HomeMy WebLinkAbout209 E 10 Ste
Permit 0 : C _3
lob Address: i. C
Description of Work:
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
Value of Work: S J U t
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - N of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: N of Fixtures N of Water & Sewer Lines N of Gas lines
Plumbing/New Residential: N of Water Closets Plumbing Repair - Residential or Commercial
Decupancy Type: Residential Commercial Industrial
Construction Type: N of Stories: N of Dwelling Units: Flood Zone: .(FEF*IA form required)
contractor Name & Address: -C
hone & Fax: _
3onding Company:
ddress:
enrage Leader.
ddress:
rchitect/Engineer:
ddress:
Contact Person:
State license Number:
Phone:
Fax:
kpplication 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
ssuance of a permit and due 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
UR CONDITIONERS, etc.
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WNER'S AFFIDAVIT: 1 certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
onstruction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENTMAY RESULT IN YOUR PAYING WICE
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN TfORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 40TICE:
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 his
county, and there may be additional permits required tom other governmental entities such as water management districts, slate agencies, or federal agencies. cceptance
of permit is v rinncation 1 wll notify the owner of the pert of the alure
of Oi./Agait Pate Print
Owner/Agents Name Sl1--
Date Owner/
Agent is _ Personally Known to Me or Produced
16 _ e L L( 0 to J LPPROVALS:
ZONING: UTIL: FD: pecial
Conditions: ev
03/M 71
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urc of GCreal / r- Date v
I-,h C-O LA ION E L Print
C brr/_A ent's Name G t-j'-ZRILffL$" t
ignaturc f nary -State of Florida Dad DINESH
V. SHAH ry
MY COMMISSION a DO 505551 Contractor/
Agent 1006sonal tebttl eor0'10 Produced
ID taoa *WARY n a0O011r'"OO' 00 ENG:
BLDG:
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 sale 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 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, -godo hereby state that I am qualified and capable of performing the
requested constrvolviJ 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. 9t
C) Ke C 90wner/Builder Signature ate ,,r _ w .
co t. A ae
t > c>l'R Ion ` c `+
Z-! u 4 2 T too _Cl/ Z
PrintOwner/Builder Name "1 / l qpt
xa 4pDINESH V. SHAH Signa
reof Notary —State of Florida Date `eF s j # D
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to aoos+
orw+r rawy woouM Nwo. co. Owner
is Personally Known to Me or has Produced
ID L. 1 e j 1
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
0-/ Downtown Commercial Historic District B<esidential Historic District
f This application is filed in response to a notice from the Code Enforcement Department
ADDRESS OF PROPERTY:
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O
Pro e
Signature:
Mailing Address: 7 D Lf C7 l Ot'
Phone: dd 7 3,?$' 7 3a F Fax:
Applicant/Agent A. -. 1? „
Mailing Address: 42gY' %0'—
Phone: 40 7 y O Q7 S (V Fax:
Print Name:
Q. n 4o r
Print Name; , j Gk E' t' .c? QL r. Q t 0 vt e./
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I certify that all info tion
jco fined i thi application is true and accurate to the best of y knowledge.
Applicant/Own • Date: - O
Please use the atta ed criteria checklist as a gui a 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)
o Site Improvements/driveway/walkway o Storage shed o Moving structures
O Replacement windows or doors o Underskirting D Awnings
o New construction/additions o Signs o Demolition
o Roofs/gutters/downspouts O 6C/Mechanical o Fences/Gates/Pergolas
o Replacement siding/flooring/porch amt o 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 accompli)hed. f or large rojects, W itemized list is
refs % men d. Attach additional pages if of cessary. '—%w1p. t&W x f-
l? ac -men a- J- 5(t7rvt C DQ—< !Q y wco_
A Certificate of Appropriateness is valid for six months unless otherwise noted
Historic Preservation Board Meeting Date:
Application is Approvedy 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