HomeMy WebLinkAbout2431 Fale AveCITY OF SANFORD PERMIT APPLICATION
rmit # : 01— 0 + Date:
scription of Work:,9,-kA /Q j f /={ t,f Aj% Total Square Footage
istoric District: Zoning: \._ 'Value oofWork$ 'F/p, a cl
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rmit Type: Biiifdind-Z Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
ectrical: New Service - # of AMPS Addition/Alteration Change of Service fcmporary Pole
eehanical: Residential Non -Residential Replacement New (Duct Layout & Energy Cale- Required)
umbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
umbingfNew Residential: # of Water Closets Plumbing Repair - Residential or Commercial _
zcupancy Type: Residential Commercial Industrial
nstruction Type: Hof Stories: # of Dwelling Units: Flood Zone: _ —_ (FENIA form required )
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veers Name & Address-: ,(/'/S Cam "2j % /j¢ ' o/ i
ntractor Name & Address
one & Fax
riding Company:
dress:
irtgage Lender:
dress.
chitect/Engineer:
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
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
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 all applicable laws regulating
istruction 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.
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
county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
eptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 7 13.
ignatureofOwn / gent Date Signature of Contractor/Agent Date
Pri"%tner/Agersame Print Contractor/Agent's Name
UEBBIE BLANTON
MY COMMISSION # DO 188491
a EXPIRES: February 25, 2007
t NOTARY Fl Notary Dqw0uM Assoc. Co.
Owner/Agent is _ PPisbhalEy'°IEnawn-te.M pt ,
Produced ID
ROVAL& ZONING: UTIL: FD:
cial Conditions:
03l2006
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID _
ENG: BLDG:
IT. Is (09
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 $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
r uested cons ction 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.
u.
Owner/Buie ignature Date
Print Owner/Builder Name
of Florida
Owner is Personally Known to
Produced ID
DEBBIE BLANTOMMYCOMMMION # DD 168491EXPIRES: February 25. 2007V
FC fJnt
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PLANS REVIEWED
CITtf OF SANFORD
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