbing Repair – Residential ❑ Commercial ❑ Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑ Occupancy Use Group(s): Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required) .........................................1................................................................................ Property Ovvne :SSI «> I�t1 L.ti Contractor: Addres� s.. -1. C—, • ^t,VA ret Address: rA Phone: �16J"3i.$S 35 3 E-mail: Phone: State License Number: Bonding Company: Address: Architect/Engineer: Address: Plan Review Contact Person: Mortgage Lender: Address: Phone: Fax: Phone: Fax: E-mail: 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 FINANCING; CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 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 'fication that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. Signature of er/Agent D to Signature of Contractor/Agent Prin�ent's Print Contractor/Agent's Name Ignature of Notary -State of Florida Date Signature of Notary -State of Florida migP., MY COMMISSION # DD629096 EXPIRES: February 25, 2011 18 O F'TARY FI. Notary Discowt Asma Co. Owner/Agent' Produced ID APPROVALS: ZONING: Special Conditions: Rev 02/2007 UTI L: FD: Contractor/Agent is Produced ID _ Date Date Personally Known to Me or ENG: BLDG: CITY OF SANFORD HISTORIC PRESERVATION BOARD APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS P.O. Box 1788, Sanford, FL 32772-1788 Phone: 407.302.5805" Fax: 407.330.5679 TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA ❑ Downtown Commercial Historic District I<esidentiarHistoric District ❑ This application is filed in response to a notice from the Code Enforcement Department ADDRESS OF PROPERTY: '3O(e E, -`147"" Property Owner Signature: Mailing Address: 36Ce. Phone: Ltb—( — Z X04 — ti 2.`J9 Fax: Applicant/Agent Signatu MailingAddress: Phone: �(�� PrintrName: vytQ�l.li14 Print Name: cA,� h Fax: `iJ01 • 311— S Z " 1 I certify that all informatio ontained in this application is true and accurate to the best of my knowledge. Applicant/O er: 1Date: I17 X0'1 Please use the attached crit is checklist as a guide to completing the application. Incomplete applications cannot be reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at 407-330-5672 to make sure your application is complete. Description of Proposed Work/Application Category: (Check all that apply) ❑ Site Improvements/driveway/walkway ❑ Storage shed ❑ Moving structures ❑ Replacement. windows or doors ❑ Underskirting ❑ Awnings ❑ New con struction/additions ❑ Signs ❑ Demolition ❑ Roofs/gutters/downspouts ❑ AC/Mechanical t nces/Gates/Pergolas ❑ Replacement siding/flooring/porch ❑ Paint ❑ Other Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building, where on the property the work will occur and how the work will be accomplished. For large projects, an itemized list is recommended. Attach additional pages if necessary. A Certificate of Appropriateness is valid for six months unless otherwise noted Historic Preservation Board Meeting Date: Application is Approved Conditions: Signed OFFICIAL USE ONLY Approved with Conditions Date: Staff Review Date: Denied ***This Certificate must be prominently displayed on the building when work -is in progress*** Requirements for Certificate of Appropriateness Application City of Sanford Owner/Builder Affidavit Construction Contracting 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. LA -t% In , do hereby state that I am qualified and capable of performing the requested construction involved with the permit application filed. I will assume full responsibility as an Owner/Builder Contractor, and will personally supervise all work allowed aw on the permitted structure. Owner/ uilder Signature bate Owner is Personally Known to Me or has Produced ID Signature of Notary—State of Florida MY COMMISSION # DD629096 ff EXPIRFS: February 25, 2011 My Commission Expires: --y-- Fl. ?otayDiscamtAssac Co.