HomeMy WebLinkAbout802 S Palmetto AveCITY OF SANFORD PERMIT APPLICATION
Permit Date:
Job Address: 70 IR P�,
Description of Work:�r ivr'�/ /ry jJii ��i� �o r ht U' 17
Historic District: Zoning: Value of Work: $
�3�
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential 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 or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: e -,-,,r,; # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for rl;rr than X)
Parcel #:
Owners Name & Address: r
X U v— -, • /'-/ /
Contractor Name & Address:
Phone & Fax
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer
Address:
(Attach Proof of Ownership & Legal Description)
SWiNF2L</
Phone: "716 J �ci cr j
State License Number:
Contact Person: Phone:
Phone:
Fax:
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 1hr,
issuance of a permit and that all work will be performed to fleet standards of all laws regulating construction in this jurisdiction. I understand that a scparaYe
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 )'F,71H(i
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 feric"ml agencies.
Acceptance.of per it is ver fication that [ wi I notify the owner of the property of the requirements of Florida Lien Law, FS 713.
Signatur of Owner/Age Date Signature of Contractor/Agent Date
0 t po ws.14 5
nt Oww/A¢ent's Name
Si " xt'__& Y Date
e EXPIRES. November 12,2006
r,"Teo, F ev° Bonded Thru Budget Notary Services
Owner/Agent is Known to Me or_..
Produced I
APPLICATION APPROVED BY: Blde. Zoning:
(Initial &
Special Conditions:
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is _ Personally Known to Me or
Produced ID
(Initial & Date)
Utilities:
FD:
(Initial & Date) (Initial & Date)
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�STOAIC
WATERFRORI' GATt?teev
CITY OF SANFORD
HISTORIC PRESER VA TION BOARD
APPLICATION FOR A
CERTIFICA TE OF APPR OPR[A TENESS
P.O. Box 1788, Sanford FL 32772-1788
Phone: 407 330-5672 Fax: 407 330-5679
Property o�F
P Y Owner:
t9cc9 vA� 110l�(/l':--,F V
. Property Address:
Mailing Address: fdlSQ
/4
Phone Number: 0
Fax Number.
Agent:
Address:
Phone Number:
Fax Number. -
Down Own
umber:
Downtown Commercial Historic District: ❑
Residential Historic District. g�
Describe all changes in material color or location to the exterior of the buildinand property:
Applicant's S
Owners'
0
Date:
% Date:
F 9 JAL USES ONLY
Historic Preservation Board Meeting Date: J_
rrr"`"'���------ Staff Review date:
Application is Approved �Approved with Conditions
Denied _
Conditions: 6p
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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 $25,000 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 near
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 ]eased 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 propext-\,r„ �o
act as vour own electrical contractor even though you do not have a license. You may instal! ;;;Ir -c r;<<<.l
wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical N irits i,
a commercial building the aggregate construction costs of which are under $25,000. The home or
building must be for Your own use and occupancy. It may not be built for sale or lease. If vot_t sell OF
lease more than one building you have wired yourself within I year after the construction is corrnfilr,:i!;, rh(.
law will presume that you built it for sale or lease, which is a violation of this exemption. You tna\ 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.
do hereby state that I am qualified and capable of perfonrtirt la,r
requested cofistruction involved with theermit
p application filed.
1 will assume full responsibility as an Owner/Builder Contractor, and will personally supervise all work
allowed by law on the permitted structure.
Owner/ ilder Signatur Date
Print Owner/Builder Name
ignature of Notary—State of Florida Date
ONV'ner is Pers nally Known to Me or has
Produced ID
-s
.11 FLORENCE A. DE GRAVE
MY COMMISSION # DD 164280
EXPIRES; November 12, 2006
Bonded Thru Budget Notary Services